Primary Care

Seen but not heard: How does the medical system value its scribes?

Physician
April 12, 2022

As an off-cycle medical student with an extended break between the completion of my M4 rotations and the conferment of my MD, I took a job as a medical scribe to keep myself active in the clinical setting (and, it must be said, provide myself with much-needed income).

I was atypical among most medical scribes, who are generally college students/graduates looking to obtain experience before applying to postgraduate medical programs, so …

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How much time do physicians spend in the EHR?

Physician
April 10, 2022

Doctors often find the electronic health record (EHR) time-consuming and annoying. However, quantitative estimates of physicians’ time on EHR tasks are sparse and not collated. We assembled evidence on hours dedicated to the EHR each day by physicians. The result is impressive – 4.5 hours.

A little background: EHR systems started in the late 1960s. The federal government implemented VistA in the 1970s in the Department of Veteran …

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Taking courage to heart and to the heart of medicine

Physician
April 9, 2022

Few individuals are called upon to be heroes like Ukrainian president Volodymyr Zelenskyy who, in choosing to stay and fight a massive, invading army, faces a real possibility of imprisonment and death. This is true courage.

Within the medical profession, there are also wars to be fought that require true courage. One thinks of the late Dr. Paul Farmer, who worked tirelessly throughout his career to bring high-quality health care to …

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Bring back CME conferences to exotic locations

Physician
April 6, 2022

It was not too long ago, but it seems like decades when traveling for a CME conference was a routine part of being a physician as looking up articles on UpToDate or giving patients bad news. But like so many other things in life, the reality of CME conferences has changed.

Most training programs give allowance to physicians for CME conferences on a yearly basis. After training, you have to keep …

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10 mistakes smart doctors make

Physician
April 6, 2022

When most people think of physicians, they think of the class nerds or the smart kids who got all As and took honors classes and were on the debate and math teams, did the science Olympiad or won the spelling bee. They think of us as brighter and more intelligent than most of society.

But we are also just human beings who have the same flawed brains and make the same …

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Is there such a thing as too much empathy?

Physician
April 6, 2022

“What does it mean to be neighbors in the trenches?” I began a recent staff meeting at our medical group.

We’d just read a passage about the Christmas Truce between the Germans and the British in World War I. The troops found themselves so close together they could smell each other’s food, hear each other’s music. It was impossible not to pause the violence in a moment filled with so much …

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Going mobile: an antidote for career regret

Physician
March 31, 2022

This year, the National Resident Matching Program provided matching services to more than 42,000 applicants. A medical student’s choice of specialty is one of the most important decisions they will ever make. But deciding which medical specialty to enter can be difficult. The majority of medical students are indecisive about their intended area of practice. Over the course of medical school, only a quarter (26.1 percent) of …

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2 insight-provoking questions when starting over

Physician
March 29, 2022

“Peace is your home, integrity is the way to it, and everything you long for will meet you there.”
– Martha Beck

In 2017, the blueprint I had crafted for my life evaporated before my eyes.

Up until that point, I had systematically checked off the steps to becoming an Air Force oral and maxillofacial surgeon. I was in the Air Force, and I was in oral and maxillofacial surgery (OMFS) residency. I …

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A physician was bullied and fired by the bully

Physician
March 28, 2022

I don’t think I became a whole person until my mid-30s. When you spend the majority of your life in school, training, and building a practice, everything else goes on hold, or autopilot. There are very few things that I made conscious decisions about. Becoming a doctor was something I decided in childhood, and then it was a mission that I felt I needed to achieve. Every action in my …

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The center of gravity in health care and the role of primary care

Physician
March 28, 2022

I’ve been as guilty as anyone of leaving my patient out on a limb. As a practicing primary care physician, I’ve had patients with diabetes who observe Ramadan, but I had no idea how to support them during their fast. I’ve had transgender patients yet didn’t have the right language to talk about their health, and nothing in the electronic health record (EHR) seemed designed to support them. I’ve sent …

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Restoring the value of primary care

Physician
March 26, 2022

In most professions, the pecking order is clear, even when there’s no formal designation.

Take pro football. Although nothing in the rulebook grants status or authority to certain players, everyone knows the starting quarterback is the most valuable person on the field. That’s because no other player can do more to win (or lose) a game.

You might assume the same type of logic applies to medicine. If saving …

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We are not defined by what we eat

Conditions
March 24, 2022

Throughout history, ancient tribes practiced cannibalism with the intent of bolstering their own courage or energy by consuming their defeated enemies. They wanted to be what they ate: full of courage and vigor. They would even eat their enemies to vanquish their energetic spirits before they ascended to the afterlife.

Christian Communion also practices the consumption of the figurative blood and body of Christ. It serves as a remembrance …

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A photographic exploration of the physician’s inner life

Physician
March 23, 2022

I entered my Manhattan apartment around midnight, roughly an hour after observing a transplant team recover kidneys and a liver from a young patient newly pronounced dead. Still wearing scrubs, I sat down on my bed, and, like a ghostly twin or guardian angel, watched myself spill tears.

The scene I witnessed in the operating room that evening as a second-year medical student was at once grotesque and hallowed, shocking and …

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A primary care physician’s gut feelings

Physician
March 22, 2022

To spend an entire college year (two semesters) studying epistemology seemed like a colossal waste of time when I was 19. We had no choice; we had to take it, and I got a pretty good mark, as I recall. It took a half year to find out what it was about, but it seemed to concern itself with how we obtain knowledge. There is inductive reasoning and deductive reasoning …

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How this physician’s self-care awakening helped her lose weight and take control of her health

Physician
March 21, 2022

For many of us, the term self-care is synonymous with self-indulgence. I used to think so too. Our thoughts immediately race towards behavior requiring us to take time away from our loved ones or shortchange them of our responsibilities.

As a child, I looked to my parents as prime role models. They were first-generation immigrants from Iran who were trying to uphold their …

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The value of hope

Physician
March 20, 2022

We all need hope. It is powerful and its absence is devastating. Hope allows us to move forward and to dream. Over decades of practice, I have found it to be the most powerful medication I can give a patient.

When we dispense hope, we must be as honest as we are with any treatment. False hope must be vigorously avoided. It is lying. In giving false hope, we might deprive …

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Looking back on 2 years of uncertainty, adversity and more than a few silver linings

Physician
March 18, 2022

Since the beginning of COVID-19, we have recognized the truth of philosopher George Santayana’s oft-quoted 1905 writing — “Those who cannot remember the past are condemned to repeat it” — and looked for lessons from the 1918 Spanish flu, the deadliest pandemic of the 20th century. Much was different, yet so much the same. There was no testing, treatments, or ability to prevent the virus then beyond shutdowns, masking, distancing, …

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Coding for social determinants of health and unmet social needs

Physician
March 17, 2022

In health care circles these days, you hear about the social determinants of health (SDOH) almost as often as you hear: “You’re on mute!” SDOH are the conditions in the places where people are born, live, learn, work, play, worship, and age that affect health outcomes. These non-medical factors like income, socioeconomic status and access to health care, safe housing, and reliable transportation drive …

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Let’s talk about bullying in medicine

Physician
March 16, 2022

Very few are talking about workplace bullying, yet many are benefitting from it. It acts contrary to the principles of care at the heart of medicine — and we need to do something about it.

How many physicians have wanted to leave medicine because they were subject to horizontal violence or bullying in the workplace? Who has felt undermined, belittled or humiliated when showing up to work on a daily or …

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From the ground up: an invitation for self-care for physicians and health care professionals

Physician
March 15, 2022

I have deep roots in the Benedictine tradition at St. John’s University, MN. I took my first steps in Guild Hall, graduated from St. John’s Prep School and University, and later married my wife Ashley at The Abbey church. My understanding of the biopsychosocial and spiritual aspects of the human condition grew from these formative years at St. John’s and inspired me to become a physician and leader. I’m grateful …

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