Start at the origin. Over two, up four. Down three, right six. Left five, up one. Keep connecting the dots. Everything will take shape.
I liked graphs. Plotting coordinates — whether it be for a parabola or ellipse — was always calming for me: numbers told you exactly where you needed to be.
But my numbers scared me. My 8-year-old feet would hesitantly step on the scale at the doctor’s office. I …
The family doctor used to be almost the only source of medical information patients had access to. Now, few people need us to bring them the latest news. It’s there for everyone to see. There’s even too much of it.
Today, our role is to help make sense of it all. In order to do that, we must possess and project authority, but we have no reason to put ourselves on …
Research shows that as many as 50 percent of physicians report some level of burnout that manifests as depression, dissociation, indifference, and even substance use disorders. Medicine has become focused on monetary gains by large corporations, major hospitals, and insurance companies. As much as doctors want to focus on quality patient care, they are forced to focus on electronic medical records that are cumbersome, seeing multiple patients with quick assessments …
The other day I asked myself why do I focus my attention on immigrants when there are plenty of other underserved and neglected populations. When an opioid crisis surrounds me, why do I speak of a crisis at the border? When structural and overt racism contributes to an infant mortality rate of 10.97 for black women’s babies, twice the rate for the nation as a whole. When only 18 states …
In most other human activities, there are two speeds, fast and slow. Usually, one dominates. Think firefighting versus bridge design. Health care spans from one extreme to the other. Think code blue versus diabetes care.
Primary care was once a place where you treated things like earaches and unexplained weight loss in appointments of different lengths with documentation of different complexity. By doing both in the same clinic over the lifespan …
The administrative burden associated with caring for patients in today’s health care system has emerged as a primary driver of the loss of joy in the practice of medicine and the epidemic of burnout among physicians.
As doctors, most of us went into medicine with a true desire to help other people. What was once a noble profession is now being worn down by outside forces trying to control us. Third-party insurance companies are driven by profits, not by optimal care of patients. Politicians are driven by their own political agendas and party alliances without even acknowledging the real problems existing in the health care system.
Twenty-five years ago, when I entered medical school, clinical notes were written in paper charts that were filed numerically on shelves. We didn’t have the electronic medical record (EMR), and burnout wasn’t on the radar.
In the past few years, this has changed. Burnout rates among medical providers have increased dramatically as professional fulfillment has decreased. We have the burden of EMRs weighing us down with excessive nonclinical work. We are …
We primary care physicians hate data. Taken on their own, numbers are benign, but when we hear the word “data,” physicians are reminded of a litany of related issues that make our lives far more difficult: checkboxes. Regulatory compliance. Prior authorizations. Unnecessarily complicated payment schemes.
By virtue of our training and the principles that guided the decade we spent obtaining our degrees, we are empiricists by nature. It’s sad to think …
I was already running about an hour behind, and the next patient on my schedule was a familiar one. But not for good reasons. This was a very complicated patient with huge emotional needs, whose visits would routinely go 30 to 45 minutes, well beyond the 15 minutes allotted. My heart sank. I would either have to hurry a visit with a genuinely needy person, …
The backbone of a great health care system is its primary care task force. From Singapore to France, elite health care systems rely on these cerebral doctors to provide preventive, urgent, and acute care along with chronic disease management. Primary care doctors have a broad-ranging impact from health care access, cost control, and impact on mortality and morbidity rates.
I was a graduate of a class of 50, of which only …
Of all medical specialties, perhaps the most difficult to understand is internal medicine.
While the name suggests that those who practice internal medicine focus primarily on non-dermatologic diseases of “Internal” organ systems (which in many ways is true), unlike other medical fields whose names …
Flu vaccination prevents millions of flu-related illnesses and deaths annually, but vaccination rates are low for many reasons.
During the 2018-2019 flu season, the Centers for Disease Control and Prevention reported that about 45% of U.S. adults received the flu vaccine. While this is an increase of 8% from 2017-2018, it falls way below the national goal of 70% of American adults …
For most of us, going to the doctor is not at the top of our favorite things-to-do list, but it may be one of the most important. Whether the visit is for a scheduled check-up or to deal with a new problem, there are ways you can make the visit less stressful and more useful.
You must remember that things have changed. In the “good old days,” when I started in …
Working in both the inpatient and outpatient setting, I have to frequently recommend my patients follow-up as soon as possible with their primary care doctors. I work in a couple of different locations, urban and rural, and I must say I have noticed a rather disturbing trend over the last few years. When I ask my patients who their primary care doctor is, I often get the reply:
Whether it’s the end of the shift when the factory whistle blows and the assembly line stops rolling for a brief period while new people take our place, or late in the day after the last patient has been seen and our notes are all written and our portal messages have …
The rise in cases of otherwise healthy young adults who have been hospitalized or even died from vaping-associated lung injury is alarming.
Many people don’t know what is contained in these vaping devices, what the reported health effects actually mean, and, most importantly, why all of this developed so quickly, considering that e-cigarettes have only been popular for fewer than ten years.
Vaping describes the process of inhaling aerosols …
The United States is currently facing the largest measles outbreak in three decades, with more than 1,200 cases reported to the Centers for Disease Control. The spread of that disease is a mere symptom of one of the most dangerous pandemics of our time: misinformation.
Social media transformed the information age, kicking it into overdrive. Now everyone has a platform to push natural remedy products or cast doubt on pharmaceuticals and …
I have advocated before for putting a visit synopsis at the beginning of each visit note. I have called that the aSOAP note. I think that works immensely better than APSO notes that only rearrange the order of the elements. The reason I say that is that in today’s EMR notes, it’s too darn hard to find the story. If a note is half a dozen pages or …
“Fashion Is Moving Too Fast, and It’s Killing Creativity,” by Veronique Hyland, talks about burnout in the fashion industry. As a former Fashion Designer turn physician, my curiosity was piqued. If you substituted the word “medicine” for “fashion,” the title would be just as relevant to the medical industry, as it is to the fashion industry. Yes, medicine is moving too fast, and it’s killing creativity and our doctors. Burnout in the fashion industry stems from the need to …
