Psychiatry
A job behind bars
At least two million people in the United States are incarcerated in 122 United States prisons. Little is known about the prisoners themselves. Did their background condemn them to bad behavior? Or did they just make grievous mistakes? Do they suffer from a mental illness masquerading as criminal behavior? Can they change their life path? A mental health specialist with 25 years of direct …
What my 10 year old is teaching me about boundaries [PODCAST]
U.S. adults should get routine anxiety screening. But then what?
For the first time, primary care physicians (PCPs) are being urged to screen their patients, above and below age 65, for mental health concerns alongside screening for physical health conditions. The United States Preventive Services Task Force has published its first recommendation for PCPs to screen adults for anxiety as standard practice. This recommendation followed a peak in the prevalence of mental illnesses in 2020. During this time and …
Enjoying the spirit of the holidays with fewer spirits
The winter holidays are almost here. And it’s the time of year when food abounds and alcohol sales double. So, in the spirit of wellness and health, I’m sharing some ideas for alcohol substitutes, safe drinking, and some general information about alcohol. Enjoying the holidays with good company, food, and drink is a treat. But too much alcohol can be problematic, especially when taking prescription medications or when struggling with …
Prudence and promise in psychedelic-assisted therapy
Psychedelic-assisted therapy (PAT) represents one of the most promising developments in psychiatry in decades. The treatment typically involves the infusion of a compound such as LSD, psilocybin, or MDMA during an extended therapy session with licensed professionals.
Although it lacks widespread regulatory approval or clinical use, significant advances have been made in the study of PAT in the past decade, with a pronounced increase in recent years. Recently, a Read more…
5 tips for treating seasonal depression during the holidays
Although the holidays are typically associated with feelings of joy and thankfulness, it is imperative that people should not automatically assume these emotions are commonly shared. Three percent of all individuals are impacted by seasonal affective disorder (SAD) during the holidays – a statistic many people are unaware of. The media promotes an unrealistic expectation that everybody should be happy during this time, but this is not the case …
A physician’s remedy for stress, anxiety, depression, and burnout [PODCAST]
The transformative power of EMDR
I became a self-involved status and achievement “junkie” in order to tune out unbearable inner voices that repeated, “You are worthless … you’re a fraud … you’re a failure.” I was obsessed with grandiosity: I owned a penthouse apartment with a landscaped terrace, a closet full of Brooks Brothers suits, a family crest ring, engraved stationery from Tiffany & Co., monogrammed dress shirts from Charvet in Paris, and towels from …
A goodbye note to my suicidal teenagers
On the day before the last day at my last job, I reviewed my patient roster. Five of my seven most worrisome teenagers were currently admitted to a psychiatric hospital for a suicide attempt. This was not completely surprising. It is the fall. Teenagers notoriously struggle two to three months after starting school, getting into academic work, falling prey to bullying and stress, or not meeting their goals. But I …
PTSD after medical education
Dear Art:
On Friday, June 11, 1982, members of the faculty convened to discuss the performance of the psychiatric residents during the last six (6) months. The following is a summation of their comments as they apply to your performance.
The faculty’s reaction to your performance was uniformly excellent. There was some comment on your earlier fear of the psychotherapeutic role, but the consensus was that this has improved markedly and that …
By failing to discuss strangulation, we are failing our patients
Six seconds is the amount of time it would have taken for him to render me unconscious.
Shortly thereafter, I might have lost my life.
One month before I finally found the strength to leave an abusive ex-partner, he rushed at me with unexpected force during an argument and wrapped his hands around my throat. I kicked desperately at his chest, terrified, heart racing, during what I believed might be my final …
What does self-compassion look like in your life?
I’ve spent years deeply uncomfortable in my skin.
Wanting to disappear.
Last night, a wave of anxiety hit me as it often does when the world gets quiet.
In tune with my body for a brief moment, my heart ached.
Why?
I envisioned that moment when we ponder what we would regret on our deathbeds.
And I saw the years many of us spend hating our bodies.
Our glorious bodies that make being present in this world …
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Letting grief make you stronger
Grief is powerful and can break your heart for the rest of your life, or you can learn from it and become stronger. Losing a loved one is something that everyone will go through, but not all come out as survivors in the end. It’s part of life, but a very difficult part. Think of your loss as a lesson to help you live the rest of your life.
How do …
Political creep: government intrusion in health care
The American Medical Association (AMA) would have you believe that the biggest threat to the medical profession is “scope creep” – the intrusion of advanced practice providers into medical practice.
The way I see it, this is no big deal; the movement will reach equilibrium, and everyone will play nicely in the sandbox.
In my opinion, the biggest threat to the medical profession is “political creep” – the increasing government …
The story of a physician, after a year sober
My first COVID vacation last year was spectacular, except that I barely remember three days because I was drinking to the point of amnesia.
I am a physician from a multigenerational family of alcoholics, and I never wanted to struggle with alcohol use disorder. Instead, I discovered that I could avoid feelings of discomfort by overworking, achieving, and staying perpetually busy. Workaholism became my drug of choice. As an adult, I …
My 5-minute conversation with a suicide hotline expert
Sandy was sent to me by her primary care physician for evaluation of anemia. As I reviewed her chart, I explained to the medical student that the blood work showed a lifelong benign condition called alpha thalassemia trait that she was born with. It had no potential to harm her. This would be a quick consult, meaning we would have some extra time to enjoy our lunch.
Read more…
Medical leaders must show their true colors
Color is often used as a metaphor for personality and emotion. Terms like “red in the face,” “feeling blue,” and “green with envy” are etched in the vernacular. Great leadership requires emotional intelligence, and the best leaders lead in full color.
Colorful leadership is about seeing the whole picture, unfiltered by our own preferences and experiences. Colorful leaders have been depicted in books, movies, and songs. The “flower exercise” …
Not listening carefully to a vulnerable patient can become a matter of life or death
Paula came to my office on a Monday afternoon, a few months after burying her husband. She and John had been inseparable. They were both my patients, so I knew John had spent the last six months battling lung cancer. They had been married forty-five years when John died. I sincerely offered Paula my condolences on that Monday afternoon. I could tell she was in pain and shared how she …
Coaching vs. therapy: A physician coach and psychiatrist explains
“Are you analyzing me?”
Psychiatrists become acclimated to this question being launched by anyone to whom we are brave enough to disclose our occupation. Mental health stigma persists, and psychiatrist jokes are part of that legacy. All humor holds some truth, and this joke reflects discomfort around the mystique of psychiatry. How does it actually work? What do psychiatrists actually do to heal people? How do you know when a psychiatrist …
Past Week
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Forced voicemail and diagnosis codes are endangering patient access to medications
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The One Big Beautiful Bill and the fragile heart of rural health care
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America’s ER crisis: Why the system is collapsing from within
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Why timing, not surgery, determines patient survival
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How early meetings and after-hours events penalize physician-mothers
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FDA delays could end vital treatment for rare disease patients
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Past 6 Months
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Forced voicemail and diagnosis codes are endangering patient access to medications
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How President Biden’s cognitive health shapes political and legal trust
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Why are medical students turning away from primary care? [PODCAST]
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The One Big Beautiful Bill and the fragile heart of rural health care
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Why “do no harm” might be harming modern medicine
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Here’s what providers really need in a modern EHR
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Recent Posts
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How to advance workforce development through research mentorship and evidence-based management
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The truth about perfection and identity in health care
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Civil discourse as a leadership competency: the case for curiosity in medicine
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Healing beyond the surface: Why proper chronic wound care matters
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Why specialist pain clinics and addiction treatment services require strong primary care
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Dear July intern: It’s normal to feel clueless—here’s what matters
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Past Week
-
Forced voicemail and diagnosis codes are endangering patient access to medications
-
The One Big Beautiful Bill and the fragile heart of rural health care
-
America’s ER crisis: Why the system is collapsing from within
-
Why timing, not surgery, determines patient survival
-
How early meetings and after-hours events penalize physician-mothers
-
FDA delays could end vital treatment for rare disease patients
-
Past 6 Months
-
Forced voicemail and diagnosis codes are endangering patient access to medications
-
How President Biden’s cognitive health shapes political and legal trust
-
Why are medical students turning away from primary care? [PODCAST]
-
The One Big Beautiful Bill and the fragile heart of rural health care
-
Why “do no harm” might be harming modern medicine
-
Here’s what providers really need in a modern EHR
-
Recent Posts
-
How to advance workforce development through research mentorship and evidence-based management
-
The truth about perfection and identity in health care
-
Civil discourse as a leadership competency: the case for curiosity in medicine
-
Healing beyond the surface: Why proper chronic wound care matters
-
Why specialist pain clinics and addiction treatment services require strong primary care
-
Dear July intern: It’s normal to feel clueless—here’s what matters
-
