The pandemic’s epidemic: opioid use disorder and subpar suboxone access
The COVID-19 pandemic has devastated America’s health, taking more than 500 thousand American lives, upending the economy, and perpetuating racial
The U.S. …
Psychiatry
The updated benzodiazepine boxed warning: What you need to know
“I am [sharing] my story as I would like to raise awareness about the dangers of benzodiazepines and advocate for stronger warning labels.”
I paused to wipe away tears before typing the final words of Bobbi’s report into the FDA’s MedWatch online reporting system. Bobbi, a physician assistant, was forced into medical detox by her state medical board after suffering adverse effects from prescription clonazepam. Six years …
The confusing policy surrounding the buprenorphine X-waiver
In the waning days of the Trump administration, a surprising announcement came down from the Department of Health and Human Services (HHS) that the barrier required to write buprenorphine prescriptions for opioid use disorder would be lifted via reform of the so-called “X-waiver.”
The X-waiver is a rare regulation in American medicine that requires an 8-hour training and documented DEA permission before a medical doctor can prescribe Suboxone to …
When the teen with depression and anxiety is yours
Every week, I see a teen with depression and/or anxiety. Sometimes that teen is mine.
And while I can certainly opine over the lack of mental health resources for our children and teens — you have to be a certain age, you have to have certain insurances, if you’re uninsured or underinsured, you can see a community health professional but only for eight sessions — what I really get frustrated with …
Duchess vs. doctor: Why Meghan Markle’s mental health matters to me
Whether you like her or not, Meghan is speaking openly about suicide. For that, I am thankful.
In her interview with Oprah, The Duchess of Sussex shared her suicidal thoughts—and how she was obstructed from mental health care, told to “tough it out” and keep smiling. The Duchess needed a doctor. Yet doctors are reported to have the Read more…
Physician suicide: We need safe spaces to talk about it
Three years ago, I met Dr. Boyce Fish*, the ER physician revived after suicide. I also met Rachel Dawson, wife of Dr. Chris Dawson who killed himself and his two children.
We all sat in red ballroom chairs in a room with nothing in it, but it felt full. All the lights were dim, and I was privy to the darkest innermost thoughts …
I’m so effing tired: How to finally boost your energy
An excerpt from I’m So Effing Tired: A Proven Plan to Beat Burnout, Boost Your Energy, and Reclaim Your Life.
Did you know that a recent Harris Poll survey revealed that while about the same percentage of women and men reported feeling burned out in their work life, 35 percent of women told the Harris Poll they felt burned …
Maybe we’re not all hanging in there. And that’s OK.
Long ago, in the BC (before COVID) era, I would chat up a local in a foreign country. Their usual response upon learning I was from the U.S. would be to seek clarification on aspects of American culture found most peculiar. There were your usual suspects — the Electoral College, imperial versus metric systems, and why we’re obsessed with the Kardashians — but the most common question was about our …
Jealousy and missed opportunities in medicine
“Julie” began the telehealth encounter in her car, greeting me with a cheerful smile. The sun glimmered through the driver-side window, illuminating the water spots to sparkle like diamonds.
“How are you doing with your suboxone dose? Do you feel that you need to go up, or are you happy with your current dose?” I asked.
“Everything is going great,” she said. “I feel no cravings – only some constipation. Otherwise, everything …
What’s in your grief toolkit?
Loss is incurable, but grief is metamorphic. The end of another human life is a fluid experience for those left behind. For most of us, grief legitimizes the range of human emotion and, at least temporarily, erases the idea of being too sensitive.
There are many ways in which this paradigm is unequal, particularly for individuals who frequently confront death. It seems that when a challenge moves into the …
Managing stress with coping strategies for the perfectionist-driven physician
As doctors, we are taught the art of assessing our patients through the doctor-patient relationship. We learn a series of open-ended questions to gain insight into our patients’ values and thoughts regarding their personal health. We learn how to evaluate lab values and make diagnoses. Through all of this, we strive to make optimal decisions for our patients to avoid the legal ramifications of medical errors and because physicians thrive …
Marijuana legalization: an unpopular view
In the mid-1990s, a few pharmaceutical companies made broad claims regarding the safety and efficacy of opioid medications for pain management. These claims were based on limited research that did not fully account for these drugs’ potentially harmful effects. As a result, we are now facing an opioid epidemic across the United States.
Now, New Jersey joined several other states by legalizing marijuana for recreational use. While there are clear differences …
Physicians are an underserved population about their own mental health care
COVID-19 has shed light on a pre-existing condition in medicine – our health care system has failed to tend to its workforce’s well-being. While generally privileged, physicians are an underserved population about their own mental health care.
Numerous articles and countless interviews have focused on the pandemic’s deleterious impact on physicians’ mental health and well-being. But this is not a new problem, nor is it caused by a lack of resilience. …
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My Klonopin withdrawal story
It was September 11, 2001. My dad had cheated on my mom again, the building that I worked in at that time had received an anonymous tip that we were a potential target for the terrorist attacks, and my mom, who needed a reprieve from my dad’s crap, was vacationing in Florida and was worried for me and my well-being. Plus, my dad was threatening to kill himself, and I …
COVID malaise, and more COVID-19 coping tips from the trenches
I write this now as both a time capsule and a vision of hope at the bitter end of 2020. At this point, a COVID-19 vaccine (the vision of hope) has been developed by several companies but has not yet received widespread distribution. Realistically, I know we are in for more quarantines, social distancing, and mask-wearing for at least another 9 to 12 months (sorry!).
My clinical work in psychiatry has …
Solving imposter syndrome in physicians
“I no longer start every day in dread,” Sheila (not her real name) told me as we completed a six-month coaching engagement. Her statement initially surprised me because that’s not how she described her interest in coaching when we began. She had simply and unemotionally told me that she needed a career change and didn’t want to jump into another not-quite-right situation. But as I recalled the time we spent …
The truth about Baron Von Munchausen, Munchausen’s Syndrome, and Munchausen’s by proxy
An excerpt from Medical Myths: A Sceptic’s Journey.
The German Baron Karl Friedrich Von Munchausen (1720-1797) was famous for his tall tales. Returning from the war, he described himself riding on a cannonball and even reaching the moon. Stories were compiled …
The pedestal that’s killing doctors
Doctors are often called “heroes” – a surprisingly uncomfortable label. Physicians are already tired of being held to a higher standard than the average person; raising the pedestal is problematic. While doctors are compassionate individuals who care about bettering lives and curing illnesses, we are also human. At the end of a standard workday, we would like to live normal lives. Unfortunately, the hours are longer, and we are never …
Female physician suicides: a silent pandemic
“Aunty blew her brains out a few weeks ago!”
Words I shall never forget.
For weeks, she had been in my thoughts. But I never called her. I didn’t because of all the myriad reasons we often give ourselves for not checking up on each other.
In my case, they sounded like this; “I am 7 months pregnant, and it has been a difficult pregnancy.” “I am in an abusive marriage.” “My pediatric …
Doctors are killing themselves, and who is taking notice?
I am a psychiatrist. My field has been marred with human rights violations and treatments that though well-meaning, did not yield the results that were intended. I have always been at the watch and helm of speaking out when I see gaps and places where my colleagues and I are called to do better. I have been treating patients for over 15 years now. I have remained silent …
Past Week
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Why your clinic waiting room may affect patient outcomes
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The human case for preserving the nipple after mastectomy
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Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims
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How new loan caps could destroy diversity in medical education
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IMGs are the future of U.S. primary care
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The ethical crossroads of medicine and legislation
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Past 6 Months
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Health equity in Inland Southern California requires urgent action
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Why transgender health care needs urgent reform and inclusive practices
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How restrictive opioid policies worsen the crisis
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Why primary care needs better dermatology training
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New student loan caps could shut low-income students out of medicine
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Recent Posts
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Past Week
-
Why your clinic waiting room may affect patient outcomes
-
The human case for preserving the nipple after mastectomy
-
Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims
-
How new loan caps could destroy diversity in medical education
-
IMGs are the future of U.S. primary care
-
The ethical crossroads of medicine and legislation
-
Past 6 Months
-
Health equity in Inland Southern California requires urgent action
-
Why transgender health care needs urgent reform and inclusive practices
-
How restrictive opioid policies worsen the crisis
-
Why primary care needs better dermatology training
-
New student loan caps could shut low-income students out of medicine
-
Why pain doctors face unfair scrutiny and harsh penalties in California
-
Recent Posts
