With the latest data calculating physician burnout at greater than 50 percent, American medicine is at a tipping point.  How to fix this crisis?  Why, make physicians more resilient, of course! Except physician resiliency is exactly what got us into this problem. Let me explain.  Doctors are notorious people pleasers.  We spend years of our life at study, sacrificing the fun and freedom of youth, deferring childbearing, and delaying ...

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The month of September has been Women In Medicine Month (according to the AMA) since 1989. Statistics are always telling:

Hospitals have always served as a lifeline to survival. Whether from pneumonia, heart attack, stroke, or trauma, they have been a community safeguard between life and death. Today, a cost of care has been added to the patient treatment discussion forcing medical decision-making to look closely at expense. Financial considerations have come to the forefront as preservation of resources will be important to national health care. This can be a threat ...

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It is 80 degrees in the exam rooms.  The air conditioner is broken and despite calling and alerting our clients, almost none of them want to reschedule.  I finish writing up a chart in the treatment room where the air conditioner from the kennels still has some influence.  Despite the temporary respite from the heat, my skin is still glistening with a thin layer of perspiration.  I look sullenly at ...

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The Affordable Care Act has been touted as the answer to our country’s huge uninsured epidemic. There is no denying the fact that millions of uninsured people signed up for insurance through an expanded Medicaid program, which is called Medi-Cal in California. The blessings of a decrease in uninsured patients makes for a great sound bite and has been repeated over and over in the media. The only problem is ...

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“We do not remember days, we remember moments.” - Cesare Pavese “A plane! A plane just crashed into the World Trade Center.” The surgical case was moving along steadily. Another surgeon had removed a skin lesion from the patient’s neck, and the pathologist had not been certain if it was a cancer. I had recommended removing the scar and several of the nearby lymph nodes. The surgery had just started and was going ...

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As the audience of medical students decried the experiences that defined their academic lives, my cohort of middle-aged doctors started to squirm. We knew these stories: Doctors mistreating medical students, nurses, and other doctors; learning to cope with brutally long work hours; the struggle to grasp vague and ever-changing expectations while quickly bouncing from one clinical rotation to the next. The four of us had eagerly agreed to participate on the ...

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I write this while sitting in our sailing catamaran, swaying in the wind and current eight feet above sand and sea grass.  I know this because I can see right through the water in the Bahamas.  There is clarity here. When I started this journey thirteen months ago, I was burning with anger.  I was angry at insurance companies for developing complex, mutable formularies, coverage policies, and appeal procedures, maximizing my ...

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Exercise. Growing up I competed in multiple sports. The physical enhancement of the human body through movement sparked my interest in human physiology and kinesiology. Consequently, my interest in physiology ultimately led me to medical school. It only felt natural, when medicine became what felt like the bane of my existence, that I’d revert back to this pursuit’s humble beginning. Given the fact that time was a scarce resource during internship, ...

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I saw a new residency graduate post about how balanced she will choose to be and how not taking work home would keep her idealism alive. Like a woman who has been pregnant and gone through delivery and postpartum, I wanted to tell her the truth about how emotions get changed in practice and how the emotions become physical ailments at times. I wanted to tell her birthing and raising ...

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