In 1996, I had an illness that nearly killed me. I was exhausted, felt awful, could barely stand up and had trouble remembering things. Yet, I somehow had to find the energy not only to take care of my newborn and 5 year old, coordinate our upcoming move, consult with doctors and other medical providers on my condition and treatment, and receive treatments that might or might not help me ...

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A commencement address delivered on August 5, 2017, to the 2017 class of anesthesiologist assistants (AAs), Emory University. Distinguished faculty, graduates, honored guests: It is a great pleasure and an honor to be here, and to congratulate all the graduates of the Emory University Class of 2017 on your tremendous accomplishment. Just think about all you have learned in the past two years. You’ve transformed yourselves into real anesthesia professionals, able to ...

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I read something recently that shocked me. Despite working in health care for 15 years, I had no idea that nearly 80 percent of the U.S. health care workforce is comprised of women (according to the Bureau of Statistics.) I did know, however, that women make up less than 20 percent of executive boards and less than 40 percent of middle management in health care. Those that do exist in the ...

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The Society to Improve Diagnosis in Medicine has on its website this quote:

  • 1 in 10 diagnoses are incorrect.
  • Diagnostic error accounts for 40,000-80,000 U.S. deaths annually -- somewhere between breast cancer and diabetes.
  • Chances are, we will all experience diagnostic error in our lifetime.
The current focus on diagnostic error raises an interesting question:  Is this a larger problem in 2017 than in the 1970s and 1980s? In this post, I ...

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“Hello Dr. Payne, thanks for calling back, there’s a consult I’d like you to see.” “What’s going on?” “Well there’s a patient up on 7 East who ...” “Wait a minute. 7 East ... isn’t there some other specialist covering there?” “No Dr. Payne, the schedule says you on Wednesdays.” “Oh, I’ll check that.” “OK, Dr. Payne, well we have this 72-year old, Mrs. Jones, who originally got admitted with pneumonia. She now has unusual inflammatory ...

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I spent the week in meetings discussing logistics and hospital preparations for the alt-right’s “Unite the Right” rally to be held this weekend in my hometown of Charlottesville, VA. We discussed the likely injuries that would occur, how we were going to decrease the hospital census to deal with potential overflow, methods of securing the campus, and the latest police updates. On Friday afternoon I summed up our discussions with my ...

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On a normal Tuesday, one of my fellow residents did the same things we all do. She woke up before sunrise, put her best face forward, came to work, saw patients quickly, wrote notes, said "good morning" to everyone at morning conference, saw more patients, wrote more notes, then went home. She said "good night" to her loved ones  —  her parents and siblings at home  —  and went to ...

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My partner Judith had pain in her sinus cavity caused by a tumor called a plasmacytoma. After her biopsy, her surgeon called Friday afternoon with the results. She asked him to wait fifteen minutes until I could be home with her to get the news. He had no flexibility and said he could speak either then or Monday. She chose to speak with him then on the phone still alone. ...

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American doctors are unhappy about a lot of things. Americans, in general, are unhappy about a lot of things. In many ways, both groups share similar concerns. But the road back to happiness may follow a similar path for both, as well. American doctors once felt part of something special. American health care, by reputation at least, was the best in the world, and we were its proud emissaries. We functioned ...

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Do you ever have that “aha!" moment? That moment when a revelation hits you with such a level of intensity that your physical being is jolted. Attention is obtained as if a Louisville slugger or defibrillator pad made contact at an opportune moment. That moment of revelation when a crimson string interwoven through the fabric of your life makes a connection, transcending childhood, college, young adulthood, professional and personal relationships. ...

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