Infectious Disease

On the front lines, America's emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19.  Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our ...

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Testing for novel coronavirus is still a serious issue in the U.S. due to a lack of lab capacity, test reagents, nasal swabs, and even personal protective equipment for health care workers. Due to these shortages, the CDC is recommending that COVID-19 testing should not be performed on patients without symptoms and instead be prioritized for: 1. hospitalized patients and symptomatic health care workers, 2. patients ...

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In times of disaster, marginalized groups often become even further marginalized. Both those of lower socioeconomic status and those with disabilities often are left out of emergency planning, as is evidenced by the current COVID-19 pandemic. From access to testing to ability to acquire needed goods and services to triage policies being adopted from community to community, those with lower SES or ...

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During the influenza epidemic of 1918-1920, my great-grandfather, Ralph Norton Mitchell, was in the military. He helped stack the corpses of those who had died from the infection. I shudder to think about what type of personal protective equipment he used. However, his survival reminds me of a feature of all epidemics--some individuals have or develop immunity, and those who have immunity can “do the work.”

Currently, we are ...

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This is a frightening time. The coronavirus is called “novel” because it is new, and what is new is often terrifying. We don’t know enough about our new microscopic enemy. Scientists, clinicians, and policymakers are all working tirelessly with limited data and learning along the way. Consider that many diseases that we regularly face have been observed, reported, studied, and treated for decades; some for centuries (although with less success than now). Novel coronavirus ...

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COVID has taught me many things in and outside of medicine.  Most importantly, it has taught me that the medical field is a family.  There is nothing that drives a family together like a crisis.  For those of us on the front lines, I’m raising a pint of the finest for you!  That “front line” not only includes the doctors, nurses, and staff caring for patients sick with COVID.  It ...

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“You are a hero! “ “Thank you for all you are doing!” It is overwhelming and tremendous; it is touching and heartwarming; it is genuine and sincere.  The outpouring of support and love for health care workers and first responders has been a bright light in the dark days of the coronavirus.  But I have been forced to wonder: What has really changed?  OK, before you get outraged by that statement, hear ...

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I am writing this a bit selfishly as part of personal catharsis, and it has been helpful serving that purpose and helping me better understand what I am experiencing. If, however, some of it strikes a meaningful chord or you have some critique or suggestions, then, of course, I am delighted to hear from you.

While we all are under stress, I have been feeling angst I ...

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Last week’s death of the first nurse to die from COVID-19 in New York City infuriated health care colleagues who blamed his death on lack of protective gear. Across the U.S., health care workers are scrambling to design makeshift personal protective equipment, also known as PPE. Nurses are resorting to wearing Hefty trash bags because they have run out of gowns. ...

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About a year ago, I wrote about how physicians are being devalued. More recently, I posted on my Facebook page how, in the current time of need, physicians are suddenly being valued more. I noted how in the midst of the COVID-19 pandemic, the powers that be are turning to the same physicians to lead us out of the crisis. I alluded to compromises being contemplated ...

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I am not a germaphobe. I have never wiped a grocery cart handle before now. I don’t wear a mask during flu season in my office. I love for my kids to play in the dirt, and I welcome the daily exposures they have in our house, school, and life. I have the utmost respect for the immune system and the amazing job it does every single day, battling more ...

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Coronavirus, COVID-19, social distancing, quarantine, flatten the curve, wash your hands, do not touch your face: These are not terms that I am reading out of any of my of medical school books, these are terms that have become a reality for every household in the world, irrespective of nationality, socioeconomic status, gender, creed, etc. I write this article not as a physician, but as a person full of fear and ...

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It is a dark time to be a physician.  Yes, because of the global pandemic- watching our colleagues in other countries die, staring down the barrel of not enough ventilators, reading the New England Journal of Medicine’s paper on how to choose who gets care and who we allow to die. But we are trained for this.  We are up to the task, to take care of the ill.  What is ...

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It is well known that physicians are more likely to screen positive for depression and have higher rates of suicide than their counterparts in the general population. But how is this fact exacerbated by the global pandemic of fear, anxiety, and mounting death tolls known as COVID-19? For starters, health care workers are at the front lines of the emerging disaster, having to ...

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I recently received a postcard in the mail titled “President Trump’s Coronavirus Guidelines for America.” The first of these recommendations is to follow the directions of my state and local authorities. In my community, notable restrictions on commerce have been handed down by my governor, my mayor, and a county judge. This has had a crippling effect on our local economy as we brace for the storm to get worse. For ...

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I am scared as I sit down to write about our journey as a small practice as we fight along with the rest of the world against the unthinkable force of nature in the form of a COVID-19 pandemic. My small primary care practice is only two years old. In a time when medical practices are already dying, the financial consequences of social distancing as a response to COVID-19 can ...

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All my life, I’ve been told that I will have job security. No matter what, as a doctor, I will always have a job despite whatever may come. I have chosen one of the most stable and secure jobs that exist. But did I?

Coming from a family of clinicians -- seven physicians, two nurses, and one LPN -- one would assume that we are safe and secure, for ...

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As I change out of my scrubs in the resident lounge bathroom, I am exhausted and numb. I put on sweatpants and a T-shirt, taking care of folding my scrubs to avoid touching the dirty spots. I wipe my phone and keys with an antibacterial and antiviral hospital wipe, and place them into my bag. I hang my white coat on a wall hook in my workroom, my stethoscope in ...

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Every aspect of life has been affected by COVID-19, including medical education. Since March 17, medical schools across the nation have suspended clinical rotations, per guidelines from the Association of American Medical Colleges (AAMC). The target end date for this temporary pause was set originally to March 31. The National Board of Medical Examiners (NBME) followed suit, declaring that Prometric testing centers were closing ...

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