Physician

If the hospital CEO emailed employees like Twitter’s CEO

Physician
December 7, 2022

To: [Group: all employees]

From: Office of the CEO

Subject: A fork in the road

Going forward, we will need to be extremely hardcore to streamline a restructured Health care 2.0 and succeed in an increasingly diseased world. This will mean working even longer hours at high intensity. Only exceptional performance will justify a new N95 mask each week.

Health care will also be much more profit-driven. Physicians and nurses will still be very …

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You’re not being frivolous. You’re being fabulously human.

Physician
December 5, 2022

[Frivolous: not having any serious purpose or value]

For years, I’ve noticed something that’s bothered me. I see it almost daily within social media women’s physician groups. The post starts with, “I know this is a frivolous question, but …” What follows are questions about topics ranging from cosmetic recommendations to travel advice.

Questions like:

“Where can I find concert tickets?”

“What color should I paint my bedroom?”

What do you all think of this …

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Aesthetics and the physician’s eye

Physician
December 5, 2022

The fall sunlight calls my eye to notice little things: the veins on a yellowing maple leaf. The askew feather on a chicken’s wing. The faintest breeze tricking the pond into patterned sin waves around a lone white duck.

What do we owe this world but our ability to parse and observe, to interpret, to be filled enough by moments of abject beauty to return to the ugliness and try to …

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7 things I’ve learned after 12 years of private relationship-based direct care in Canada

Physician
December 4, 2022

I’m a hand surgeon. After six years of academic practice, I opted out of the public and universal health care system my country is famous for to create the first private hand surgery practice in Montreal, Canada. That was 12 years ago.

Opting out of the system means that I do not get any payment or reimbursement from the government in a country where private insurance does not pay for private …

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The unstoppable momentum of a medical “fact” with no source

Physician
December 3, 2022

When I started my company in 2009, personal experience was a driving force in identifying the problem I wanted to help solve. As a neurosurgeon, I often treated patients who were neurologically devastated by acute bleeding in the brain after years’ worth of poorly controlled high blood pressure. In many cases, when I asked the family why the patient quit taking their hypertension medication, they described the patient as “not …

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Bring the real You to your workplace

Physician
December 3, 2022

Life is short, so make yours extraordinary. Capitalize on what makes you, YOU, and be your own unapologetic self.

The Almighty designed us as unique but imperfect and flawed individuals, prone to sin and blundering error. But that’s the great part of being human; we’re expected to sin, blunder, and make mistakes. We’re made to err for the sake of learning and growth; otherwise, we’d wither into uninspiring nothingness. Keep this …

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We get what we incentivize

Physician
December 1, 2022

We get what we incentivize.

This is a basic rule. I’d love to say it’s a basic rule of humanity, but unfortunately, I have a background in psychology, so I know it goes a lot deeper than that—it’s a basic rule of every living creature. Humans are, in many ways, just very big pigeons. We reliably prioritize certain rewards. We prefer smaller sooner rewards to larger later rewards; we push the …

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Why even doctors need regular doctor visits

Physician
December 1, 2022

After a great game of doubles tennis, a good friend brought up a recent visit with his primary care physician while sitting with friends, trying to cool down. He expressed appreciation for his position but complained about the need to see his doctor every three or six months, all the while acknowledging various medical problems being addressed.

This led to general comments by several non-physician friends about how they feel that …

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A doctor’s grief

Physician
November 30, 2022

Last evening I crumbled in the arms of my patient and wept. This was unknown territory to me, an unexpected role reversal. For three weeks after my Mom’s death, I maintained a stoic distance as patients offered their condolences, as they asked about my mother, and empathized. We doctors have been trained to do this, to face death, to keep our emotions at arm’s length. But this patient, who has …

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When your letter to the editor is rejected or ignored

Physician
November 30, 2022

Dear Dr. El-Dalati,

I am sorry that we will not be able to publish your recent letter to the editor regarding the Chowdhury article of 16-Sep-2021.  The space available for correspondence is very limited, and we must use our judgment to present a representative selection of the material received.  Many worthwhile communications must be declined for lack of space.

The response from The New England Journal of Medicine (NEJM) seemed simple and …

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Has medicine lost its why?

Physician
November 27, 2022

From the halls of ancient Greece to the heights of television screens, the myth that the physician is more god than mortal has stood the test of time. As such, we are held to moral and superhuman standards no matter how tough things get. And thanks to our friend Hippocrates, we are oath-bound in our virtues to help anyone in need; while putting OUR personal needs aside, of course. Many …

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It’s called crying and it’s normal

Physician
November 27, 2022

Doctors treat people in all types of situations. Life or death. Sometimes both. Babies die, children die, and teenagers die. Women die. Men die. Sometimes you even have the misfortune of delivering a stillborn. Everyone experiences death, but for doctors, it’s part of our daily norm. Day after day, for decades throughout their career, we have to experience death and the pain of others. Beyond being knowledgeable and competent in …

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A goodbye note to my suicidal teenagers

Physician
November 25, 2022

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 …

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The physician’s real problem isn’t burnout

Physician
November 25, 2022

I read an article recently suggesting that physicians were burned out from hearing about burnout. The proposed solution was to create systemic changes to help alleviate the burden of complexities of care that have polluted health care delivery. The solutions involved adding a team of individuals, including nurse practitioners, physician’s assistants, pharmacy assistants, and other physician extenders.

Once again, rather than focus on the physician-patient relationship on which medicine is based, …

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PTSD after medical education

Physician
November 24, 2022

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 …

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What does self-compassion look like in your life?

Physician
November 22, 2022

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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Medical support staff is neglected, disrespected, and mistreated

Physician
November 21, 2022

Medical support staff is leaving in droves and leaving patients’ health at greater risk. Calls and messages to doctors’ offices have surged as patients try to access care. Wait times skyrocket to book visits.

News stories about the current state of the health care system typically focus on the plight of doctors and nurses. Studies detail the “Great Resignation” impairing the health care industry–a new report published …

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The slow death of primary care: a Canadian perspective

Physician
November 20, 2022

Loss of autonomy, gaslighting, abuse, exploitation, and hypocrisy are all strong words. Just writing them brings to my mind the harsh reality of my experience and the collective experience of others who have dared to speak up. These words come to mind when I think about primary care in Canada. I recognize similar sentiments are heralded by my U.S. colleagues and those in the United Kingdom.

The system is failing. …

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Ambulatory medicine today: Focus on what you can control

Physician
November 20, 2022

Patient volume has recovered across the country, and most medical offices are back to a steady state of care delivery—but ambulatory care has changed irrevocably. We’ve entered a phase shaped by crisis and marked by even more intense cost pressure and consolidation. What steps can independent medical practices take now to help ensure stability and prosperity moving forward?

Offer employees a more rewarding work experience.

The great resignation—unprecedented turnover in the labor …

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