Eight female nurses at a United Kingdom hospital are suing their employer for not assuring their psychological and physical safety. The nurses work in specialized areas that require their changing uniforms once daily. There is a trans-female nurse, similarly specialized, who changes with them. He wanders about the locker room in briefs or nude, the women report, ogling them as they exchange clothing. It has also been related that he …
As physicians, we are often collectively gaslit—made to believe that somehow, we are responsible for system failures. Many physicians are brainwashed to “drink the Kool-Aid” and accept phrases like, “This is the way things have always been done.” We are made to feel inhuman when we advocate for ourselves as if we are somehow to blame. The system uses terms like “unprofessional,” “unable to cope with the rigors of being …
A million vulnerable patients have died in the last decade, and while I have no doubt the rate of overdose and poisoning will drop nationwide—killing a million vulnerable patients has that effect eventually—I choose not to contribute to that death rate. This decision is in accordance with my deeply held beliefs. In 2014, Governor Asa Hutchinson signed the Arkansas Conscience Protection Act into law, supposedly protecting health care professionals who …
As health care predictive algorithms, including the Prescription Drug Monitoring Programs (PDMP), expand their reach beyond traditional enforcement of health care regulations, the concept of a social credit score has emerged as a powerful but controversial tool. Like predictive policing, social credit scores use an individual’s behaviors, online activity, and social interactions to assess their perceived trustworthiness and risk to society and are used as fodder for the prosecution of …
There’s a patient who comes to see me every week. Every time we part ways, I say, “OK, Susan (name changed)! See you in a month!” But inevitably, she’ll call on a morning when she knows I’m in the office, and my staff will fit her in. She likes to tell me about what she did with her granddaughter that week. She doesn’t have anything terribly wrong with her; she …
I am 31, and my dad turned 54 this year. He had me when he was just 23 years old. I was born in Islamabad, the capital city of Pakistan, and he came from a small village in Punjab.
He is a self-made man who struggled all his life to give his children a better future. No one from our village ever went to school. He was the first to get …
I am a person—a person with hopes, dreams, fears, and a favorite color. I am just like anyone else, trying to find my place in this world. Yet you only see me as a nuisance. I am always in your way, you say. I am an idiot. My existence is like a personal insult to you—and you never miss a chance to show it.
I was once a bright-eyed child full …
The COVID-19 pandemic was war, and I served in a foxhole. I survived, in part, by drowning my sorrow in song—music I abused as if it were drugs. I heard “Spaceman” by Nick Jonas today while driving to the hospital, and, at the peak of the chorus, dopamine surged in my brain, making me queasy. My neck hair stood up, and I went clammy. This was not a monstrous rush …
An excerpt from My Brother’s Keeper: The Untold Stories Behind the Business of Mental Health―and How to Stop the Abandonment of the Mentally Ill.
Throughout history, civilized societies have recognized the vulnerability and suffering of the ill and accordingly granted them special rights and protections, as well as a unique designation: “patient.” This is changing. In the 1990s, when I was involved in negotiating managed care contracts for a community …
For an introduction to SPR, click here. For a history of SPR, click here. To learn how to distinguish real vs. sham peer review, click here.
We don’t hear about SPR as often as it occurs because those who have experienced it have likely signed nondisclosure agreements or self-isolated in shame after …
I’m primary care and I see a patient in a 10-minute appointment who tells me she now has a disabled daughter who is 22, had a stroke, and currently cannot cope with all that her disrupted life is demanding of her. I am also expected to fill out that FMLA paperwork for that patient and respond to 20 back-and-forth portal messages on that same patient over the next two days, …
In the August 2023 issue of MD Linx, Stephanie Srakocic writes about a Philadelphia jury that awards a $1.4 million verdict against a nurse practitioner for failing to treat hyperthyroidism. The patient, who is hyperthyroid, is admitted to the hospital for acute abdominal pain, nausea, and vomiting. The patient subsequently dies. The implication is that the patient is under the care of a nurse practitioner, and there is no …
Ecclesiastes was probably written by many ancient scholars, although Jewish tradition holds that it was written by King Solomon. Whatever the provenance, I think the first chapter holds a nugget of wisdom that we need to try hard to remember:
What has been is what will be,
and what has been done is what will be done; there is nothing new under the sun.
Is there a thing of which it is said,
“See, …
I had a dismal start to the second year of my psychiatric residency, and my subpar performance was noted by many faculty members. One professor approached me and told me to discuss the situation with my psychotherapy supervisor, adding, “Don’t let your supervisor sugarcoat it.” The professor knew that my advisor was an extremely kind and gentle person who would prefer to leave out the details of my performance so …
I miss my stethoscope—the small black one with the tiny neonatal head. I wore it around my neck constantly while on duty in the NICU and L&D. It served as an outward symbol of my knowledge and experience. Inwardly, it reminded me of all the things I could detect about a baby by simply looking, listening, and gently touching. My little stethoscope was ready in any emergency. It helped me …
Continuous quality improvement undoubtedly contributes to the ongoing honing of best practices in medicine. This health care-specific parallel of total quality management programs in business helps us daily inch closer to the ultimate goal of eradicating patient harm. Health care professionals familiar with these variation-reducing processes are likely well-versed in the popular Ishikawa fishbone diagram. While the focus is intended to be spread across materials, processes, equipment, and …
In December 2019, I reached out to the grief counselors at the hospice organization that cared for my mother as she passed. It had been almost a year since her death, and I was running out of time to seek help. I had spent so much energy ensuring my daughters were OK, believing, as I was taught in medical school, that grief just passes. Back then, I learned grief lasted …
Primary health care is the cornerstone of non-emergency medical services, offering essential support to patients and promoting overall wellness. Even individuals in good health benefit from regular visits to their primary care physician (PCP) to sustain their well-being. However, the primary care sector faces numerous challenges today, ranging from increased patient demand to the complexities of modern health care needs. Addressing these challenges is essential to sustaining the effectiveness and …
All physicians understand that the gradual disintegration of private medical practice in our nation is already happening and that our government continues to take complete control of health care and the medical profession by any means possible. Physicians in medical practice (both employed and independent) are reaching a level of intolerable strain imposed by fee restrictions and medical practice mandates, among other challenges.
All of these issues result from one core …
Reflections: Day 5
It’s a strange feeling to look down at my phone calendar and realize that nothing will be grayed out because it happened, but only because time keeps ticking.
It’s interesting and beautiful to watch my kids keep moving forward as the community around us is so devastated: playing music, rediscovering the joy that is reading, helping clean up the yard, making a game out of who does which chore …
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