Hayward Zwerling is an endocrinologist who blogs at I Have an Idea.
Although I had never been diagnosed with anxiety, my career as a physician has always entailed a high degree of stress, and this has had consequences.
The stress of running a solo private medical practice
When I was running my solo private practice, there were always competing demands for my time: Patients waiting to be seen, patients or physicians on the phone waiting to talk to me, staff issues, scheduling problems, dysfunctional …
I retired early from the profession I loved because the devolution of the health care system had made it impossible for me to care for my patients in a manner that met my standards. It also left me with a wound of “moral injury” which makes me leery of re-engaging with our health care system.
My early career
My first post-training job (1989) as a physician was in a BCBS clinic. After …
The high cost, low quality, and systemic inequities of the U.S. health care system have prompted its redesign. The current health care system is now controlled by consolidated health care institutions, insurance companies, pharmaceutical companies, and health information technology companies (CHIPHIT complex). The CHIPHIT complex, along with the federal government, will shape the future health care system. However, independent health care policy experts, independent health care providers, and members of …
Massachusetts is again experiencing a COVID-19 surge and our hospitals are overwhelmed, mostly with unvaccinated patients.
As a practicing physician who takes care of many high-risk diabetic patients, I ask all my patients about their COVID-19 vaccination status. I explain to my unvaccinated patients that the benefits of vaccination far exceed the risk, both at the individual and societal levels.
Unfortunately, this conversation only convinces a minority of the unvaccinated to get …
The U.S. is progressively falling behind other countries when rated on the percent of the population that is vaccinated against COVID-19.
I ask all my patients if they are vaccinated against COVID-19 and estimate that 80 percent are vaccinated. The unvaccinated can be unscientifically categorized into three groups, highlighting three real but anonymous patients.
Politically indifferent, medically uneducated, under peer pressure
The first patient is in their 5th decade of …
Today’s health care system has become so standardized that if a person in a medical office were instantly and magically transported to a medical office in another city, the person would instantly recognize that they were still in a medical office. Our offices are now antiseptic, cold, and devoid of educational material and humanity, and this office decor can adversely impact a physician’s ability to provide care to their patients.
When …
“The medical profession now understands that social determinants of health are probably the most important driver of a patient’s overall health, and these determinants are largely the result of political decisions. Clearly, we have a professional responsibility to teach our patients the science underlying their health issues. Don’t we also have a …
I walked into my exam room to see a patient I first met two decades ago. His medical problems included poorly controlled diabetes, hypertension, hyperlipidemia, and a substance abuse disorder. Over the years, our health care system has served him well as he has remained free of diabetic complications and now leads a productive life. Watching this transformation has been both professionally rewarding, personally enjoyable, and I look forward to …
During my 2+ decade tenure as a physician I have always believed that a physician’s promise of confidentiality was a pre-requisite to obtaining accurate information from a patient. With the enactment of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) the rules which stipulate when a physician must disclose confidential medical information (protected health information, PHI) without the prior consent of the patient were codified into law.
In today’s …
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