Specialist

The unsung heroes: respiratory therapists

Conditions
November 6, 2021

Working day after day, year after year, in a busy high acuity ICU, we all have become a “second family.”

The public doesn’t hear much about respiratory therapists, especially during this COVID nightmare. But they have been the unsung heroes.

So who are the respiratory therapists, and what do they do?

Respiratory therapists are specialized health care professionals trained in critical care and cardio-pulmonary medicine. They work therapeutically with people suffering from acute …

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Burnout and bias? Or medical gaslighting?

Physician
July 29, 2021

Five years into my practice as an academic allergist/immunologist, my perceptions continue to evolve. Though once primarily informed by my mentors’ wisdom, I continue incorporating my experiences as both physician and autoimmune patient to guide my practice. Though we all know medicine isn’t like it used to be, nostalgia is bittersweet. In its wake, the real question remains: how are we going to respond to ongoing changes and fight for …

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Let’s talk about hierarchy and priorities in medicine

Physician
July 23, 2021

Life is full of hierarchies — whether you are the older brother in the family, the supervisor in a company, a chief resident in medicine. There is always a hierarchy. It is a pecking order that keeps our society organized. You know where to look for guidance. Who is the person above your title that can help you with a challenge you are facing?

Even within surgical specialties, there is a …

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The expanding role of specialists in value-based care

Policy
June 13, 2021

Value-based care has become a buzzword over the past decade with early experiments in Massachusetts, followed by creating Medicare accountable care organizations (ACOs) as part of the Affordable Care Act. As commercial insurers jumped onto this bandwagon, most providers became familiar with the concepts of gainsharing, upside and downside risk, and bundled payments.

Much of the activity in this space has focused on primary care, particularly for ACOs and ACO lookalikes. …

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Will separating obstetrics from gynecology help specialist burnout?

Physician
August 30, 2019

At the end of a long table covered with hors d’oeuvres and a birthday cake, I struck up a conversation with three primary care physicians.

I was hungry for their opinions.

Inside the crowded apartment, we spoke for some 20 minutes about the systemic and cultural causes of burnout in primary care—a conversation that informed the first article in this series.

As I was about to leave, I …

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Is it OK for a physician to retire early?

Finance
August 17, 2017

This is a tough post to write. I struggle with this issue daily. Is it OK for a physician to retire early? The obvious answer is: yes. Each individual should live their life as they see fit. But with a continued shortage of physicians (granted this is more in rural areas and not big metropolitan cities), and the time, money and resources required for training physicians, is it selfish to …

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How a blanket changed the way I thought about medicine

Education
August 4, 2017

My sister calls my name three times before I hear her. I am so distracted by the palm trees and the ocean view that I don’t feel her put the car in park. I look up at the “Physician Parking Only” sign straight ahead.

“Hurry up and get out. We’re running late, and I don’t want to have to stay after my shift ends,” she says.

“Don’t you always stay like two …

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The decline and fall of informed consent

Physician
July 21, 2017

Margaret Edson’s 1999 Pulitzer Prize winning play, Wit, tells the story of the final hours of Vivian Bearing, PhD, an English professor dying of cancer.  Early in the course of her disease, one of her doctors sees the value of her case from a research point of view and asks her to enroll in a clinical trial of an investigational therapy.  In the film version of the play, which stars …

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In this world of burnout, doctors have to remember why they do this

Finance
July 19, 2017

Recently, I had the privilege of presenting the Clinical Specialty Award for General Surgery at the 2017 Graduate Awards Celebration at Western University of Health Sciences College of Osteopathic Medicine of the Pacific (COMP-NW). It was amazing to hear all the accomplishments and meet so many wonderful new doctors in this year’s class. I also got the opportunity to meet a few proud parents and professors.

The list of accomplishments of …

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The truth behind the 27 contact lenses stuck in the patient’s eye

Video
July 18, 2017

By now I’m sure you’ve heard about British woman who reportedly showed up for cataract surgery only to have her doctors discover that 27 contact lenses were unknowingly stuck IN her eye:

After this news story broke, many friends and family reached out to me asking how this could be possible! Here I will explain how this is (and isn’t) possible by clarifying some …

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The high stakes of diagnosis

Video
July 13, 2017

Xiaoyin “Sara” Jiang, MD, FCAP often calls herself a cellular detective, solving the mystery of disease under the microscope. Surgeons send their patients’ tissue samples to her for a diagnosis, and she knows that getting the answers right is high stakes – life and death.

Created by the College of American Pathologists.

Pay off your medical school loans for free? Here’s how.

Physician
June 27, 2017

We are all panicked over student loan debt. The size of the loan can be worrisome — sometimes overwhelming. The average medical student debt is over $160,000, and it’s not unusual to owe $300,000 to $450,000! The compounded interest is growing every day and adding to your anxiety. Most early career physicians state the stress related to paying off these loans is their greatest emotional burden. Think about that — …

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A healthy lifestyle can prevent many of the diseases this pathologist diagnoses every day

Video
June 19, 2017

Kalisha A. Hill, MD, FCAP is a mother, a runner and a pathologist. She believes that a healthy lifestyle can prevent many of the diseases she diagnoses every day. You’ll meet her, learn about her expertise and see why her clinical partners rely on her diagnoses to guide their treatment decisions. Healing begins with her and that’s what patients count on for their care.

Created by the Read more…

The best places for a doctor to practice: It’s more than money

Physician
June 30, 2015

I would think that when physicians decide where to set up practice, there are things that they would want to think about other than how much money they’ll make.  Yet if one reads Medscape’s current list of the best and worst places to practice, it would appear that money trumps everything else (although Medscape said it also considered factors like “cultural attractions”). What Medscape apparently did not consider …

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Physician regulators get paid so much more than front line doctors

Physician
May 13, 2014

Medicine has always had it regulatory fiefdoms, but in 2002 they were greatly expanded. At that time, a charter on “medical professionalism” was published by the American Board of Internal Medicine, the American College of Physicians, and the European Society of Internal Medicine in the Annals of Internal Medicine that touted three fundamental principles:

  1. the principle of primacy of patient welfare
  2. principle of patient autonomy
  3. principle of social justice

The first set of professional responsibilities for physicians was a …

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Do medical scribes threaten patient privacy?

Physician
April 27, 2014

Medical scribes are a burgeoning field with many institutions and practices exploring their use while the many commercial enterprises who lease out scribes are pushing for their widespread acceptance. There is no accepted definition of what scribes do or what their background or training should be. There is no mechanism for licensure of them in any state. They are poorly defined medical assistants. The field is in its infancy and …

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To put patients’ interests first, we have to put our own aside

Policy
November 23, 2013

I first read Dr. Matthew Moeller’s piece from this past March for the first time this week after a classmate of mine passed it on to me. I’m a first-year medical student — bright-eyed but sleep-deprived, trailing the smell of the cadaver lab everywhere. I entered medicine fully aware of the long, arduous road ahead, almost exactly as Dr. Moeller described it; with many of my classmates in my …

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