"Continuing to do this work the way I was doing it was not sustainable. I needed to get off the merry-go-round. I just didn’t know how. I didn’t think I could stop myself—transplant was my duty, my responsibility, and what I was trained and programmed to do. It was hard to imagine leaving my post, but I needed to find a graceful exit, an elegant off-ramp that would satisfy my need for a tidy conclusion. One way or another, I wanted off the roller coaster, so I could never again be crushed by a p...
Jun 08, 2021•12 min
This episode is sponsored by the Dragon Ambient eXperience at Nuance. The exam of the future has arrived with clinical documentation that writes itself. Recently, I participated in a virtual webinar, “How AI technologies improve the patient experience,” along with Dr. Jesse Affonso, orthopedic surgeon at Cape Cod Orthopedics. We discussed the difference between patient experience and patient satisfaction, the correlation between the two, and the role technology plays. In a nutshell, I think it’s...
Jun 07, 2021•28 min
"Machine learning is only as good as the information provided to train the machine. Models trained on partial datasets can skew toward demographics that often turned up in the data—for example, Caucasians or men over 60. There is concern that “analyses based on faulty or biased algorithms could exacerbate existing racial gaps and other disparities in health care.” Already during the pandemic’s first waves, multiple AI systems used to classify x-rays have been found to show racial, gender, and so...
Jun 06, 2021•26 min
"The future of health care will be focused on prevention rather than focused on performing excessive medical treatments, diagnostic tests, and procedures. Many centralized processes, services, products, and entities will become unbundled, including insurance, hospitalization, inpatient and outpatient coding, medical billing, payments, patient care, medical education, licensure, and certification. Physicians, including Leah Houston, MD, are developing blockchain-based platform technologies for im...
Jun 05, 2021•19 min
"In addition to leaking private information to an unauthorized individual who just happened to ask for Ms. Mann by name, Larry commanded Nigel to worsen this HIPAA violation. Given the tone of his command, Larry must have felt right proud of his informing an aggressive, unconfirmed querent. If so, perhaps he should have paged Nigel prior to blindly succumbing to clamorous callers. During all of his back-patting, did Larry consider that maybe the unauthorized querent was unauthorized for a reason...
Jun 04, 2021•18 min
"Even though prostate cancer patients are anxious to receive treatment, they still want to minimize their exposure to anyone outside their COVID bubble. One procedure that is especially attractive to our patients is focal therapy high intensity focused ultrasound (HIFU). Focal therapy HIFU is appropriate for patients whose prostate cancer is diagnosed at a higher grade and stage, but is still confined to the prostate. We use guided imagery to locate and destroy only the diseased portion of the p...
Jun 03, 2021•19 min
"We need to crawl before we walk and walk before we run. The first step is to establish your why. Why do you want the financial freedom to practice medicine because you want to, the way you want to instead of because you have to? Without a why, even achieving financial freedom can be an empty victory. After this, start your financial education. Pick a personal finance book and read 10 pages a day. Read one finance blog post each day. Small efforts will lead to big rewards. After this, you are re...
Jun 02, 2021•16 min
"My children are embarking on their own lives now. While their paths are not taking them into medicine, I see how medicine has influenced their lives. They are committed to investing in themselves to reach their desired outcomes. They understand the value of dreaming big as they create a life and career they may not envision before. They help others. They enjoy the process through the long hours of study and hard work. From that perspective, it was worth it all." Stephanie Wellington is a physic...
Jun 01, 2021•18 min
"Decreasing the burden of combustion material, whether from a cigarette, a power plant, or an engine, will not only pay off now in reducing COVID-19 but also in future pandemics and in reaping the health care benefits of decreasing the constant toll of tobacco and air pollution in our communities. As physicians and others in health care who want to do all we can to bring an end to this pandemic and build healthier futures for our patients and loved ones, we should make sure to reach out to our l...
May 31, 2021•23 min
"My world tumbled upside down. I was managing taking care of three children from home, helping them navigate the realities of our new world while trying to keep my staff employed and safe. I sadly said goodbye to many team members as they made the difficult choice to stay home. We had to figure out how to deliver health care in this new world, where PPE was not widely available, and so many questions lingered about the virus. I had to put the needs of patients, staff, and my children before my o...
May 30, 2021•14 min
"We can’t escape shame. But don’t despair, dear reader, because shame resilience can be cultivated. There are mental-fitness skills that can be learned which are self-perpetuating. I taught myself these skills and, in doing so, healed my own wounds – you can, too. Once you have the skills to recognize and manage shame in a healthy way, you’ll no longer be held hostage by the perceived need to betray yourself by pretending to be someone other than who you are. An enormous weight is lifted, and th...
May 29, 2021•23 min
"There were many things to be processed about that event. It happened within the context of the COVID-19 pandemic, its disproportional effects on the African American community, and a few days after the murder of George Floyd, an African American man killed at the hands of a Minneapolis police officer by asphyxiation. His murder was the third in a row of recent and widely publicized, unjust killings around the country. First, Ahmaud Arbery; second, Breonna Taylor; and third, George Floyd — all w...
May 28, 2021•17 min
"We created a core team of individuals from different levels and functions who met daily. This team’s purpose was to receive and synthesize department-wide information and transform it into new ways of working for our doctors, nurses, ancillary, and support staff. We had a compelling vision which was shared with our department. We made it clear to everyone that they were supported and valued and that we would do everything we could to save as many lives as possible. We knew the importance of mak...
May 27, 2021•25 min
"Where do we go from here? Conventional wisdom suggests that we can only transform ourselves. This is why I propose that we attempt to recognize the Trump that lies within each of us and to heal him. We are plagued not just by the pandemic but by the human condition—and no part of us should be left behind. We often persuade ourselves we have outsmarted the Leviathan by traveling to a far-off land, only to find that the beast followed by sea, swimming clumsily but steadily along in our wake." Bec...
May 26, 2021•22 min
"Social connectedness is the remedy to the COVID fatigue that is running rampant in the United States. We need to stay connected to those we love. At the same time, we must also recognize that life is going on in the age of COVID-19, which means what happened to Mariana is occurring in all of our communities. Vulnerable populations need our help, and in our case, NSRN is working to be there for them through this uncertain time. We encourage all Americans to seek out opportunities to become more ...
May 25, 2021•20 min
"As I leaned against the pristine wall, my vision suddenly dimmed. Everything turned gray. I gulped for air. My arms and legs went numb. I felt that drowning sensation I’d had in third grade when a nun pushed my head between my legs to keep me from fainting in church on a brutally hot June day. Or like the time when I was eight months pregnant, took a hot shower at the university gym, and almost belly-flopped onto the concrete floor. I prayed that I wouldn’t pass out on my first day of medical s...
May 24, 2021•17 min
"Clinicians want specific things from a pathology consultation. They want a short turnaround time and a clear and coherent report, which can be discussed with the patient and correlates with the clinical findings. Unfortunately, this does not always come to pass, particularly with some smaller or disrupted specimens, resulting from minimally invasive surgery. It takes a cultural change to reach that balance between what pathology and pathologists are, and what the perception about the field is. ...
May 23, 2021•19 min
"Yoga therapy differs from contemporary yoga in that the profession has a defined scope of practice based on educational standards and accreditation requirements for training schools and yoga therapists. In dealing with pain conditions, certified yoga therapists possess understanding and knowledge of pain theories and pain physiology and may collaborate with a patient’s health care team to develop an individualized care plan. While pain and musculoskeletal conditions represent the most common re...
May 22, 2021•17 min
"We eventually got the news that Dr. Rathburn had hung himself from one of those beautiful trees that the wind made dance. How sad. It adds to my own grief. Who had found him? How did he look? Babies born with a nuchal cord have the cord wrapped around their neck. That’s the closest I have seen to a hanging. I once delivered a baby who had it wrapped around three times, and by the time he was born, his little face looked bloated and bruised, tongue swollen and sticking out, and he had petechiae ...
May 21, 2021•13 min
"Why else should a person become a doctor? Because there is always something to learn. Because holding someone’s hand when they’re scared is a profound gift that feels as good to give as it does to receive. Because your job will call on you to be brave, honest, and the best human you can be. Because you can work with people who are as devoted to and optimistic about our fellow humans as you are. Because you can choose your patient populations, your clinical settings, the procedures that you do, ...
May 20, 2021•19 min
"I firmly believe that if physicians leveraged themselves and their knowledge of medicine, there would be no need to for them to undertake ventures in the fields that they know little about. The old adage goes like this: Physician, heal thyself. I call on my fellow physicians to heal themselves by dropping the cloak of victimhood and taking charge of their professional and personal destiny. We all spent years in medical school, residency, and for many, fellowship to become experts in our field. ...
May 19, 2021•18 min
"The hospital systems ignored us by putting us lowest on the totem pole for the COVID vaccine. The pharmaceutical companies overlooked the strains on us and increased our vaccine prices. The medical supply companies took advantage of us by limiting our supplies and increasing prices astronomically. Worst of all, the insurance companies (knowing we are already the lowest reimbursed field) changed coding and billing requirements and reimbursements in 2021, ultimately decreasing our reimbursements ...
May 18, 2021•14 min
"As members of the health care workforce, we must recognize the crucial role we play in influencing vaccine uptake. With the death toll over rising in the U.S., the stakes could not be higher as the final death count will hinge on how quickly we can translate the vaccine’s efficacy into real-world effectiveness through optimizing uptake. We should aim to increase vaccine uptake at 'warp speed.' Now is the time to harness the power of social media to combat disinformation. Now is the time to use ...
May 17, 2021•20 min
"Dr. Good’s willing intervention and active interest in my development kept me in medical school and led me to become an academic anesthesiologist. When his career took a turn toward administration, his mentor, Dr. J. S. Gravenstein, took over. He convinced me to stay at the University of Florida, and a couple of years later, when I mentioned a need for a good introductory anesthesia textbook geared to medical students, he suggested we co-write one. So we did. Writing Essential Anesthesia: From ...
May 16, 2021•18 min
"I realized that training in psychiatry would give me the opportunity to understand suicide far better, and hopefully allow me to make a difference at an earlier stage. My exposure to psychiatry in medical school was clearly not enough. I was ill-equipped to fully grasp when individuals begin to have thoughts of suicide and when those thoughts progress into planning or researching methods – and then acting on them. As I thought back to the numbers of dead-on-arrival patients that I attended to i...
May 15, 2021•22 min
"Medical professionals face uniquely challenging pressures. Our work itself is extremely demanding, and always has high stakes for those we care for. External circumstances that impact our work carry uncertainties that add more stress. Constantly feeling targeted as the financial solutions to greater health system issues compounds our burden. While some choose to talk about their struggles openly, many stay silent and suffer in solitude. There is reluctance to share for fear of being judged nega...
May 14, 2021•15 min
"I hope being a parent will now equip me to be a better pediatrician. I hope I can teach them whatever I know about safe sleeping, breastfeeding, and newborn care, but I also hope to acknowledge the reality and struggles of parenting. I hope my statements and recommendations do not sound generic and rehearsed. I hope I can tell them every child is different and will not follow the book. I hope I can be more understanding and empathetic towards the angry and worried parents and applaud them all f...
May 13, 2021•16 min
"As I approached retirement from medical practice, I had an epiphany to take up writing and attended the Harvard CME course on Writing, Publishing, and Social Media for Healthcare Professionals. I met some extraordinary people working in the health care universe who wanted to share their insights. Through my writing as an advocate for patients and physicians on popular social media platforms, I landed a new job. I was recruited by the CEO of a health care startup to become the director of digita...
May 12, 2021•16 min
"As if COVID-19 weren’t bad enough during the pandemic, another public health crisis – substance use disorder (SUD) – has gone from bad to worse, while access to behavioral health services is shrinking. As of September, more than half (52%) of community behavioral health organizations have seen an increase in demand for services, and half of those that offer SUD services saw their demand jump in the previous three months. At the same time, due to lack of revenue or pandemic-related restrictions,...
May 11, 2021•14 min
"With my natural affinity for numbers, I analyzed the reviews’ precise impact after a few years, and the results were astounding. The system generated over $225,000 during a 3-year period. My practice acquired 162 new 5-star reviews on Google, and my partner and I generated over 200 5-star reviews on Yelp. I calculated that each 5-star review was 'worth' over $900 to my practice in the form of new referrals, and the overall return on investment was 1,900 percent. Needless to say, it was a huge s...
May 10, 2021•16 min
