The first week of my big attending job, I saw a patient with fever, sore throat, no cough, and tonsillar exudates. Well-trained to manage septic shock, but having no idea how to practice in a primary care clinic, I crafted a vast array of infectious an…
Imagine that you hired a teenager to sell hotdogs at the local fair, but the teenager started telling customers that hotdogs were really not very healthy, that the price was ridiculously high, and that they could find healthier, cheaper options just ar…
At age 33, I got my first job as an outpatient pediatric attending. With great pay, nice coworkers, and exceedingly better hours than in training, to everyone around me, I had finally “landed.” Soon after I began working, however, I woke up…
Many providers enter medicine to comfort patients and their loved ones. However, much of what I do doesn’t live up to that intention. In the past few months and particularly the past few weeks, I’ve spent most of my afternoons making little…
“Whether led by the patient or by a primary care physician or nurse practitioner, a proper leadership-based problem-solving methodology is a critical tool. The approach itself is not nearly as important as the discipline to use a formal approach….
After being a coach for a couple of years now, there is an immediate danger I see right now. Many of you are doing too much. Unsustainable, dangerous amounts of work. Dangerous to yourself and dangerous to others, which makes it dangerous for you, too….
A patient undergoing chemotherapy for breast cancer was diagnosed on April 20th with profound secondary adrenal insufficiency (hypophysitis: ACTH undetectable, cortisol 0.2) caused by immunotherapy (pembrolizumab). She was started on corticosteroids an…
Doctors don’t get sick. Right? We’re certainly not supposed to. Throughout our training, the consequences of illness are dire—if you have to miss a day, someone else, someone you know well and care about, will have to fill in. They will pro…
Doctors don’t get sick. Right? We’re certainly not supposed to. Throughout our training, the consequences of illness are dire—if you have to miss a day, someone else, someone you know well and care about, will have to fill in. They will pro…
“We can talk about the system-based approaches we have instituted to avoid burnout and the negative emotional consequences that arise from medical errors, miscommunication, or negative outcomes that occur outside our sphere of control: Just cultu…
