Sixteen months into retirement, the absence of any externally imposed schedule still leaves me partly edgy. Medicare, COBRA, and cell phone bills come due at expected dates. The check goes out the next day, but it could wait another day or a week. Shab…
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a carotid bruit detected on routine medical examination. He reports no history of previous focal neurologi…
I enjoy a fairly small private practice and a manageable telepsychiatry side job with good support staff. But even the small scale of my outpatient clinical practice doesn’t fully insulate me from the pain of unnecessary practices that I wish would bec…
We are going to need new types of physician leaders to get the change in health care clinicians want. When I observe current physician leaders, I notice the bulk often fall into two distinct groups. On one side, there are the out-of-touch and on the ot…
When I was accepted to medical school, I debated — hard — whether or not to attend. Out of the physicians I shadowed and interviewed, 19 out of 20 advised me not to become a physician. Their dissatisfaction was rampant. Over and over, I was told, “Don’…
A recent article was published in the Atlantic about Americans being the worst patients. Americans are part of a broken and dysfunctional health care system with exorbitant costs, a maelstrom of bureaucratic red tape, and insurance coverage that barely…
As we approach Christmas, you only need to go to the nearest mall to witness the frenzied activity in preparation. People scurry around trying to find the perfect gifts for their loved ones and co-workers at the lowest prices. While gift-giving indeed …
Mindfulness and meditation. Meditation and mindfulness. Allow me to elaborate. I went to medical school in the 1980s. Nobody talked about complementary and alternative approaches to healthcare or mind-body medicine. It wasn’t because we students th…
“It should be in my chart.” I’m sure we have all heard this statement uttered with a subtle (or not so subtle) edge of frustration from our patients after asking a question such as “what medications do you take?” I find clinicians despise this comment…
Next in a series. In prior posts, I described my Healthcare Incentives Framework. If you haven’t read those, I recommend you check them out first to have the full context for this post. But here’s a refresher of the main points of the framework without…
