An excerpt from How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers (Second Edition). Copyright 2018 by Toni Bernhard. Excerpted with permission from Wisdom Publications. The fifth way I cultivate compassion for myself is to consciously work on opening my heart to the intense emotions — and emotional swings — that […]
I am recalling a workshop on unconscious bias from last year, the moderator hands outpatient prototype profiles to each table of participants. Ours is a glossy paper with a color photo of our patient, Jane, and a clear outline of her type of employment, hobbies, interests, family members, religious beliefs, and how she prefers to […]
Value remains one of the most widely invoked and variably interpreted concept in American health care delivery. Beyond patients, stakeholder groups across the health care ecosystem are undertaking value-based initiatives, including payers (e.g., value-based insurance design and payments), provider organizations (e.g., value-based care redesign), pharmaceutical companies and pharmacy benefits managers (e.g., value-based pricing and formularies), […]
In academic medicine, promotion depends on the weight of our curricula vitae, measured primarily by the number of papers we publish in peer-reviewed journals. Physicians strive to jump through the hoops of publishing their work in “top” journals ranked by the “impact factor” (yearly average number of citations for a given journal). Yet the “impact […]
To paraphrase Bill Gates: “The purpose of humanity is not just to sit behind a counter and do things. More free time is not a terrible thing.” I have innovated. I developed a mutation assay. I discovered that vacuum ultraviolet light from excimer lasers is safe to use on human tissue. I invented an imaging […]
First of all, many osteopathic medical schools are located in underserved areas — or as underserved as possible while still having enough of a medical community to make training possible. My school, LMU-DCOM is located in the middle of Appalachia, for example. Osteopathic medical schools generally encourage students to specialize in primary care, at least […]
The medicine I practiced between 1974 to 1992 is gone. Evidence is the coin of the realm in the courts of modern medicine. The rule “first, do no harm” demands a corollary — be paranoid. We receive extensive training and licensure to “touch” patients. Any person who is not a physician who cuts into another […]
Recently, a generally healthy friend of mine had two small, unrelated surgeries over the course of a few months. For the first, a small operation on his hand, he received a prescription for 30 oxycodone pills. He used one the night after surgery, to make sure pain wouldn’t wake him. Over the next few days […]
Non-clinicians skip over some of the most necessary underpinnings of doctoring and speak too much about housekeeping issues: blood pressure targets, aspirin use, mass screenings, immunization rates and so on. People without medical degrees could do those things. But there are steps that must be taken before we worry about the measurables. These are the […]
Some days in medicine seem like an epic saga in which the world seems to be playing whack-the-doctor. It is easy to vilify doctors and cast much blame at them. And true, we bring some of this onto ourselves. Today was one of those days, and by the end, I was just all too ready […]
