Recovery has to be number one. If you want to get back to practicing medicine, everything will fall into place if you take care of that. Don't take your recovery for granted. If I took one pill, it'd be all over. I don't drink alcohol. I'm a Catholic; I don't…
"During addiction, the brain becomes 'hijacked,' which then 'exaggerates the need for the drug and minimizes the dangers associated with the use of the drug.' This is so affirming because the chemicals in my brain told me I was going to die if the opioid was not available. It was…
If you feel as if you don't have time for yourself and your health and your fitness, set your alarm clock an hour earlier. I thought about that and thought, “That's crazy. I can't do that. I need my sleep. I had a late night. I was on call. I…
My definition of burnout was this realization that I was in a situation that I was powerless to get myself out of. I was in a situation where I was powerless to help the people that needed me most at that given time. For the first time in my life,…
"My own burnout episode forced me into some heavy-duty soul-searching and serious reflection. I got lost in the world of seeing as many patients as possible, battling for more operating room time, and keeping up procedure volumes, prior authorizations, and electronic medical record keeping. I failed to notice early warning…
You need to take care of yourself. You need to keep up with your medications and doctor's appointments and consider speaking to hospice nurses or therapists of some sort. Because you are going through as much as your loved one, only you're watching it on the outside. You need to…
I would describe it as pre-grief before death. Although the feelings may be very much the same. It's the waiting, it's the not knowing. And as I said, it's not talked about very often, so for me, it felt like, “What would happen today? Was anything gonna change? Would I…
"I experienced many deaths when I was a nurse, from babies, kids, young adults, the elderly, and my own family. It was always heartbreaking, but I found that staying with the dying and the family and supporting them in what little way I could made the experience more bearable. I…
“What's your comment in terms of this increasing public distrust of medical institutions?” Some of it is a vast collection of medical information, so you can go to your favorite search engine, put a term in, and get a whole host of things that make you feel like you're an…
With my transition to opioid-free, I went from a mindset that this is a necessary evil for controlling pain for my patients after surgery so that they can achieve the outcome of having a repair or reconstruction to this is not necessary. And I approached my patients with that mindset…
"How do we manage this? All patients meet with the physical therapist before surgery and within two days after surgery. They use transcutaneous electrical nerve stimulation (TENS) before and after surgery. They get a regional anesthetic block from one of our anesthesiologists, supplemented with local injection during surgery. They use…
Lifestyle medicine is the medical specialty that uses evidence-based lifestyle and therapeutic intervention as a primary approach to prevent, treat, and often reverse the chronic diseases that are so common today. And it does that by addressing the root causes. It looks at the whole person and enables people to…
When patients don't feel heard, and that's often the case when we as physicians have very little time to see them and they are confused about the type of information, or they don't feel heard because they don't really have the time they would like with their physician. When that…
"Scientific research impacts our lives, however, and much more profoundly than we generally appreciate. Considering the wide-ranging benefits, science is not just for scientists. Research discoveries are often translated to tools and applications down the road, usually without reference to the original science behind them. Without science, we would not…
In the previous practice, we had 20 minutes for a new patient and 10 minutes for a routine visit. I allot 55 minutes for a new visit or an annual check-in in my practice. And 25 minutes for a routine visit. I also buffer every appointment, so after every appointment,…
The administrative role in medicine has grown exponentially over the past four decades. Doctors are required to work harder and harder, spending less and less time with patients and diverting revenue to overhead, and the result has. Corporatization results in doctors spinning the hamster wheel as fast as they can,…
"My quality of life is outstanding. I leave work every evening only after every call is answered, fax addressed, a prescription delivered, then retreat to my home a mile away. The proximity makes it easy to see patients after hours, on weekends, and on holidays; I promise to see patients…
I feel like a lot of systems, especially hospital systems, are telling doctors there's no negotiating. You just sign it, you DocuSign it. I disagree because I always get changes, and it's always about leverage. And so I always talk to my docs about what leverage you have. Because trust…
I think doctors sometimes forget that they're running a business with people. And so anytime you're dealing with human beings, you're going to have some tension and some stress, and you need to know, are you classifying them correctly, and what do you do when they file an employment discrimination…
"Being a transactional lawyer for physicians is never dull because the more the regulations, guidance, and laws change, the more questions everyone has. But it’s more than just getting an answer to a question and being in compliance. Doctors are feeling overly worn down and out of control, and the…
60 percent of physicians are burned out. They would share and write their story on KevinMD, and then other physicians would chime in to comment and say, “I feel that way too. This is my story.” And then they'll share their story in a comment. And that normalizes burnout, right?…
There is no more physicians' lounge anymore at the hospital. You have hospitalists, and then you have outpatient physicians, and we never see each other. In fact, I'm an outpatient primary care physician. I don't know the last time I rounded in a hospital. It must have been 15 years…
In this special episode, I'm on the other side of the microphone. I'm interviewed by CMEfy's Brian Cohen on the Co-Learning Clinician podcast, and we discuss the concept of physician co-learning, opinion pieces vs. gold standards in medicine, what I learned from interviewing physicians, physicians being more than their degrees,…
What makes it great for business because there's homogeneity, a predictability. Steve can be replaced by Mary and Joe and Sean and whoever else. If all I am is a servant to a corporation that has no real importance to them other than the ability to service their cascade, I…