Why Do Doctors Write?
The first patient I ever wrote about wasn’t actually my patient; as a first-year medical student, that possessive grammatical construct—“my patient”—hadn’t yet entered my consciousness, much less my lexicon. In any case, by the time I met him, he was already dead. More
The Assault on Science
The memo came out on a Wednesday, and agencies had until 5 p.m. on Friday to scrub their websites of anything that might “promote or inculcate gender ideology.” As a result, hundreds of government websites were shorn of articles, pages, and data sets. The Trump administration is signaling its contempt for evidence-based science and its disregard for human health and life. More
Protecting Immigrant Patients
It was hardly two weeks after the election when a doctor in our clinic received a letter from one of her patients, an undocumented immigrant. The patient had diabetes and suffered from rotator cuff tendinitis, which makes reaching backward quite painful. “Is there any possibility you can write a letter,” she asked, “stating that if they handcuff me, can they please handcuff me with my hands in front of me?” As a physician, it was hard to read this without feeling sickened…. More
A Grave Prognosis for the Affordable Care Act
Shambolic “repeal and replace” attempts are no longer needed to render a grave prognosis for the Affordable Care Act, the law that provides medical coverage for 45 million Americans. The most virulent threats are proliferating in the judicial system. More
Another Hospital Billing Trap
We needed a X-ray to rule-out a fracture so opted for an urgent-care center, which did it quickly and efficiently. As the three employees closed up shop for the day, I reflected on how urgent-care centers filled a perfect niche between the ER and the impossibility of snagging an immediate orthopedic appointment. But this is health care in America, and nothing ever closes up tidily. Two weeks later a bill arrived…. More
Sunday Crossword Puzzle Clue
On a recent Sunday, my editor from Beacon Press was killing time doing the Washington Post crossword puzzle. Imagine her surprise to come across 86-across–a book that she had edited! More
Covid Vaccine Heebie-Jeebies
Few patients seem to have specific reasons for declining the Covid vaccine. There’s just a vague hedge, or an abashed, “I don’t know, I just don’t.” It’s as though they have a communal case of the heebie-jeebies. More
It Shouldn’t Be This Easy to Lose Health Insurance
Why do Americans even have to “remember” to get health insurance every year? We don’t ask citizens to remember to enroll with the fire department every year, or to remember to sign up for electricity service or water. More
Unfinished Symphony
The baton came down and everyone was off. I tried to catch a few notes but was immediately flailing and thoroughly lost. It went downhill from there, for a solid hour, an experience that could comfortably be compared to extended root canal, although dentists generally provide anesthesia. More
The Curious Side Effects of Medical Transparency
We demand transparency in government, charitable institutions, nutrition labels, and middle-school grading rubrics. The medical record should be no different. And yet, in writing medical notes in this new age of full medical transparency, I can feel an awkwardness creeping in. There is something disquieting about knowing that my every word might be scrutinized. More
Even with lawsuits and co-pay caps, will Insulin ever be affordable?
The sausage-making of how insulin is priced is not for the faint of heart. I’m a physician, not an economist. But the diagnosis seems plain as day: greed. Once we’ve allowed health care to be an economic entity like mobile phones, sports cars, and jewelry, all players with fingers in the pie will extract as much money from the process as the market will bear. More
Serving Patients Through a Screen
Years ago, when telemedicine first edged into my clinical consciousness, I pooh-poohed it as a second-rate simulacrum, valuable perhaps for rural communities lacking access to specialists, but otherwise hardly worth the crinkly exam paper it was replacing. I’ve staked my entire career on the irreplaceable value of the connection between patient and clinician. But I’ve changed… More
Access to Primary Care
“Doctor, it’s taken so long to get this appointment with you!” This is the opening line of so many medical visits, and I find myself constantly apologizing to my patients on behalf of our system. After the pandemic-induced lull in routine medical care, we’re right back where we started—doctors booked for months, patients struggling to get appointments. More
Memorializing Covid
COVID-19 does not seem amenable to grand memorials, at least right now. Perhaps because the millions of deaths from COVID-19 have been diffused so widely, often in isolation—and of course still ongoing—the memorials that are starting to crop up are very human in scale. More
I Feel Safest (re Covid) in My Own Hospital
When it comes to Covid, our patients seem to be moving on. We healthcare workers, however, don’t have that option, as Covid is now the third leading cause of death in the U.S. Covid may not be the only thing on our mind as it was at the outset, but it’s still part of every staff meeting, every communication, every clinical day. More
