“Give us a sense of how dire a situation is in a rural setting.” In the lowest tier hospitals, 40 to 50% of those hospitals are in the red. In rural areas, it is so common to have less than 20 days of cash on hand. If you had 10…
Overall, the system was designed for an urban setting where you've got a demographic of Medicare versus private insurers, and that pay base really determines your viability. When you move to the rural area and flip those ratios, so you have a high percentage of Medicare and Medicaid, the numbers…
"Without a strong rural health care system, our nation’s ability to expand and contract with surges in demand will become very limited. When hospitals work together, they can better ensure that no community is left without a rural hospital for urgent care." Richard Watson is an emergency medicine physician. He…
“If doctors were to see patients like yourself, definitely empowered, bringing in your data and suggestions for therapy that a physician may not be comfortable with. What kind of advice do you have for us to better listen to you?” My first advice would be to evaluate what we've brought…
We spent an hour together, and he was just puzzled by what I was doing. We went through a phase where he asked me if I was trying to play doctor, and I said, “No, but I'm trying not to have this happen to me.” And what he did is…
"I have come to appreciate why doctors find self-directed patients challenging, if not downright difficult. I wish all docs would engage with us, hear us out, and offer an explanation and further discussion when they disagree. The doctors I choose to work with seem to understand and respect my efforts,…
We used to be a clinic and a hospital; now, we are called a firm. So we've taken on business language and are now called providers. No longer doctors; most people now in medicine are employees. So their independence has been taken; the worst is that the patient has become…
I've held the hands of my patients. I've been the one whose hand has been held. I've received trust and given trust, and the therapeutic decisions my patients and I reach were not subject to the interdiction of a third party. I do not want to have my life's role…
"With regard to health care in the USA, the quote from Dickens is twice correct. We are in the best of times for knowledge, capability, and potential. We also are in the worst of times with regard to the application of our knowledge and the outcomes achieved, especially when compared…
Numerous studies have shown that patient experience does matter. Patients are more likely to fill their prescriptions, follow up on their follow-up care guidelines, and return to the doctor if their doctor was nice to them, listened to them, and treated them respectfully. Anecdotally, I see it in my dad.…
It was arrogance. I think that allowed the physicians to not even consider that something could go wrong during a procedure in which they participated, and it was arrogance. I think that allowed the young physician to stand at the foot of my sister's bed and simply say, “She has…
"Yes, the opioid crisis in this country has caused a reckoning in the medical field about how to treat patient pain. Ignoring the pain will not make it go away. Options are available beyond opioids, and policymakers and health care providers need to be aware that attention to effective health…
“One of the things that you wrote in your article is that no job is too tough if they pay you enough. That was what you were told. So tell me about your mindset as you were considering this transition.” You know, that's certainly what I was told. And you…
For those other surgical residents or fellows just encountering the attending job market and they're considering various offers, what kind of advice do you have for them? Money is important, but it's not the only thing. Culture's important. There's a lot more wellness and well-being and burnout, and you gotta…
"It has now been almost four years since I transitioned to academia. I see fewer patients per day and take fewer call. I also have more time with each patient, more time to recharge, more time for other academic pursuits, and more time for creative outlets. My compensation has decreased,…
If you enjoy medicine in general, if it was exciting to you to be in medical school, if you want to learn about all kinds of various aspects of medicine and really help people in a way that they weren't afforded this help in the past, and be able to…
f you follow trends in other industries in a few years, healthcare's gonna catch up to that industry. So I looked at how other industries would use social media and use platforms to get their voice across, and I thought that we, as physicians, also need to get our voices…
"Doing medical-legal consulting is a great way to use your medical training in a non-clinical field that really helps people. One of the many things we can do is help attorneys refute the question of a pre-existing medical condition. Often opposing counsel will try to lay off accident injuries as…
I think every health care professional is responsible for the mental wellness of their patients. I know it's an unfair statement because there's so much more going on. I'm in these doctor's offices all the time. There's not a lot of time to spare people around, and they're ultimately trying…
Someone getting screened for behavioral health or substance abuse should be the same as taking their blood pressure. Blood pressure became a preventative measure because the number of people with cardiac issues became too costly. We're on the same path when it comes to mental health, and we have to…
In this special sponsored episode, I’m joined by Ernie Wallerstein, CEO of Mental Health Technologies, or MHT. MHT is a cloud-based platform that enables health care clinicians to identify patients that may be suffering from undiagnosed or inadequately treated mental health and substance abuse disorders. As a primary care physician,…
“How did you make this patient the protagonist in her own story?” I have this magic wand question, which sometimes I ask patients when I'm confused trying to figure out what's going on or how it can meet their needs. And the magic wand question is: “If I had a…
“How do you maintain the focus on each patient's story in the emergency department?” Curiosity. I feel like one of the first impulses that we have as clinicians, and I think it's a good impulse, is like we want to do something. We want to help. And there are so…
Jay Baruch is an emergency physician and author of Tornado of Life: A Doctor’s Journey Through Constraints and Creativity in the ER. We discuss his emergency medicine journey, poignant cases, the importance of stories in the doctor-patient relationship, why writing is so important, and how physicians can be creative. The…