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The EHR is Down! $@&#!

The advantage to patient care without the crutch of an EHR. What do you do?

Chào: (Vietnamese: Goodbye/Hello)

One of the first words I was taught by my parents was “chào”. In Vietnamese, you say chào and bow when you greet someone or when you leave as a sign of respect. In my first blog about self-discovery, I detailed the burnout and why I left clinical practice. In this second blog of the trilogy, I wanted to share encounters with patients as I told them goodbye. While I received great advice when I started practice, no one ever talks about how hard it is to leave.

Karoshi - {Japanese  過労死: Death by Being Overworked}

Over the last few decades, Japanese workers were collapsing dead at their desks or committing suicide due to the high stress stemming from their jobs; Japan coined this phenomenon, “Karoshi.” In 2021, the World Health Organization and International Labour Organization issued a warning:  working 55+ hours a week is a serious health hazard and increases the risk for death from heart disease and stroke. But since the pandemic, I see many colleagues working hard at the expense of their health, family life, mental and emotional well-being. I never thought I would be burned out because I had passion for my job.

Teaching and Academic Burnout

RheumNow recently highlighted a publication that reported about a third of physicians in academia intend to leave. To our colleagues in non-academic situations, this may seem incredibly high. I think an important contributor to the intention to leave academics is that something that used to be a benefit has now become a challenge: namely, teaching.

Choice Overload (and the Way Out)

I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”.

What Happened to the Pharma Reps?

Dr. Jack Cush weighs in on changes in pharmaceutical "detailing" with suggestions for the future.

Best of 2022: I Need a Nemesis

A nemesis is so much more than the "enemy". Your nemesis defines what matters most to you and how you will overcome. Seth Godin once said, “Pick your enemies, pick your future”.

The Best Prescription

The craziest question that you can ask any doctor is “what is your best therapy for __?”.    Crazy, because there are exponential answers, with factored layers that make each decision unique to that doctor. Each doctor has her own cha-cha-cha algorithm to a particular problem. The problem is, we each dance to a different cha-cha-cha tune in the practice of medicine.

I Need a Nemesis

A nemesis is so much more than the "enemy". Your nemesis defines what matters most to you and how you will overcome. Seth Godin once said, “Pick your enemies, pick your future”.

Best of 2021: Zoomatology – Present in Absentia

Are you a zoomatologist or a doomsatologist? Zoom has replaced the meeting, the teleconference or the board meeting. If your old meetings were bad, then your replacement zoom meetings will also be bad, if not worse. Largely because you have failed to master the medium. Here are the rules of Zoom.

Best of 2021: Consults in Cars

In this episode of Dialing for Doctors (aka, Tales of Telehell), we consider a growing subset of telehealth seekers connecting from their cars. This has happened several times and it always catches me surprise. While I've had "live" televideo visits with patients walking the dog, waking up in bed, and from the waiting room of another doctor's office, consults in cars is about the nuttiest. What is the patient's role in telehealth?

Interview Season

We are at that time of year when rheumatology fellowship programs across the nation are exploring potential candidates to train. Program directors work hard to attract the finest candidate, hoping to shape a future leader; applicants want to impress programs with their experience and desire a place where opportunities are available to explore their potential. So how does a program choose from a large pool of qualified applicants to fill just a few seats? What should applicants look for in a program to ensure a good fit?