I just didn’t understand. I was an excellent student. I know this is true of most of you. Given the nature of this publication, most of our readership have graduate degrees. This means that collectively, after completing four years of college, we all made the financially dubious decision to pursue post-graduate education, like lemmings jumping…
Concierge Care: Basketball, Hotels & the Future of Rheumatology
I wouldn’t normally look to professional basketball as a model for healthcare, but sometimes answers come from unexpected places. The observation that elite athletes are not like you and me—medically speaking—is not new. In the second century AD, the pontifex maximus in Pergamum recognized this fact and appointed Claudius Galen physician to the gladiators, making…
Set Up to Fail: The Criminalization of Clinical Practice
On Dec. 27, 2017, RaDonda Vaught killed Charlene Murphey, allegedly. Ms. Murphey was a lifelong resident of Gallatin, a suburb of Nashville, Tenn. She was well known from having worked at the local Walmart for 24 years, before she retired in 2012, when she was 65 years old.1 On Dec. 24, 2017, she was helping…
Stronger Together: The Future of Physician Unions
If you ever want to be depressed, turn to the internet. This might strike some of you as a truism. Certainly, between the pandemic and the war in Ukraine, it is difficult to open your browser without being smacked in the face by a dismally depressing piece of news. In this particular case, however, I’m…
Zombie Therapies: Ivermectin & COVID-19
He just didn’t get it. I love my mechanic. After many years of taking my car to mechanics who took my money without explaining what they were doing with it, I finally found someone who loved to teach. Whenever I bring my car to his shop, class is in session. He gestures for me to…
Prior Authorization Is Under Review
I just couldn’t believe it. Like all of you, I receive many requests to see patients urgently. And like all of you, I can’t possibly accommodate all of those requests. So I triage: I look through the referrals and try to differentiate patients who want to be seen from those who need to be seen….
Harder to Breathe: The Infrastructure Behind Medical Oxygen
Last year, in Texas, they had no room to breathe. Texas has 301 designated trauma centers equipped to provide intensive care, 200 of which can care for at least four critically ill patients. In August 2021, 75 of these hospitals reported having no available beds in their intensive care units. Zero. This was due, in…
The Transformative Power of Tragedy
On Sept. 11, 2001, I was at work. I had accepted a position as an assistant chief of service (ACS) for the Department of Medicine, which is Hopkins-speak for a hybrid position that involves all the administrative duties of a chief resident, plus the responsibility of an attending. For a year, I admitted patients to…
Understanding Risk in the COVID-19 Era
On Sept. 9, my 5-year-old son boarded a bus for his first day of kindergarten. In some senses, this was no different from any other year. We spent weeks trying to get him excited for school (he is not a fan of changes). We went to kindergarten orientation, toured his classroom and sat on his…
Revisionist History: Seat Belts & Resistance to Public Health Measures
Some were furious. State by state, laws were enacted to ensure compliance. In most states, the laws were accompanied by a modest fine, as an added incentive. By the time the laws were written, most understood they were based on good science and common sense. The potential to save lives and prevent tragedy was finally…
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