Several years ago my aunt got in a car crash. It was a fender bender, nothing serious. After the crash she started to have some problems with her vision which she had checked out. What they found was very concerning, her symptoms were a result of a very massive brain aneurysm. She was a doctor, her two brothers were doctors and her daughter was a doctor. They decided not to consult too many people and act quickly without panicking the family. They found the best neurosurgeon in the area who worked at UCLA. They went into the operation and she never came out. My uncle, her brother, had passed away in an almost identical fashion. Both of them had a genetic abnormality where the collateral circulation in their brain is different. In both cases the brain started bleeding and there wasn’t a back up vessel and both left their operations… Continue reading →

It’s estimated that by 2030 most physicians will be employed for hospitals (source needed). This has major implications for autonomy. This can be a force of good driving doctors to follow best practices and keep patients safe. But it depends on what the health system keeps as a core value. Many systems still value finances above all else. No organization can function without but we should be careful to distinguish long term success with short term return. If a hospital system prioritizes short term return then it will force it’s doctors into shoddy territory: seeing a patient every 10 minutes, reading CT scans in less than two minutes, or making interns work without supervision overnight.

What is a physician to do?

It’s more important now than ever for doctors to use their voice to speak up for patient safety. For too long that voice has been fragmented advocating for higher… Continue reading →

Everyone knows the headlines, another innocent person killed, harmed, or nearly injured as a result of what appears to be negligent healthcare. A patient looks ill, pale, sweating, in great amounts of pain and is quietly bleeding internally while doctor after doctor walks by writing it off as an exaggeration. A nurse proclaims that a mistake was made during surgery and instead of being applauded she is slaughtered in front of her peers for questioning authority. I can go on and on. There are too many stories to share, all of them sad, none of them meaningless. Sometimes people get in trouble, other times it gets brushed under the rug and only in rare cases does the mistake go onto to change hospital policy. Since 1999, report after report have implicated medical error as a serious cause of death and injury. A lot has changed since then, and we know… Continue reading →