There are small moments of reflection that pop up in any given day that can affect how we approach our practice of medicine. Something at home affecting us at work, or vice versa. Like a Venn diagram, the two circles overlapping by just that slight amount at the center. One such recent intersection for me…
Comments closedWhen I first turned to writing as a method to cope with the stresses of my practice, I had no knowledge of the field of narrative medicine. In fact, I had been through 4 years of medical school, 3 years of residency, 3 years of subspecialty fellowship, and over a decade in the practice of…
Comments closedAs 2018 draws to a close, I want to end on a hopeful note. In this post I share how the era of immunotherapy, specifically immune-checkpoint-inhibitors, has changed the landscape of community oncology practice, by significantly extending survival rates in stage 4 (metastatic) non-small-cell lung cancer. I want to tell you the story of Joe.…
2 CommentsAn oncologist colleague once said to me at a funeral, “People assume that as oncologists, we understand more about death than other people. But we really don’t.” He then faced a church filled with mourners and delivered a heartrending eulogy. I’ve thought of his words often since. Every time I counsel a patient and family…
Comments closedIs the duty of the physician to capture the patient stories, or capture a billing code? In July 2018, the Centers for Medicare and Medicaid Services (CMS) proposed revamping Medicare payments for office visits. CMS plans to collapse Medicare fees for levels 2 through 5 office visits into a single price beginning in 2019, as…
Comments closedHello Readers. This week I am pleased to share a link to my latest narrative essay that I am privileged to have published in JAMA, in their popular “A Piece of My Mind” series. Entitled Making Room, it is a very personal piece for me, in which I have tried to write about doctor work life balance,…
Comments closedPost updated 3/13/19 Welcome to Episode 3 of The Prior Authorization Games: Where the Odds are Never in Your Favor. In which I chronicle more examples of how to fight insurance company denial of services. My latest and most flabbergasting interactions with the insurance companies when requesting “prior authorization” for necessary medical care for my…
2 CommentsUpdated 03/14/2019 In my first year of oncology fellowship, our program director asked us an eye-opening question: what percentage of people with cancer survived 5 years or more? At that time, in 2003, the little-known answer was 60%. Fewer than half of us fellows, physicians in a subspecialty training program to devote our careers to…
Comments closedpost updated 3/15/19 Adjuvant chemotherapy, what is it? This comprehensive post will break it down for you, with an easy to understand example included. One of the most common questions I hear as a medical oncologist from my patients at an initial visit is: “My surgeon told me she got all the cancer. So why…
Comments closedPost updated 1/20/19 Fighting insurance company denial of prior authorizations Greetings Readers. I thought I would try something new and start somewhat of a series. If you didn’t see my original post on prior authorizations, this link will take you right to it. Last week I found myself on the phone, yet again arguing on…
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