Doctors Tell All – And It’s Bad

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The recent article, “Doctors Tell All – And It’s Bad,” published in The Atlantic is confirmation how troubled our healthcare system is, with a new twist, how unhappy doctors are caught smack in the middle.

Meghan O’Rourke describes doctors’ difficulties, our system’s breakdown and the effect on patients’ care, outcomes and comfort. 

Some notable excerpts:

Without being fully aware of it, what I really wanted all along was a doctor trained in a different system, who understood that a conversation was as important as a prescription; a doctor to whom healing mattered as much as state-of-the-art surgery did. 

“Yet empathy is anything but a frill: not only is it crucial to doctors’ humanity and patients’ dignity, it can be key to medical efficacy. The rate of severe diabetes complications in patients of doctors who rate high on a standard empathy scale, Ofri notes, is a remarkable 40 percent lower than in patients with low-empathy doctors. “This is comparable,” she points out, “to the benefits seen with the most intensive medical therapy for diabetes.”

Medicine today values intervention far more than it values care.”

I long have been following the writing of doctors who have been themselves chronicling how care has gone missing from healthcare – Doctors Danielle Ofri, Sandeep Jauhar , Victoria Sweet, Rachel Naomi Remen. 

This is another worthwhile read to understand what’s really below the icecap.

Join the Big Blue Test movement

For the fourth year Manny Hernandez, founder of the Diabetes Hands Foundation, is making sure we experience the benefit of activity on our blood sugar – and as a result, getting diabetes supplies and insulin to children in need around the world.

The movement is called the BigBlueTest – and you can’t fail.  

Sign up here and this is what you’ll do: 

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Record your results on the sign up page above – and if you can spread the word. With 35,000 people taking the test, $35,000 will go toward life-saving supplies. And, you’ll see what a little activity can do!

Send your thoughts about living with diabetes directly to the FDA


Six days ago, Adam Brown, T1D and senior editor of diatribe, sent out a call to the Diabetes Online Community – to encourage people with diabetes to take a 5 minute survey. The survey results will go directly to the FDA and inform a groundbreaking patient=led discussion with the FDA November 3.

The event will include patients, both with type 1 and 2, representatives from the American Diabetes Association, JDRF and diaTribe. Presented, will be the numerous challenges we face every day – that’s what will be captured in the survey. Those insights will then be shared directly with the FDA.

Help us tell the FDA what matters to us and what we need, including what the biggest barriers to diabetes management are. This truly is an event where your voice will be heard and will count.

Immediately, numerous patient advocates in the DOC took up the cause to spread the word. Here’s a quick from the heart video appeal from  fellow advocate Manny Hernandez.   

How doctors get groomed

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In my last post, I talked about the patient filling gaps in healthcare. Dedicated to researching how we can help improve care for other people with diabetes, and how health care providers can be more empathetic and present with patients – what I see as critical to care for people who live with a chronic condition – I love reading books written by doctors that describe their world. 

I’ve already shared I’m a big fan of physician/authors’ Danielle Ofri and Rachel Naomi Remen and I’m currently reading the book, “Intern” by Sandeep Jauhar.

Jauhar describes his first year as a resident at a big city hospital. As he points out, efficiency and getting through rounds seeing patients is more important than any quality time spent with patients. It’s a stunning, shocking, eye-opening revelation how grueling medical training is, how little “care” is actually given patients and how the process all but completely trains empathy out of burgeoning doctors. 

Here’s are a few excerpts:

“By this point in my internship, I had already come to appreciate that there was a fundamental disconnect in the hospital. Good relations with patients weren’t rewarded; efficiency was, which meant focusing on the work at hand, operating with a kind of remote control, in front of computer screens and nursing charts and requisition forms, and on the phone. Face-to-face time was a relatively insignificant part of the job. The high counters around the staff workstation delineated not just a workspace but a type of kingdom, too. It might as well have been ringed by a moat…

If internship was supposed to stoke intellectual curiosity, I never saw it. Like me, most of my classmates seemed disengaged, mentally exhausted. With patient rosters of fifteen or more each, we were preoccupied with getting our work done. Anything that got in the way- even a bona fide medical mystery- was more often seen as a bother than a learning opportunity…

The worst was when you were alone with patients and you realized you knew next to nothing about them. They’d be on bi-level positive airway pressure ventilation or something, and you didn’t want to go through the chart to figure out why, but you felt guilty, so you hedged and read a little bit and learned a little bit, and read some more and discovered some more, and you realized how much you learned was dependent on how deeply you were willing to look, and what was pushing you was a sense of duty, but the cut was ill defined and couldln’t you just ignore it and go home? …

There was a constant tug of war between desire and duty: Your desire was to get the hell out of the hospital and have a life; your duty was to be a good doctor… If you did everything you were overwhelmed. If you didn’t you felt guilty…So I compensated by writing off-service notes, hoping someone on the next rotation would address the issues my team had ignored.”

As Jauhar writes as well, for all the work loaded on nurses’ shoulders without equivalent power, they are the force in a hospital who can make your life hell or tolerable. 

I find the book engrossing and it helps me to understand the fierce pressure, competition, opposing forces, desire not to show any weakness or ignorance and time constraints being a good, kind and caring medical professional costs in our healthcare system. It’s a sad and unfortunate revelation.