Monthly Archives: September 2018

The Pros and Cons of Needing Medication


Part of the reason this year has been so deflating for me is the need to go back on medications. Last year, I was able to get off all my medications and be prescription-med free for over 8 months. With this year bringing the challenges of worse and worse migraines, anxiety, acute on chronic pain, and weight gain which had led me back to pre-diabetes, I am now on more medication than I have ever been. 💉💊👩🏻‍⚕️
On the one hand, these medications have helped me in many ways. Especially with my anxiety, I just could not function anymore on my own without the medications. Before I was in a state of 24/7 panic attacks, and the biggest change I’ve had on the meds is that I am able to be calmer and sleep better for the first time in my adult life. It doesn’t stop the worry or the racing thoughts, but it has helped them significantly, especially the physical symptoms associated with my anxiety.

Why does it feel like such a failure to have to be on medications? I recommend and prescribe them for my patients every single day. I guess I’ve always had the attitude that I could overcome anything on my own. It’s humbling to know that it’s the true. For now these medications are necessary and are helping me to get my health back on track. In the end that’s what this has always been about. My quest to lose the weight and keep it off has never been about looking better, it’s always been about feeling better and being as healthy as possible. 💪🏻🏃🏻‍♀️👩🏻‍⚕️


Normalizing obesity and fat acceptance- is it a mistake?


I cannot get behind fat acceptance, or better stated in medical lingo as “normalizing obesity”. As a physician and as someone who has been obese or morbidly obese my adult life, I know first hand what it’s like to hate my body and feel ashamed of it. I still do this very moment as I type this, that’s something I have to work on. Funny thing is, I am much more understanding of my obese patients than myself, and I think my own struggles make me more empathetic. There is a place in which you can encourage people to lose weight without being cruel and judgmental.
I would never tell myself or any patient to accept that their body is destined to be obese and to just make the best of it. Just as I would never tell a drug or alcohol abuser to give up on sobriety. Obesity in this country, at its core, is caused by addiction to foods- to processed sugary foods and to lifestyles that are less and less active and more sedentary. There’s a reason we are now using naltrexone to treat obesity just as we treat our heroin addicts- it curbs the cravings. We are still learning more about why some people are more susceptible to obesity, and I hope in years to come research will continue to shine more light on the subject. In the meantime the vast majority of us obese people need to find our version of the winning formula that works: less calories in, more calories out.
I think the bigger problem this article is alluding to is bias against obese patients. As I’ve said before, that’s a real thing and a huge problem. It makes me sad to see how obese people are treated in this country; we are treated the same way that we treat drug abusers, alcoholics, smokers, and the mentally ill. No one chooses these problems. But I hate myself for being obese, so I can understand why other people would hate me for it, too. As everyone has seen the last two years, with a healthy calorie-counting diet and daily exercise an obese person can transform to one of (nearly) normal and healthy weight. But I harbor a dark passenger inside me that triggers me to binge eat and eat to the point of sickness. Do I consider that to be a personal failing and sign of weakness? Yes, yes I do. That’s the bias I bring against myself. Are there genetic factors that predispose me to these behaviors, I’m sure there are. In the end I feel like it’s up to me, and to my patients, to overcome what genetic factors we may have. And the good news is that if diet and exercise alone don’t help enough, there are medications and surgery that can. I want myself and my patients to feel healthy, strong, and capable. Being fat doesn’t make me a worse person, but it does make me less capable of living a long, full, healthy, and active life. So I won’t sign off on fat acceptance; I won’t normalize obesity. I will keep doing everything in my power to help myself and every one of my patients live our best, healthiest lives.

The Pay Gap- a Rude Reminder of it’s Existence Courtesy of a Sexist Doc

As we were all so rudely were reminded today, by the now infamous sexist Dr. Gary Tigges, a pay gap exists in medicine just like in all other fields. Looking back on the history of medicine, and of the world, it’s not hard to see how we got there.
Medicine, like any other scholarly pursuit, was dominated by men for several hundred years. Modern medicine, in the 21st century, saw the spread of medical schools and the numbers of licensed physicians increase dramatically. Women lagged behind men for decades and decades, until just the last few years. In the US, the majority of people entering medical school are now women. We will continue to outpace men in the coming years.
So why is there still a pay gap? Just like in other fields, the answer is complex. It starts with the fact that women historically have entered lower paying specialties like pediatrics, family practice, and psychiatry. Men have domineered the specialties that pay higher- namely any specialty where procedures and surgeries are performed. Women have faced discrimination getting into these surgical and more lucrative specialties for years, thus amplifying the pay gap, and are only now in the last 5-10 years breaking into them in record numbers.
Even when women get into the specialty of their choice, they still make on average 27% less than their male counterparts (source Doximity survey), which amounts to over $100,000 less per year. The usual reasons apply here: being punished for taking time off to have children, being seen as less dedicated to their jobs, having to call off due to childcare or family emergencies, women who negotiate for higher salaries are viewed as abrasive or demanding, etc.
So how can we end the gender pay gap in medicine?
1. Compensate non-surgical specialties with higher wages. Medicine has become a culture where “pay for procedures” has dominated for years. Let’s value traditional medicine by increasing pay for those who practice the bread and butter of patients’ care.
2. Salary transparency. Contracts for payment are so cloaked in mystery that we often don’t know how much our colleagues make. It is frowned upon to discuss salary, which only allows men to continue to earn more.
3. Encourage, don’t dissuade women from negotiating. Offer other benefits than salary- like flexible scheduling or extra vacation days to incentive women.
4. Don’t apologize for our success or undervalue our worth. Own your accomplishments! Get rid of “I’m sorry” syndrome of perpetually apologizing.
5. Finally make paid family leave a reality!!!!! It is a stain on our country that we have not enacted this in the year 2018.
6. Imbed affordable childcare into all our hospitals and doctors office. Childcare is often expensive and can be unreliable, let’s make it a no-brainer by having it available in the workplace.
And last- but most importantly- speak up and speak out! Don’t let your voice be silenced and use your vote to elect candidates who prioritize closing the wage gap!

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