The ideal day in medicine without specialists:
9am: perform an EBUS
10am: knee replacement
12pm: admit a patient with acute hyponatremia
1pm: cardiac cath on a STEMI → triple vessel disease → convert to CABG
3pm: read a blood film for schistocytes
5pm: deliver a baby
I’m sorry, but I disagree with this decision. We seem to operate under the assumption that physicians are responsible for fixing every aspect of society, which is unrealistic.
First, we already have trained professionals in nutrition—dietitians. Yet we consistently underpay them and fail to provide adequate access to their services. While physicians receiving 40 hours of nutrition education isn’t inherently a bad idea, delivering the behavioral interventions required to meaningfully change diet often takes hours of patient engagement. In the current system, many physicians are fortunate if they can spend 5–10 minutes with a patient a few times per year.
The problem is not that people are unaware they should eat more fruits and vegetables. The larger issue is that the food system itself heavily subsidizes and incentivizes highly processed foods. Structural changes to that system would likely have a far greater impact than physicians repeatedly telling patients to eat more fruits and vegetables.
At some point, we need to acknowledge the limits of what can realistically be addressed within a brief clinical encounter. It’s all so exhausting.
everyone should feel bad for me cuz I’m so sleepy and have to be at work even though I’m soooo sleepy and kind and cool and beautiful and extraordinary 💔
Initially I was angry but now I want to thank Meaghan Oppenheimer for releasing me from what would’ve been a 10 year Tell Me Lies psychosis. My blood pressure thanks you deeply.