Month: December 2015


Our nation is struggling to provide basic healthcare for all of its citizens for a variety of reasons. One of the simple reasons is that we’ve created a medical education system that simply is not producing enough primary care doctors for a population that grows older and more complex. Fortunately, at my current institution, we’ve set upon a path to try to help with this, through the development of a primary care track  in our Internal Medicine residency program. It’s exciting to help build something from scratch that will hopefully inspire some young physicians to pursue general internal medicine and provide excellent clinical care while tackling some of the biggest issues in healthcare today.

Advocacy is one of these themes that I hope will be a hallmark of our program. As generalists, we advocate on many levels. We advocate for our patients when they face terrible illnesses and uncertainty. When the healthcare system lets our patient down, we advocate for them to help overcome road blocks. We advocate for those that the political world far too often marginalizes such as immigrants, elderly, children and women. We also advocate for our own physician and healthcare colleagues against the powers that be that preclude our efforts to take care of our patients.

Advocacy is a common ideal amongst the intrepid medical student that too often gets lost as a result of accumulating student debt, burnout, lack of mentorship and the general rigors of residency. I’m hoping with our primary care track, we can reinvigorate these ideals and empower the next generation of physicians to keep advocacy an integral part of their career.

I never had any specific training with advocacy. I’m learning this on the fly. But the modern world has made this much easier for busy clinicians like myself. This blog, though it’s reach is small is a personal quest to advocate for issues I care about. Social media is a powerful tool that brings the world immensely close together. I can directly communicate with people who can help me make a difference. In fact today, I tweeted our local congressman @REPEBJ to hopefully ignite a relationship with legislators who can advocate and enact change at the government level.

I also found a tremendous amount of resources at Society of General Internal Medicine Advocacy to help bring this theme to our primary care track.

If anyone reading this has other ideas, please let me know! This is an exciting and important endeavor for us a program and the people of Texas!




Denying Healthcare

It seems like whenever I listen to politicians, it’s all about denying people something. Denying refugees a chance at life has been a big point of emphasis recently for many of these would be leaders.

In healthcare too, politicians and other influential groups continue to use their clout and biased selfish ideals to deny people a chance to be healthy and take care of their bodies. Recent iterations of our healthcare “System” promoted a for-profit scheme that emphasized quantity instead of quality of care, while denying access to care those who need it the most and are at greatest risk ; immigrants, elderly, children, minorities, the poor and women.

The adoption of the Affordable Care Act (ACA), though not a perfect solution, is finally pushing the needle towards a model of care that’s inclusive, focusing on quality and giving access to those at greatest risk.

Despite signs of early success, the ACA continues to take fire from bellicose politicians who want to tear it down for their own political gain. Other critical forms of healthcare access, like Planned Parenthood continue to be targets of both politicians and terrorists. It’s a national shame that women are being denied access to healthcare  by both the edge of a sword and the edge of a pen held by male dominated leadership.

As someone in general medicine, every day I see the tremendous importance of providing access to comprehensive healthcare. It is a place people come for the pure purpose of wanting to be a healthier contributor to society, devoid of politics, judgment, racial, religious or gender bias. I’m proud to be able to provide that. I urge all of our politicians to recognize how important this is and become leaders that focus on giving to their constituents rather than denying them healthcare.






Keep them out?

My blog was never intended to be about political discourse. It still is about me, medicine and my personal journey here. But this journey would not have been possible if 40 years ago the political climate on immigration was as toxic as it is today.

After the bloody civil war that gave birth to my native country of Bangladesh, a young educated Muslim man who escaped extermination, seized an opportunity to escape famine, post-genocide  political upheaval of his mother country to chase the American dream. It’s as genuinely American as any other immigrant story. With a few dollars in his pocket and a can-do attitude, my father came to New York and established a legacy as the Christopher Columbus of our entire extended family.

It’s that American idea of hard work and self reliance that led him to become a successful engineer in New York City’s department of transportation. He was responsible for the roads and bridges that people of all faiths, colors and ideals traverse daily in New York City. It’s the same roads and bridges that certain business men used daily on their way to becoming national political candidates. It’s that same infrastructure that came under attack on 9/11, just a few blocks away from his office. Covered in debris, he escaped the fallout, walking  for hours, side by side with people from all over the world. Once again, he found himself in a war zone, attacked by his fellow Muslims.

Through the  years, despite these experiences he remained a devout, pragmatic and moderate Muslim. It is a perspective that influenced my sister and myself but also the numerous family members he helped support and immigrate over the past 40 years. It is a family tree, entering it’s 3rd generation, littered with remarkable success stories defined partly by the fact that we are all Muslim, but just as importantly, as Americans dedicated to honor, community and service.

When we reflect on our family’s journey to this moment in time, we rarely contemplated the “what if” he had never immigrated. But now we do wonder with the myriad of immigration proposals being suggested that target specific people like Muslims. What if he had been kept out? America certainly would not be safer for it. America would have only lost a small but vital part of its soul.



IOS, Android and the battle for my #mhealth soul

The preamble story to this discussion is as follows.

My 3 year old son is quite adept at using my Iphone. He was more interested in my phone than the Macy’s Thanksgiving day parade. He was so engrossed in it, I had to physically carry him to the bathroom to take care of business. In that process, he accidently dropped it in the toilet. My phone was toast. I shrieked and cried (on the inside) while I had a  massive digital heart attack.

Now it’s decision time.

My initial instincts were to stick with what I knew and the Apple ecosystem that was flourishing in my home for the past 7 years. My wife has one. My kids use a 2nd generation IPAD  for their activities. I also use a 3rd generation IPAD mini for work and day to day activities. We even have our old Iphone 4’s in our kid’s bedrooms that play music and function as a sound machine for their sleep. We also have Apple TV’s for entertainment purposes. My wife and I also share a Mac desktop. This ecosystem has been working well, but admittedly has given me Apple tunnel vision and a general fear of  trying Android devices.

In addition, my interest in the concept of #mhealth has been growing recently. Specifically I’m appreciating  how remarkable smartphones are and their potential to  be a game changing element in healthcare.

In medical education, mobile devices like a smartphone gives trainees and veteran clinician’s access to real time evidence based information. Social media is a ubiquitous platform for networking, advocacy and expanding medical knowledge. There is a growing capability of technology to collect numerous forms of patient data with the smartphone being the fulcrum that processes that information and connects patients to their clinicians. #Mhealth is and can be so many different things. We are just scratching the surface of its immense potential.

With that in mind,  I’ve started a #mhealth interest group within the Society of General Internal Medicine. We will be meeting for the first time this spring and I look forward to collaborating with people want to explore this area further.

SGIM 2016 Annual Meeting

But it took my precocious son’s butter fingers to make me realize I’m only experiencing  half of the #mhealth world by avoiding Android devices. So with much trepidation but in an effort to be a more complete digital physician, I’m going to jump ship from Apple temporarily. I hope by the time the SGIM meeting rolls around, I’ll have a better perspective on the smartphone #mhealth world.

I’m already noticing a difference. I have so many different phones to chose from…

And what’s KitKat, Jellybean and Lollipop???