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Articles by Tracey O'Connell
Sham peer review (SPR): strategies for saving your career and soul
For an introduction to SPR, click here. For a history of SPR, click here. To learn how to distinguish real vs. sham peer review, click here. We don’t hear about SPR as often as it occurs because those who have experienced it have likely signed nondisclosure agreements or self-isolated in shame after being ostracized by an institution built upon helping others. Victims commonly blame themselves when it’s often their own excellence that led to the experience.
An open letter to my stepdad, who chose to love me
Tracey O'Connell, MD, PCC · Follow 6 min read · -- Dear Jim/Dad/Papa, I’m remembering today how you came into my life when I was 5. So funny that you’d been my father’s cardiology attending in medical school, only to begin dating my mom a few years after my parents divorced.
Legitimate vs. sham peer review (SPR): Is there a difference?
For an introduction to SPR, click here. For a history of SPR, click here. When summoned for a peer review, how can you tell if it’s a sham? The biggest clue is whether the peer review process seems intended to help or harm you. If you feel sincerely supported by colleagues and the peer review proceedings are uniformly applied throughout your practice, you have less cause for concern.
A retrospective commentary looking outside in on Inside Out 2
The rave reviews speak for themselves: See this movie! Like all things Pixar, the two Inside Out movies equally entertain and educate both children and adults. My excitement and enthusiasm for the sequel began about 6 months before the actual premiere. Once I'd learned that Dacher Keltner, a psychologist at UC-Berkeley and one of my biggest academic crushes, had been consulted in the making of the original film and the sequel, my educated and child-like parts grew giddy in anticipation.
Creating a subspecialty track for experienced hospitalists
A formal clinical track should allow experienced hospitalists to function as inpatient subspecialists: a so-called “focused practice in inpatient subspecialty.” This proposal makes sense on multiple levels. First, there is a shortage of inpatient subspecialists, particularly in small community settings. Hospitalists, qualified and certified as inpatient subspecialists, could fill this gap.
Sham peer review: Why is there no malpractice insurance for this?
It’s estimated that up to 10 percent of all peer reviews are “shams,” thus, it’s worth a few minutes of education so you’re not left grappling if you suspect you might be the target of one. As physicians, we purchase malpractice insurance (or it’s provided by an employer) to protect us from patients who file suits claiming negligence or harmful treatment decisions.
The sham peer review: a hidden contributor to the doctor shortage
Imagine you’ve worked in a clinical environment for an extended period. You might be a resident or fellow getting ready to graduate, an attending who has been operating for years, or a full-fledged partner in private practice. As your morning alarm sounds, you check your email and see: “Informal Meeting–Mandatory.” The content of the email is vague, but it seems you’re being asked to meet with several colleagues in your department to discuss your recent performance.
My relationship with Toby Keith
My heart broke hearing that Toby Keith died yesterday morning at age 62. Admittedly, I hadn’t thought about him in years. I didn’t know he’d been diagnosed two years ago with stomach cancer. I went on to read that he wrote a #1 song every year for 20 straight years. He was a prolific singer-songwriter and musician, a rare combo, much like Taylor Swift. He couldn’t help but write songs, about life, and love, and the world as he saw it. Like most celebrities, he was controversial.
Medical professional gaslighting: the lack of psychological safety in medicine
Toward the end of my third year of medical school, I was 25, newly married, and overwhelmed by responsibility. I hadn’t enjoyed the clinical rotations. The hours and the degree of human suffering were just too much. My husband and I fought about how unavailable I was. I had to complete my 6-week psychiatry rotation 3 hours away from home.
Who do we become when we love work too much?
On June 4, 2022, CNN.com published an Opinion piece written by Carolyn Chen: “Why ‘do what you love’ is the worst graduation advice.” As a mother of a recent college graduate, with two others close behind, I read it to garner insights into which encouraging words to use with my own babies entering the adult workforce. The target audience is college graduates, narrowing the relevance to those privileged to go to college or able to even consider finding one’s passion and making it one’s job.
What do we do with our sadness and anger?
When my boys were little, they responded to frustration differently. One would get angry, throw toys, yell, bite, refuse to cooperate. The other would become pitifully sad, appearing abandoned or lonely. The sad one received more attention because when we see someone who’s sad, it pulls on our heartstrings and evokes innate compassion. Seeing another in a low energy, low pleasantness state makes us want to reach out and offer comfort. It’s biologically programmed.
No one taught us the skills to cope with feeling bad about ourselves
In her book Daring Greatly, Brené Brown says, “If we want to be fully engaged, to be connected, we have to be vulnerable. In order to be vulnerable, we need to develop resilience to shame.” If you’re a physician who is “not good at being vulnerable,” then it’s likely you’re steeped in shame, but you’ll never admit it. Given the social capital that comes with being a doctor, it may surprise you to learn that we’re masters of shame.
What if the hierarchy in medicine was dismantled?
About a year ago, before the pandemic hit, I was at the local fitness center, having just completed a group exercise class, when my former residency program director entered the room. I hadn’t seen him in 20 years. He looked exactly the same, give or take a few grey hairs. We smiled and heartily greeted each other. We’d known each other since I was a medical student. When I did my rotation through radiology as a fourth year, he’d mentored me and encouraged me to pursue radiology as a career.
Long-term sequelae of a life in medicine
It’s a Friday in January 1997. Another two-week block of nights behind me, 75 hours a week with a weekend off in between.
Can physicians live wholehearted lives?
Brené Brown’s book, The Gifts of Imperfection, has recently been re-released with a new cover and subtitle: 10th Anniversary edition, Including New Tools to Make the Work Your Own. I’ve had my original paperback copy for 8 years. It’s dog-eared, highlighted in three different colors, with lots of hot pink Post-It notes sticking out of all sides. Brené has published five other books, yet The Gifts of Imperfection continues to be her biggest seller.
Despite struggles with my own mental health, I’d never exchange them for an ordinary existence.
What are you doing to take care of your mental health on World Mental Health Day? Tell me, is something eluding you, sunshine? Today, I’m listening to Pink Floyd for 2 reasons: 1. This morning, I did a 10-minute yoga flow with Denis Morton, who played Pink Floyd’s Us & Them. It set my whole mood on this cool, rainy day, comforting me and making me feel ridiculously alive. 2. It’s World Mental Health Day. I was 10 or 11 when I first heard Pink Floyd.
If you really want to make a dent in physician suicide, talk about your own feelings
September, National Suicide Prevention Month, is coming to a close. National Physician Suicide Awareness Day was September 17. What happens now that September’s over? All month, I’ve wanted to write this post. I’ve been hesitant because I’ve been grieving the loss of a dear friend who took his own life on August 30. He wasn’t even 50 years old. If you’d met him, you’d have never suspected in a billion years he was depressed.
A revolution in health care needs physician coaching
I know you don’t know me, but I feel like I know you from your transparency and radical honesty in all of your public communications. I know that you speak truth to bullsh*t while remaining civil. I know that you are more than aware of the lack of adequate mental health services across the nation. I know you see the catastrophic toll medicine takes on the mental health needs of health care providers specifically.
If you’re falling apart, should you still perform the pancreas biopsy?
Many radiologists choose the specialty because they don’t like interacting with sick people. As a highly sensitive person, I went into radiology to distance myself from patient suffering, as a means of self-protection. Radiology has allowed me to compartmentalize, sort of. It allowed me to have three healthy babies: one in residency, one at the end of fellowship, and one two years into private practice. I went back to work after six weeks of maternity leave each time.
Are physicians martyrs or models?
This concept comes up in Glennon Doyle’s new #1 best-selling book, Untamed. In this memoir, she looks at her unhappy marriage through the eyes of her daughter. She has been staying in the marriage for her children, believing that getting a divorce would be bad for her kids. As she is combing her daughter’s hair, she has an epiphany: I am staying in this marriage for my little girl. But would I want this marriage for my little girl? Am I a martyr or a model?
Vulnerability is challenging but necessary for health care professionals
As someone trained in Brené Brown’s curriculum for helping professionals, vulnerability is my jam. As a physician? Not so much. The COVID-19 pandemic has thrown already burned-out healthcare providers into the arena with more than just a shortage of equipment. We are now expected to risk our own lives caring for others, which was not part of the original job description. Medical providers are not Marines, nor do we work for the Secret Service; we never signed up to take a bullet for another.
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