Clinical

Arya Shah, MD Arya Shah, MD (2 Posts)

Resident Physician Contributing Writer

Brigham and Women's Hospital


I am a PGY-1 psychiatry resident at Brigham and Women's Hospital and a Class of 2018 graduate of the Mayo Clinic School of Medicine. In continuing to pursue creative endeavors, and in working to engage my classmates in the arts, I hope to show people that creative expression can help to keep burnout at bay and help to keep humanism alive in medicine.




We’re Ignoring a Key Factor in the Opioid Epidemic

In order for the country to make meaningful progress in tackling the opioid epidemic, we need a cultural shift in the way patients and providers think about pain.

Pharmaceutical companies and physicians are being demonized for their manufacturing and dispensing of opioid analgesics. Money-hungry executives from Big Pharma caused the crisis by brainwashing doctors to prescribe these medications left and right. Greedy doctors want patients dependent upon them for years, ensuring a steady stream of paying patients in their waiting room. Drugs drive the market. Drugs lead to big profits for everyone involved. The more drugs, the better.

Figure 1. “Relationship between System 1 and System 2 thinking.” Daily encounters lead to the activation of System 1 or System 2 thinking. Problems demanding higher levels of thought either directly or indirectly activate System 2. Repetitive exposure decreases the demand for System 2 thinking and increases both productivity and the risk for error.

Systems-Based Thinking: How Subconscious Thought Affects Medical Decision Making

System-based thinking describes a set of subconscious thought processes aptly named System 1 and System 2. The profession of medicine relies heavily on SBT — the ability to rapidly diagnose, treat, and improvise during stressful situations is dependent on these systems, which develop and mature throughout one’s training.

A Modest Proposal: There is No Substitute for Time in Medicine

Physician burnout has emerged as an increasingly concerning phenomenon in medicine. As high as 51% of physicians in a Medscape survey report symptoms of burnout. Doctors face higher demands with less time and support. Academic medical centers, which historically have been insulated from outside forces, are now seeing larger patient censuses, leaving less time for physicians to work through each patient’s case carefully.

Gabrielle Navon, MD Gabrielle Navon, MD (1 Posts)

Resident Physician Contributing Writer

Saint Louis University School of Medicine


Gabby is an internal medicine resident at Saint Louis University Hospital.