It’s easier to fool people than to convince them that they have been fooled. Mark Twain   It is fitting that my final installment of this series has its focus on the last word of my title. Me. Pointing out corruption, financial or political influence, and bias arising from self-interest of corporations, institutions, and journals is important and true. It’s also a safe distance from looking at myself – my own implicit bias. Ultimately, I am the final arbitrator of what I accept as truth. And I can no longer lay claim to a defense that I did not know such conflicts and corruptions exist ..read more

It’s called “the green journal.” When I was in medical school in the 1970’s, it was the source most frequently quoted by faculty at OHSU. The American Journal of Medicine is the official journal of the Alliance for Academic Internal Medicine, a prestigious group of internal medicine department chairs at the top 125 medical schools across the U.S. In addition to its academic rigor, one of its primary stated aims is to enhance knowledge and improve effectiveness of public health interventions. On September 28, 2023, the green journal published a paper that was stunning. The focus was an analysis ..read more

New Year’s Day is the morning of the year. Like mornings of mere days, it inspires fresh hope, but on an immensely grander scale. We wake each morning, after a split second of eternity in sleep, relieved to find ourselves still here. We have once again spun around the earth’s axis, traveling 20,000 miles or more since yesterday, spinning day into night and then back to dawn. Without batting an eye or breaking a sweat, we have rocketed about a million and a half miles as we orbited the sun. All just since this time yesterday. And we’re going to do it all over again in the next 24 hours. Mysteri ..read more

Written By: Alyssa Emo DO/OB/GYN Having a scheduled cesarean section? Here's what you can expect.   You will arrive to the hospital about 2 hours before your scheduled surgery. The labor floor can be a crazy place at times, so the scheduled time occasionally gets pushed back if there is an emergent need for the Family Birth Place operating room (OR). Luckily this is pretty uncommon.   You will be checked in and brought to your postpartum room. There the nurses will admit you, go over your medical history, plans for baby (feeding, vaccinations, etc.), and get your labs and IV started ..read more

Written By: Elizabeth Oler, MD/OB/GYN I see women of all ages every day with various types of pelvic organ prolapse. Almost every time I meet someone for their first prolapse visit, they are surprised to hear that it is a relatively common issue, because it’s another one of those women’s health conditions that nobody talks about!     Sometimes, women are sent by a primary physician who notices the prolapse, and they don’t have any symptoms. Other times, women notice the prolapse themselves and understandably get really worried. But fear not! Although it ..read more

If you haven’t received the letter yet, it is in the mail. At least it will be if you are serious about providing good patient care. The intent of the letter is to intimidate. To threaten. And it works. Providers change their practice, blindly accepting the judgment, from someone they’ve never met, that they were doing something wrong. A judgment made by one far removed from the exam room, one isolated from the repercussions, someone who could never do your job. Still the letters pour in. From the Prescription Drug Monitoring Program Advisory Commission Prescribing Practice Review Subcommittee ..read more

Written By: Stacie Hanna DNP, CNM "Physiologic labor and birth is powered by the innate human capacity of woman and fetus. There is no unnecessary intervention that disrupts normal physiologic processes”. Let’s talk about what a physiologic birth in a hospital looks like: low intervention intermittent monitoring jacuzzi tubs birth balls freedom of movement eating and drinking in labor amazing nurses who provide bedside labor support until I can get to the hospital doula support availability if desired bringing items from home and signs of affirmation to make the space yours pushing and deliv ..read more

Over the past months, many new providers have joined Evergreen. I want to welcome each one. Each of you brings something unique, something special, something we need, to our group. All of you will add energy that can lift us toward our goals. Warren Buffet is a self-made multibillionaire whose personal wealth was acquired entirely within his lifetime. The story is told of a conversation he had with the pilot of his personal jet. "You must have more goals in your life than transporting me around”, said Buffet. The Pilot admitted he did. Buffet than gave him a 3-step process for prioritizing suc ..read more

It isn’t so much what we don’t know that gets us in trouble. It is the information we are certain is true, which turns out to be wrong, that creates the most harm. Ambrose Bierce, in the Devil’s Dictionary, defined this feeling of being positive about something as “the art of being mistaken at the top of one’s voice.” Medicine is humbling. A medical school attending physician at OHSU summed this up with his encouragement to remember “today’s dogma is tomorrow’s dog shit.” I will summarize 4 major studies in Cardiology that will challenge your assumptions about present day management. These stu ..read more

It takes courage. Because the injury often comes from colleagues or institutions who should have your back. A betrayal of trust. It hurts. Professor Michael Joyner from the Mayo Clinic boasts a named professorship, a distinguished investigator award, and continuous research funding from the NIH since 1993. He defines what it means to be an expert in his field of exercise physiology. Then he dared enter the space of ideas regarding transgender athletics. He was shut down from a direction that caught him unaware. It was his own institution. The Mayo Clinic. A place of medical innovation. A place ..read more