I have written about the support that a partner/spouse provides to someone living with cancer — with prostate cancer and for young adults with cancer — and I always include the partner in discussions about treatment choice or sexual difficulties.
But a number of my older patients are single, and their experiences …
Who said that the older years are golden? They seem pretty grey to me.
It’s a change in nomenclature that’s come a bit out of the blue over the last few years. The forces appear to be aligning to gradually push the word “doctor” out of the center and towards the periphery of health care. Whether we are talking about administrative communication or health care information technology order entry — it seems that we are no physicians or even clinicians, but we have all …
Why we need to stop calling physicians “providers”
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old man is evaluated during a routine examination. He feels well other than mild knee pain. He drinks six to eight cans of beer per night. He has no personal history of liver disease, but his older brother was recently diagnosed with hereditary hemochromatosis.
On physical examination, vital signs are normal; BMI is 24. He …
Test your medicine knowledge: 55-year-old man with elevated liver enzymes
I admit that on one level hearing and reading about the many complaints from physicians about the changes in health care that make their daily practice steadily less productive, less enjoyable and less satisfying along with insights into all the reasons why our system is dysfunctional is helpful in at least knowing my pain is widely shared.
Maybe it’s the simple act of venting that bonds us to some small degree, …
Why physicians face a leadership paradox
Most of us would agree that there aren’t enough valid and meaningful health care quality measures to guide patients’ choices of hospitals and physicians. While the federal government has steadily expanded the number of publicly available measures on its Hospital Compare website, it still falls short of what many patients, payers, and providers would like. This is particularly true in the realm of outcomes such as …
The ProPublica Surgeon Scorecard: When journalists become scientists
I want to share a recent anecdote from my clinic that highlights how patient-centered family medicine is cost effective and simply good care for patients.
I saw Mr. F, a 75-year-old gentleman. Like many of my patients, he has a history of high blood pressure and obesity. He also had a heart attack in the past as well as two additional stents placed in his coronary arteries. I was seeing him …
This is what patient-centered family medicine looks like
As a physician, you are required to have keen senses. Touch, smell, hearing, and sight are absolute necessities for most practicing physicians while we can only hope that taste is reserved for meals and non-professional situations. I recently returned from a week of vacation in the great outdoors and found myself wishing that I had more olfactory agnosia. Olfactory is a Latin adjective from olfacere that translates “of or relating …
The aroma of medicine can be found everyday in hospitals
Marissa Mayer, the CEO of Yahoo, recently announced that at age forty she is pregnant with identical twins.
Much of the current media attention has focused on how Ms. Mayer will run a $35 billion multinational technology company and care for three young children. Such concern makes a major assumption: that she will deliver two healthy babies at full term. From my perspective as a specialist who cares for …
Marissa Mayer sends a mixed message to working women with high-risk pregnancies
I have previously written about a patient on this site: “How elderly patients can be stubborn to their own detriment.” In that post, I discussed how the patient repeatedly turned down appropriate therapy for her hypertension, saying she didn’t need the help. Now I’m writing an update.
Due to the patient’s refusal to accept treatment for her hypertension, despite counseling on the part of her cardiologist and primary care …
A patient turns down hypertension treatment. What happens next is tragic.
Since 1921, the Miss America competition has ignited public debate. Typically though, the controversy doesn’t revolve around a contestant’s attempt to convey the positive influences nurses have on their patients. Contestant Kelley Johnson’s decision to perform a monologue for the talent portion of the Miss America program was a surprising departure from traditional acts generally showcased. Her recent appearance in scrubs and a ponytail prompted ridiculing banter between hosts on …
Nurses save more lives than opera singers
Toxoplasma gondii is a parasite that causes opportunistic infection in helpless people. It may have met its match. The cost of treating toxoplasmosis, a rare but extant infection, just shot up exponentially. Drug-resistant strain, you ask? Have physicians in infectious disease gone mercenary, you wonder? No. A change in ownership.
Daraprim (pyrimethamine) is a nifty drug that kills parasites. It’s been around for eons. I still recall its name from my …
Blame the system, not Martin Shkreli
My father suffered a massive stroke on a September night not long after his 83rd birthday. It left him conscious yet unable to talk and communicate, unable to swallow and almost completely paralyzed.
After numerous scans and other tests, his doctors determined that there was no chance of recovery. My father would never walk, talk, or swallow food again. With nothing more to do for him in the hospital, we — …
Terminal dehydration: A gentle way to die?
The physician community lost a member on November 18th, 2013. His name was Ben Bullington. And I’m sure that the vast majority of physicians don’t have a clue who he was. I had no idea who he was until about a month ago.
Dr. Bullington was a rural family doc. He practiced for years in Montana, in a town of less than a …
Being a musician made him a more compassionate physician
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A while ago, I asked an 8-year-old patient of mine what she wanted to be when she grew up. She replied, “I’m not sure because right now I want to be a doctor, a firefighter, and a teacher … so maybe I’ll do all three … I’m not quite sure.”
Uncertain about how to respond, I mumbled something like, “I don’t think you’ll have much free time.” Adulthood tends to make …
What’s happening in Syria is a conversation we need to have
An excerpt from How to Live Well with Chronic Pain and Illness: A Mindful Guide. Copyright 2015 by Toni Bernhard. Excerpted with permission from Wisdom Publications.
“Remembrance of things past is not necessarily the remembrance of things as they were.”
– Marcel Proust
For the most part, I’ve adjusted to my new life but, occasionally, I still catch myself engaged in distorted thinking about the past. I’ve taken to calling …
Beware of “Good Old Days Syndrome”
On the business side of health care, doctors are at a disadvantage. Because of their training, or lack therein, and native personality, they often fail to understand the realities of the market place, take confrontation personally and are suckers for an aggressive sales pitch. They feel that their motives are pure and because they sacrifice themselves and their families, over many years, they should receive respect and success. “I build …
For doctors to survive today, they need emotional intelligence
Part of a series.
PCPs in the current reimbursement model are obliged for business reasons to see many patients per day which, of course, means less time per patient. PCPs are frustrated, and patients are less satisfied. With less time, it is hard to build a strong doctor–patient relationship and without it there is less opportunity to build trust. Readers of my posts at KevinMD know that I …
Can an insurer actually improve the plight of the PCP?
Planned Parenthood is under attack, and certainly not for the first time. The organization, federally funded by the Family Planning Services and Population Research Act since 1970, provides a wide range of medical services to women (and men), including routine physical exams, STI screenings, contraception, and abortion. This latest movement against the organization gained traction following a series of heavily-edited videos from the so-called Center of Medical Progress, …
Why the the cost of Planned Parenthood is worth it
It’s been over a year since my older sister Anna died, so I choke up less readily while speaking about it. The raw anger is less, but the frustration of losing someone to a preventable medical mistake will always remain with me. Anna was five years older than me, my only sister, and the one I often turned to for advice. We were close despite living 600+ miles apart. She …
It’s time for health care to stand up to medical errors. Will we?
I always wondered what the saying “the apple falls so closely to the tree” meant. I never bought into the concept of similar cliché sayings of “like father like son” or “mother like daughter.” I viewed these ideas as being founded upon by poorly defined concepts of traits and inheritance. Such notions completely undermine the ideology of “I think, therefore I am” as coined by Rene Descartes. I maintain that …
Preventive medicine requires us to lead by example
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