We are data druggies.
We spend our days like desperate junkies crawling the carpet, sifting through the shaggy strands of patient histories with shaky fingers in search of facts. Every word our patients utter we feed to the never-ending demands of the electronic chart.
We find a fact and we enter it. The database grows. Someone somewhere adds another question we are supposed to …
The electronic chart turns us into data druggies
Doctors and nurses said patients and their families created the largest obstacles to end-of-life decision-making in the ICU in a large survey published in JAMA Internal Medicine.
About 1,300 staff at 13 academic hospitals in Canada rated barriers to end-of-life goals of care on a 1 to 7 scale. Doctors and nurses considered the largest barriers to end-of-life …
Doctors and nurses need to be better trained in palliative care
The feminization of health care is fundamentally changing care delivery in the United States and it is doing so in ways that will accelerate the pursuit of improved quality and affordability.
Historically, health care providers and health care leaders have been selected for and nurtured traits that are traditionally seen as “masculine” — traits such as heroism, independence, and competition. Yet it …
The feminization of health care is here. And that’s a good thing.
At 3 a.m. last Saturday, I was feverishly devouring medical journal articles on subarachnoid hemorrhages (which I now know are a type of stroke caused by bleeding into the space surrounding the brain), trying to determine just how much I needed to be panicking about the health of a loved one. With every text message update from the rural hospital he …
Thank you health care providers for being on call
“Your wife has gestational diabetes.” My heart stopped when my wife’s physician called to tell me this. “I want you to tell her because it’ll be easier to give it some time and let it sink in. Tell her to call me if she has any questions.” But I had questions — about a million.
Let me give some background information. I’m …
A physician’s experience with a false positive test result
How is it that, in this day and age, a talented teenager treated for lymphoma emerges cured but with a life-threatening eating disorder? How is it that, in our nation’s capital, a boy dying at home from neuroblastoma experiences excruciating pain in his final moments? How is that, when we develop new drugs to treat children with cancer, we do not, at the same …
Pediatric palliative care: We must do more
We must be “brave, brave, brave,” as we exhaust and challenge ourselves to reconcile the disparities that exist in our country. These words, delivered by keynote speaker Bryan Stevenson at the 2013 Teaching and Leadership Development Summit, inspire me as I continue on my mission to help break down barriers that give rise to health challenges in our nation. Towards this end, I strongly believe we need to build a …
We need to build a robust army of physician advocates
I recall a talk on imaging biomarkers for Alzheimer’s disease (AD). “Take this with a pinch of salt. I have a financial conflict of interest (COI) in the success of these markers,” the speaker warned. I glanced at the audience — MDs and PhDs with a cumulative IQ higher than the French intake of wine. I looked for pinches. I searched …
The loud chorus against conflict of interest
Well, decision time was here and it looked as if Bill would choose surgery, and why not, with the doctors liberally throwing around the word “cure.'” The various tests Bill endured, breathing tests, echocardiogram and MRI of the brain, were all within tolerable ranges, we were told. The oncologist noted some marks in the brain that suggested mini-strokes, but Bill didn’t hear this or it didn’t register with him, or …
Surgery in a patient with schizophrenia. Did it affect decision making?
In the past, physicians were responsible for both the business and practice of medicine. While administrative personnel played an important and complementary role in practice and hospital management, physicians were the cornerstone. In comparison, today the leadership structure in medicine is now an entirely foreign landscape. Administrators dominate medical practices today and, according to the New York Times, …
Rise of the administrators: Hasta la vista, docs
A hospital can be full of discomfort. My patients tell me that the food is unappetizing. The beds hurt their backs. The noise echoing through the hallways at night makes it impossible to sleep. And for those patients near the end of life, the treatments being offered may no longer be of benefit, causing more pain than good.
The answer to discomfort for those who are very ill is comfort care, …
Comfort may be the most important thing that physicians can provide
Your First Patient: The opportunity to dissect a human body is a once in a lifetime opportunity. The cadaver that you will use for dissection was donated by a person who wished to make a contribution to your education as a physician. It is not possible to put into words the emotions experienced by that individual as he or she made …
The moment medical students discover a profound appreciation for humanity
Fifteen months ago, the Federal Drug Enforcement Agency, or DEA for short, began an investigation in four states: Alabama, Arkansas, Louisiana, and Mississippi. The DEA was looking for illegal drug trafficking, as they do. But they were looking for prescription drug dealers, not Columbian drug cartels. And they found them. They are doctors.
Forty-eight people were arrested, seven of them doctors. DEA …
It’s time for pain doctors to step it up
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There can be little doubt that these days that political correctness has run rampant. Terms like “racist,” “sexist,” or “homophobic” are thrown around so frequently and early now that one has to wonder what is actually being accomplished. If you were to ask a physician what PC label they most fear, it would be “disruptive.”
Let’s face it. We are no longer …
The day this physician was labelled as disruptive
“Only one rule in medical ethics need concern you — that action on your part which best conserves the interests of your patient.”
– Dr. Martin H. Fischer, German-American Physician and Author
“A physician shall, while caring for a patient, regard responsibility to the patient as paramount.”
– Principles of Medical Ethics, American Medical Association
“I pledge to pursue the practice of surgery with honesty and to place the welfare and the rights of …
The physician is the ultimate patient advocate
I take a deep breath as I get ready to go see Mrs. H. I can predict after sign-out from the ER doc where this is likely to go. Mrs. H. is an 87-year-old woman who comes to the emergency room with weakness. She stumbled and fell to the floor but could not get up to reach the phone to call …
Please, can this patient be just a little more sick?
Let’s get this straight. I am a penny pincher, who hates waste and wants a lean and efficient government.
But, that said, we have to face the fact that our massive privatization of what once were government functions has been a failure. There are some public services that get really loused up when done privately and for profit.
This is a classic mismatch …
Have we gone too far down the road of privatization?
I hear this fairly often: Women telling me they asked their GYN for an IUD and were told that they couldn’t because they had never had children. Their GYNs are wrong and unfortunately it’s not just a few who think this way.
A study from last year tells us that 32 percent of OB/GYNs think that women who have never …
What to do when your doctor says you can’t have an IUD
As a child and family therapist and as a parent, I often see the efforts that families make to try to maintain a sense of family connection in an era of technology, increased demands and very busy schedules. Most families express a desire for more quality time together and an increased sense of connection amongst family members. The medical families that …
How physician families can spend more time together
Swim season, sleepovers, and summer sports camps — many tweens and teens are asking about tampons. It’s time for a refresher.
1. It’s OK for her to use a tampon. Using tampons is normal and safe, even from the very first period. In other words, there is no medical reason that a young girl cannot wear a tampon. Using tampons do not imply “sexual maturity” or advanced sexual interest. Tampons are just another form …
7 things parents need to know about tampons
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