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Medical malpractice claims drag on too long

Peter Ubel, MD

Physician

August 11, 2013

I am very fortunate to have never been sued. That is not necessarily because of my amazing ability as a physician. I always practiced in Veterans Affairs medical centers, where my status as a federal employee meant I would not get sued by my patients. I also had an incredibly appreciative patient population.

But I know that most of my physician peers have been sued, successfully or unsuccessfully, at least once …

MKSAP: 19-year-old woman with progressively worsening diarrhea

mksap

Conditions and Diseases

August 11, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 19-year-old woman is evaluated for a 3-month history of progressively worsening diarrhea, abdominal pain, and weight loss. Her brother was diagnosed with Crohn disease at age 16 years.

On physical examination, temperature is 37.4 °C (99.3 °F), blood pressure is 110/65 mm Hg, pulse rate is 90/min, and respiration rate is 20/min. Abdominal examination …

Physician contracts and the female doctor

Linda Brodsky, MD

Physician

August 10, 2013

The healthcare workplace is undergoing profound changes. Where once a letter and a handshake were enough to create a life-long working relationship between colleagues, now the multiple work settings and relationships create many possibilities. Understanding not only how to get into the relationship, but also what might happen when you need to leave or are forced out of a relationship is critical.

True case report:

A woman internist arrives at work one …

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Physician contracts and the female doctor

Why a Miracle Whip advertisement is offensive

Dr. Charles

Physician

August 10, 2013

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I happened to see this Miracle Whip advertisement in a magazine left open by a patient in our waiting room, and I really found it offensive. Let’s dissect the ways in which this advertisement sullies the notion of food, and examine how far the concept of Miracle Whip strays from real food that should be enjoyed.

At the top of the page it …

More health information is not necessarily better

Jessie Gruman, PhD

Patient

August 10, 2013

Have you ever felt that claims about the effects of our access to new and more health information overshoot the mark? For example, you may be searching for help in understanding some ambiguous findings from diagnostic tests. Perhaps you think you are having troubling side effects from your new medication but then it may just be a reaction to something you ate last night. You may be hunting high and …

The demand apathy that doctors increasingly face

Jordan Grumet, MD

Physician

August 10, 2013

Monday afternoons are always the same. I pick up the kids from their grandparents. We drive home with their backpacks and a carton of home made food. We park in the garage, and carry all the contents of the car into the house. As the kids unload, I push the recycle container to the front for street pickup the next day.

Occasionally, I stop and socialize. Yesterday, I waited at the edge …

The very best physicians do not judge their patients

James C. Salwitz, MD

Physician

August 10, 2013

It occurs to me there are several keys to being an excellent physician. One must love science, enjoy hard work, have the courage to make tough decisions, carry a modicum of intelligence and suffer angst at receiving 94% on an organic chemistry test. In addition, the very best physicians, those we admire and to whom we flock, have a secret weapon. They do not care.

I do not mean that they …

MKSAP: 58-year old woman with fatigue and weight loss

mksap

Conditions and Diseases

August 10, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 58-year old woman is evaluated for a 3-week history of fatigue and weight loss. The patient has no significant medical history and takes no prescription medication, but she does take a daily over-the-counter multivitamin and a calcium supplement. She has a 50-pack-year smoking history.

Physical examination reveals a lethargic, ill-appearing woman. Temperature is 37.3 …

This was not a congenital deformity, but a preventable crime

Bhupesh Vasisht, MD

Physician

August 9, 2013

I started seeing patients the moment we arrived at Apollo Hospital in the small rural town of Bilaspur. There was no time to rest. These patients had been waiting for us for weeks to arrive. It was during this clinic time, on this day, that I realized something that really struck me to the core. I have been to India to do these missions many times. Heck, I have been …

To change health care, we need more physician leaders

Davis Liu, MD

Physician

August 9, 2013

There is a stunning gap between what we know and what we need to do in health care to make it more affordable, accessible, and higher quality. In a recent piece by NPR, research shows that when it comes to treatment of low back pain, doctors are prescribing more powerful pain medications (narcotics) and ordering more imaging tests like MRI and CT scans when there is no evidence these are …

6 tips to prevent being intimidated at the doctor’s office

Toni Bernhard, JD

Patient

August 9, 2013

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I’ve had my share of unsuccessful experiences with doctors and at medical clinics, including being intimidated by them. But after twelve years of chronic illness, I’m happy to report that I’m doing better in this uncomfortable setting. Here are six strategies to help minimize the odds you’ll be intimidated and to help ensure you make the most of the short time allotted …

Immunization workers murdered: The price of killing Osama bin Laden

Edward Pullen, MD

Physician

August 9, 2013

The price has been in lives. The capture and killing of Osama bin Laden occurred without loss of any U.S. military lives. It was hailed as a hugely successful special forces and intelligence operation. Still to believe that the operation was accomplished without the loss of life is both incorrect and naive. The lives lost have been those of polio vaccination workers murdered in the backlash against the use of …

My health care wish list if I were king

Bob Doherty

Health Policy

August 9, 2013

I think we all have fantasies from time-to-time what we might do it we were made King for a day (only benevolent kings, of course—no despots need apply!) What decrees might we issue to make the world a better place? What changes would we order to make our politics better? What improvements would we institute to make health care better? Well, here’s my (health care) list:

1. I would decree that every …

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My health care wish list if I were king

When a doctor offers to speak the language of medicine for you

Miranda Fielding, MD

Physician

August 9, 2013

These days they have navigators for everything. When we got lost back in the day, we used to consult a map, or lacking a map, we would pull in to the nearest “filling station” (what we used to call gas pumps) and ask for directions from the friendly young man who would appear to wash our windshield, check the oil and the tire pressures, and of course, pump the gas. …

Doctors need to place their families first

Neil Baum, MD

Physician

August 8, 2013

Several years ago I wrote an article for physicians on the topic of balance, and one of the suggestions was to place family first. There are two stories that I have learned since the publication of that article that I would like to pass along.

Balance in a doctor’s life is best achieved if there is balance between family and work. One of the best suggestions is to place …

Why family physicians are a threat to themselves

Paul D. Simmons, MD

Physician

August 8, 2013

In recent months, AAFP President Reid Blackwelder has been editorializing and debating what they see as the encroachment of nurse practitioners (NPs) and other “mid-level providers” (physicians are, presumably, “upper-level”) on the practice territory of family physicians (FPs). Dr. Blackwelder has repeatedly said that NP and physician roles are “not interchangeable.” The AAFP’s position on this issue seems to be resistance to the increasingly common decisions by state legislatures to …

A doctor’s attitude toward his older patients

Martha Deed, PhD

Patient

August 8, 2013

At first we thought it was funny when the doctor said, “Fatigue. That’s a tough one. At 75-years-young, your chronic conditions are catching up with you, sapping your energy.”

That was the end of exploring the presenting problem at my husband’s twice a year primary care visit.

On the way out to the parking lot, we said we’d like to be bugs on the wall when, 25 years from now, someone says …

Radical changes to how I think about care

Rob Lamberts, MD

Physician

August 8, 2013

A patient calls or emails me with a problem. I talk with them over the course of a few days, using whatever form of communication works best. Eventually, they need to come to the office to be seen – either for something needing to be done in-person (examination, procedure, or lab test), or because of the advantages of face-to-face communication. At the visit, I not only deal with one problem, …

Can prayer heal the sick?

Michael Kirsch, MD

Physician

August 8, 2013

Faith and reason entered my medical universe recently.

A patient underwent surgery to resect a colon cancer. The tumor had metastasized to the lymph nodes, an unfavorable prognostic event. The surgeon entered the room and advised the patient that her survival is likely limited to 1-2 years. The patient and her husband were devastated. The distraught husband spent the next 24 hours sobbing in a painful and despondent state. He related …

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Can prayer heal the sick?

Why I pray for my patients

Rajeev Kurapati, MD

Physician

August 7, 2013

We have come a long way in medicine, treating serious illnesses and preventing life-threatening diseases. As a hospital-based physician, I treat various severe diseases every day throughout the ICU, medical, and surgical floors. On a normal day, I roll at a fast pace — admitting, treating and, discharging patients has become fairly routine for me. On any given day, we have an …

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Why I pray for my patients

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