Question from a reader: “What are your feelings about when a patient breaks up with you? I love love my doc, but …”
Patients “break up” with me all the time. Well, not all the time, but it’s not uncommon. There are many reasons, some of which are under the patient’s control, and some which are not. Moving across the country is …
So you want to change doctors. Here’s how to do it right.
I’m a family physician in Eugene, Oregon — a sweet town where folks are pretty darn friendly. I still do house calls. Patients often surprise me with gifts. And nearly every appointment ends in a hug.
Kindness is contagious.
I like to return the favor. So every few weeks I celebrate “patient appreciation day.” I thank patients with balloons and chocolates. Why? For …
Did you forget to thank someone? It’s not too late.
In case you were wondering — robots won’t replace anesthesiologists any time soon, regardless of what the Washington Post may have to say. There will definitely be a place for feedback and closed-loop technology applications in sedation and in general anesthesia, but for the foreseeable future we will still need humans.
I’ve been practicing anesthesiology for 30 years now, in the …
Should I become an anesthesiologist? Read this first before you decide.
In the world of health care, we face a lot of questions and challenges. Hospital administrations across the country are grappling with these and always on the lookout for solutions. As far as raising the standard of health care quality, there’s been great progress over the last several years in the areas of patient safety, adhering to best practices, and trying …
Want to solve health care problems? Ask the right questions.
There’s a simple way to define value. Ask why we exist.
Imaging exists because clinicians are uncomfortable with uncertainty. Imaging exists because emergency physicians feel that being 98 percent correct about the absence of pulmonary embolism is not good enough. Radiologists exist because imaging is not an assay on a Western blot with a 100 percent accuracy. Radiologists exist because information is …
It’s time for radiologists to stop hedging
A patient undergoing a colonoscopy pressed “record” on his smartphone before being sedated, hoping to capture instructions from his physicians after the procedure. What he heard instead was shocking: “In addition to their vicious commentary, the doctors discussed avoiding the man after the colonoscopy, instructing an assistant to lie to him, and then placed a false diagnosis on his chart.”
The incident cost his …
A patient secretly records his colonoscopy. It cost this doctor her job.
In the last several shifts I’ve worked in the ED I’ve had more people stop and compliment me on my care. I’ve heard the usual, “Do you have a private practice?” compliment and, “I’ve been here a lot and you really took the time to hear what I was saying, I appreciate that.”
Kudos are nice. They are what makes a tough …
How to improve patient satisfaction in the emergency department
I have received many questions on this topic from medical students so I thought I would share my thoughts on choosing the right medical specialty for you. I hope you find this helpful.
1. Relax. The medical degree offers more flexibility than any other graduate degree. Even if you realize your selected specialty no longer fits you there are multiple areas your degree …
Med students: 10 essential tips to choose the right residency
Being related to a famous person is somewhere between a cruel joke and a minor distraction. My father was immensely talented and worked very hard at his writing, but the degree of his success was a fantastically unlikely bit of luck. There are lots of talented, hard-working artists who don’t make it.
The important thing in overcoming mental illness, whether or not …
A doctor shares his story about overcoming mental illness
Here’s a question for you: Which causes more deaths, motor vehicle traffics accidents or firearms?
I asked a bunch of people that question, including a bunch of doctors, and everyone said that motor vehicles did, by a lot.
According to the Centers for Disease Control and Prevention (CDC), in 2013, 33,804 people died from motor vehicle traffic accidents — and 33, 636 died from firearms.
They kill the same number of …
Which kills more? Guns or cars? The answer will surprise you.
Quintessential Messi. One moment he is standing over the ball, in a seemingly harmless position at midfield, the next thing you know you are picking the ball out of the back of the net. How did this come to pass? How did things change so rapidly? When you watch it the first time, it’s disorienting. It makes no sense. How does …
The physical genius of Lionel Messi, and how it relates to surgery
Desiree wrote in, “My 15-month daughter and a few other kids at her daycare were just diagnosed with hand-foot-mouth disease. I would like to hear how common it is, what treatments (or ways to soothe) you find helpful, and how you would differentiate this from measles or chickenpox. For example, my little one has blisters all over her body, not just H-F-M. …
My child has hand-foot-and-mouth disease. What do I need to know?
Recently I’ve been asked to write about rural surgery, what it’s like, what’s good about it. Everything has its ups and downs.
First of all let me say that whatever your job is, the money you get paid to do that job is for the crappy part, and every job has a crappy part. The trick is to find a job that …
What’s it like to be a rural surgeon? Read this to find out.
A recent series of articles in the Washington Post and a segment on NPR have caused quite a stir. The articles are about what we have called for decades shaken baby syndrome. It can be fatal. We now use the term non-accidental head trauma. This term replaced the older one because it is more specific; children can be …
The controversy about shaken baby syndrome actually isn’t one at all
As a little kid, I used to love the bedtime story about Humpty Dumpty and his fall from the wall. “Humpty Dumpty sat on a wall. Humpty Dumpty had a great fall. All the king’s horses and all the king’s men couldn’t put Humpty together again.” Until recently, I never thought about this story as a logical and sad analogy to …
Stop the Humpty Dumpty approach to health care
I am going to make a bold statement here. Are you ready for it? There is nothing wrong with health care providers thinking like businessmen.
I know what you’re thinking, but I feel the word “business” gets a bad reputation in medicine. We immediately associate the term with profit-hungry, egocentric individuals, a preconceived notion probably rooted in their unfair depiction in popular …
4 reasons why business and medicine go together
“Knowledge is power.” The words of Sir Francis Bacon still ring true almost 400 years later. For the most part, knowledge can provide the power to change lives, change communities and change the world. People born in adverse conditions can potentially improve their circumstances with a degree from higher education, and it is why the first college degree in a family …
For physicians, medical knowledge can be both a blessing and a curse
I have been exposed to many patient interactions during my first year of medical school. However, my first real patient interaction was when I accompanied my attending to a homeless shelter in downtown Phoenix. I can clearly remember being very excited the day before the visit to the homeless shelter; this was to be the first time I would actually interact with real patients. …
To a patient: Stay strong. Don’t lose hope.
Note: This case is meant to illustrate the potential negative effects of inappropriate imaging. It is not intended as a diatribe towards any member of the health care team. Really the only “mistake” made here was the ordering of the CT scan in the first place.
A 37-year-old woman presents to her local emergency department (ED) with a 4-hour history of heartburn …
How heartburn caused a patient to lose her left leg
I am presenting my startup costs here, to give some ideas for those providers who are considering starting their own family practice, or for those who say it can’t be done anymore.
To become a business, I spent $50 for the state LLC filing, and $12 for business cards. I already had my medical license and DEA from residency, so the only certificate …
I started a family medicine practice for $11,000. You can, too.
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