One of the many things I didn’t know about breast cancer before I got a front-row seat was just how many choices it entails. I didn’t realize that so much of the experience wouldn’t have clear-cut, yes/no answers.
You’re confronted by your first choice before you even know you have cancer. When my mammogram revealed suspicious specks, I was presented the choice of a stereotactic or surgical biopsy. I opted for the …
A good screening test is relatively inexpensive and noninvasive. In addition, effective treatment should be available if the disease being screened for is confirmed. Lastly, detecting the disease before a patient becomes symptomatic must be more beneficial than detection after the patient experiences signs or symptoms.
The latter point is often debated in prostate cancer screening, which is done by obtaining a serum prostate specific antigen (PSA) and performing a …
Sports physicals are universally required in the U.S. on an annual or seasonal basis for students wishing to participate in sports. All states have requirements covering public schools. The reason for the exams is to ensure that the athletes can participate safely. These exams are not intended to replace a regular physical. There are no absolute standards for what should be included in these exams. Most would agree that …
Medically speaking, what’s a guy to do when there is no right answer? My patient’s solution is often to ask me what I would do given his particular circumstance. He isn’t happy when I respond with, “I truthfully don’t know.”
In reality, I always know what I would do. I’d gather knowledge, see consultants, and explore every possible option to its fullest. Then, most probably, I would still not be …
I hate the bouncy houses. I mean, I really hate them; I get a sick, nervous stomach when the boys are inside them. And it’s created a parenting perplexity for me. See the photo? I bet my HR is about 160 and my BP 150/90 (translation: high). I’m not kidding, I have a visceral and then flight-type response when the boys jump … it’s one of those instinctive parenting responses …
Over the past several decades, there has been a shift in the kinds of patients seeking medical care.
The progression has been from sick to early sick to well to worried well to worried sick.
The reasons are beyond the scope of this article. There is a subtle and hidden, but potentially very damaging, factor operating in the diagnostic process when large numbers of well people seek medical attention in a …
She was overwhelmed with grief when she walked into the room and saw her mother silently and peacefully dead in the hospital bed. Her death was expected, but as always, no-one is ever quite ready to let go. She started to wail loudly and speak directly to her deceased mother about the pain she was inflicting by dying.
She was compelled to hold her prayer beads and started to dance around …
Starting a new job can be exciting, a new challenge, while embarking on a new journey. I have the opportunity to meet many new fellow docs, staff, and kind patients. However, I have to admit that it is a tad more challenging in the beginning when starting a new practice from scratch. I do miss the familiar patient faces that knew me and trusted my medical abilities without question. But …
As a physician, and as an interventional radiologist, I consult with many patients. Similar to anyone who sees and talks with many people, I encounter a significant diversity of personality types, cultures and attitudes. One thing I have noticed is that each person has a certain level of expectation regarding their care, illness, and our potential interaction.
I have visited with many people who are simply happy to have someone …
Although filled to the brim with patients, hospitals were created to support doctors, not us patients. Historically, their organizational structure focused on doctors’ needs and doctors’ requirements. The concept of centering hospital care on patient needs and requirements is a relatively recent development.
How can a hospital switch from being provider-centered to patient-centered? Shifting such a complicated and cumbersome behemoth a full 180 degrees is a huge undertaking.
I believe it …
In early February, my new patient was a middle-aged woman from here in Silicon Valley with a self-discovered 2 cm right breast mass. Her internist was all over this. She quickly had a core needle biopsy, was evaluated by one of our breast surgeons, and was referred to me for an opinion regarding pre-operative (neo-adjuvant) chemotherapy. I saw her …
Simply put, habits are hard to break and bad habits like smoking, drinking, sedentary lifestyle and overeating are making our population sick. Who in the healthcare system can tackle these issues before they manifest into chronic disease?
Doctors are trained to diagnose and treat, but they aren’t trained to help people change their behavior, nor should they be since most physicians, particularly general practitioners, are already severely overloaded. Nurses provide …
Jackson’s blood pressure was low, and this had the emergency room physician scrambling, barking orders. A nurse was busy at each arm, attempting to place large-bore IV’s so that fluids could be given rapidly and thus improve the low blood pressure. Other nurses were preparing strong antibiotics for immediate administration. An automated blood pressure cuff was attached to the left arm, inflating every 3-4 minutes with a characteristic grinding …
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When working with a patient population with chronic and terminal illnesses, very often, stressful and difficult conversations take place frequently. Often the news is not good or not what the person wants to hear. Having the assessment skills and knowledge about how to read body language and react accordingly to manage the interaction in a positive way are important skills to have.
Here are 5 tips that can help you navigate difficult …
The nature of an average child’s free time has changed. For the past 25 years kids have been spending decreasing amounts of time outdoors. The time that our kids do spend outdoors is frequently a part of an organized sports activity. Other activities taking up our children’s time include indoor lessons and organized events such as music, art and dance lessons. Another big indoor activity, taking up to 7.5 …
I was getting ready for the day, my 2 1/2 year old was watching Sesame Street. In the show, the segments change every few minutes or so and seem to weave old-school 1970′s content (familiar to me) with newly created vignettes that have a modern feel and construction. I like it nearly as much as the boys. One of the stories this morning was about tooth fairies. An animated group …
Taking a trip to the grocery store can be more dangerous than you’d think.
Waiting for you in each and every aisle are marketing ploys aimed at suppressing your better reasoning, the ultimate result being you making poor dietary or financial decisions – whether you know it or not (enter the 100 calorie pack, my arch nemesis, right behind diet soda). But it doesn’t have to be that way – …
Sure you are comfortable with your current doctor, after all you are still alive and kicking. Besides it has taken you years to figure out what you can safely tell your doctor and when it’s ok to speak up.
Yes, the fact that your doctor is often late and never seems to listen to you bothers you just a little. You aren’t displeased enough to stop giving your doctor high Read more…
Over 1.5 million Americans travel abroad each year for medical procedures.
Services typically sought by travelers include elective procedures as well as complex specialized surgeries such as cardiac surgery, dental surgery, joint replacement, and cosmetic surgeries. However, virtually every type of health care, including alternative treatments, psychiatry, convalescent care and even burial services are available.
U.S. based healthcare providers have taken notice as have self-funded employers and health plans. The …
If someone asked me at this point in the year, which happens to be nearly the end of my first one, what I liked most about medical school, it would have to be the patient’s stories.
I could do without the hours of science classes and my utter lack of motivation to learn any subject that I am told is important. I could also do without the people who need …
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