I really hate it when a nurse practitioner is called a mid-level provider.
“Mid-level provider” isn’t even a legal or academic term. It is slang developed to demean or minimize a health professional, who is not an MD.
The term “mid-level provider” is primarily aimed at nurse practitioners (NPs) as well as physician assistants (PAs) and midwives. It is insulting to health professionals …
During my third year of residency I trained for and completed an Ironman triathlon. I’ve discovered, despite its growing popularity, many people have no idea what a triathlon is and often nod at me in hesitant approval when I talk about this particular passion of mine. An Ironman triathlon is a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run, completed in succession, all in one day.
And it happens …
Imagine this: You are sick. You are the sickest you’ve ever been. You want to die. You almost did die. You want to bury your head in your cozy bed for the next two years.
But you’re not in your bed. This bed has plastic for covers and sandpaper for sheets. You need to throw up every thirty minutes but you have to share a bathroom with someone you don’t know, …
For days, I have been trying to get long-term patient, Stan, on the phone; his blood work came back abnormal, and we need to repeat it. I called the number in our file a bunch of times. The odd thing is that sometimes it rings without stopping, sometimes it is answered by a machine, which immediately beeps and disconnects, and at …
I met Madelyn for the first time last month in clinic. Six months prior, she was an otherwise healthy 14-year-old girl. One afternoon, Madelyn’s phys ed teacher led a gym class aimed at completing fitness and health assessments on all of the children in the grade. One at a time, each child was asked to step up and onto a scale …
Here’s a doctor’s health tip for patients that I’ll bet you haven’t heard before.
If you’re a patient who walks into a hospital for an elective procedure of any kind — surgery, or a diagnostic test — and you find out that Joint Commission reviewers are on site, reschedule your procedure and leave. Come back another day, after the reviewers have left.
Why? …
Taking call is the worst thing about being a doctor. There, I said it. But wait! What about medical malpractice lawsuits? What about dealing with patients’ suffering or dying either from their illness, or far worse, relating to decisions you made or procedures your performed? Certainly these are far worse events than being on call.
Granted. However, these awful events are part of …
I got a letter the other day from a local urologist requesting clearance for a patient of mine to have surgery. The doctor wanted to know whether there were any contraindications, from the standpoint of the patient’s cancer, such as bleeding, infection or poor wound healing, which would preclude local anesthesia, bilateral incisions, sharp separation, ligation, and electrocauterization of the vasa …
Nearly all physicians are now subject to patient satisfaction ratings. In my case, and many thousands of my colleagues across the country, it is via the survey tool sold to health care facilities by the Press Ganey Company. There are also many, many online sources that rate physicians.
The idea is a good one: Physicians should be subject to feedback from patients about patient perceptions of how good a job the doctors …
As a medical student I was in awe when a professor looked at a patient’s hands or nail beds and described their medical condition without taking a history. I was also enthralled by a TED talk by the best selling author, Abraham Verghese, where he described a lesson that Arthur Conan Doyle, author of Sherlock Holmes, learned as a medical student at the medical school in Edinburgh, Scotland from the famous physician …
When I first met Ralph, he was 82-years-old. He suffered from shortness of breath which started when his wife of 56 years was diagnosed with a rare bone cancer. Upon further investigation, I diagnosed him with a weak heart and a very tight aortic valve which required immediate surgery. Ralph made it; his wife died. Today, twelve years later, he brings me treasures from his metal detecting hobby on the …
In an effort to save on human resources costs, some hospitals have decided to make locum tenens* doctors and nurses line items in a supply list. Next to IV tubing, liquid nutritional supplements and anti-bacterial wipes you’ll find slots for nurses, surgeons, and hospitalist positions.
This depressing commoditization of professional staffing is a new trend in health care promoted by software companies promising to solve staffing shortages with vendor management systems (VMS). In …
I have long been a fan of the Case Records of the Massachusetts General Hospital, which is published weekly in the New England Journal of Medicine. For many years, I made a point of recommending them to medical students and internal medicine residents as a model of concise yet comprehensive case presentations.
No wasted words, no missing information, and none of the filler that trainees often added when they presented cases, such …
ADVERTISEMENT
Painful wait times at the doctor’s office. It’s an old story with few exceptions.
As a dad, I have to deal with many of the same issues of parenting that you deal with: sleepless nights , fevers and holding my kids down for shots (my wife did it once, I think, then she promptly retired from this job). However, waiting at the pediatrician is not something I have to do. So, I can’t truly empathize …
The very basic definition of a hospital is a place of healing and recovery. Health care is in a tumultuous state of flux at the moment, with the universal drive for quality improvement and the need to reign in costs. These issues, along with the desire to enhance our patients’ satisfaction and overall health care experience, were barely even talked about a decade ago. Now, they are all the buzz …
I would like to explain why Michael Kirsch’s article, “Why the ER admits too many patients,” is wrong, in all the myriad ways, in his contention that emergency physicians (EPs) admit too many patients because of improper motivations. Note that I am not going to argue that EPs don’t admit too many patients — that’s a legitimate discussion to have and there may be some merit …
ADVERTISEMENT
Every player in the medical arena has found itself challenged by conflicts where one’s self-interest competes can skew what should be pure advice. This issue is not restricted to the medical universe. Every one of us has to navigate through similar circumstances throughout the journey of life. If an attorney, for example, is paid by the hour, then there is an incentive for the legal task to take longer than …
The doughnut shop I pass on my drive to the hospital isn’t the kind of place where you might expect to see outpourings of random kindness. It sits in the shadow of a raised highway, a few doors down from a bail bond business and a block away from a prison complex that resembles a medieval castle.
One Sunday before Valentine’s Day, the line to get served there was long, checkered …
When I first learned to take care of patients in the hospital, as a third-year medical student, we used a mnemonic to help us remember what to order when a patient was first admitted. Patients would come in to the hospital from a doctor’s office or from the emergency room and the nurses needed a set of orders to know what to do for the patient. The mnemonic we used …
ADVERTISEMENT
There is, of course, stuff we can chew and swallow that isn’t food. Play-Doh comes to mind. As does Silly Putty.
My thoughts turned to those substances, among others, when my friends at Time magazine asked me recently to opine on the suggestion that junk foods should carry warning labels. My first inclination was: No, that’s too much. But then it dawned on me: Is anything that …
Get free updates delivered free to your inbox.
