A loyal reader alerted me to news of a lawsuit brought by an obstetrician in South Carolina who is suing a hospital for suspending his privileges. He had performed a cesarean section while sitting on a stool because he had a foot fracture secondary to diabetes. Several witnesses said that the doctor “had been unable to properly view the surgical field, …
I noticed that my writing and conversations with others convey far less emotion than usual. My reserve for tolerating stress had reached maximum capacity, which I realized upon my first day back at work from vacation three weeks ago as exhaustion immediately erased any sense of relaxation from my trip. Perhaps I should have requested two weeks off instead of one? Either way, …
I would think that when physicians decide where to set up practice, there are things that they would want to think about other than how much money they’ll make. Yet if one reads Medscape’s current list of the best and worst places to practice, it would appear that money trumps everything else (although Medscape said it also considered factors like “cultural attractions”). What Medscape apparently did not consider …
Teleradiology has the same effect on radiologists as Lord Voldemort has on Muggles. It’s the feared end point of the commoditization of imaging, with Rajeev in Bangalore outpricing Rajeev in Chicago for reading follow-up CTs for lung nodules.
But despite the fears of U.S. radiologists, their counterparts in India have more pressing things on their mind.
“U.S. radiologists think that Indian radiologists are …
Idioms are expressions everyone understands as something other than what the literal words say. For example, when I talk about “putting all of my eggs in one basket,” everyone knows I’m not really talking about eggs.
We say things like:
It’s raining cats and dogs.
It was a piece of cake!
I heard it straight from the horse’s mouth.
We have a few idioms in medicine, too. If I talk about “hanging crepe” in a …
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 …
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 …
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 …
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 …
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 …
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 …
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 …
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 …
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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 …
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 …
“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 …
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 …
The medical world has made terrific scientific and technological progress over the last century. Previously incurable diseases can now be treated as day cases, and patients no longer have to accept a paternalistic, one-sided relationship with their doctors. Hospitals too, have a come a long way if you look at pictures of what they used to look like in those old …
This cartoon is based on data from the 2015 Medscape Physician Compensation Report. Dermatology is on one end, internal medicine on the other. The other specialties in between. Doesn’t seem to be a trend between the cognitive and procedural specialities, which is a bit surprising. You’d think the latter would skew towards the “happiness” side.
Do you …
1. Due to intermittent monitoring versus continuous fetal monitoring which is standard in the hospital, the patient has increased mobility and a wider range of laboring positions/options: sitting, standing, walking, water, birthing balls. The American Congress of Obstetricians and Gynecologists (ACOG) has agreed that there is not a medical benefit to continuous fetal monitoring compared to intermittent monitoring in low-risk women.
2. …
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