Since it strikes at the very core of what this blog is all about, I couldn’t pass up the opportunity to comment on Dr. Karen Sibert’s recent op-ed piece in the New York Times.
She argues that, especially given the current shortage of primary care doctors in this country, being part of the medical profession confers one with the moral obligation to serve and, as such, conflicting …
More likely than not, a physician or a dentist has at one point provided discounted or free healthcare services to some patients by waiving all or part of a fee or the copayment and/or coinsurance obligations as a “professional courtesy.” According to the Office of Inspector General’s (OIG) Compliance Program For Individual and Small Group Physician Practices guidelines, however, this practice may expose a physician to an investigation.
To be sure, not all professional courtesy discounts or free …
Here are 22 false assumptions, practice failures, and everyday clinical errors that we believe are common in modern medical practice:
1. Lack of appreciation of the phenomenon of physician persuasion and its hidden power. The placebo effect is scientific, potent, and worthy of use.
2. Lack of understanding of the power of prevalence or pretest probability in the diagnostic process, leading to frequent false positives and “overdiagnosis” of nonexistent diseases.
3. Lack …
I wear lots of hats. Over the years, I have developed analogies for most of the things I do and for the things I want my patients to do. Analogies help people conceptualize the complexities of medicine in a way that makes sense.
Today, I had my chef’s hat on. I was actually treating a young chef and found myself talking about food and medicine. There is a direct correlation. My …
As a physician recruiter of prominence, a number of times during any given week I get a fair number of calls from physicians in training who, honestly, should not be calling me whatsoever and I am very frank in telling them this. The call normally starts something like this:
“Hi Bo, my name is Dr. Doe. I am finishing up my dermatology residency and I want to be there in …
This is a difficult story to tell but if I am to be true to the complete experience of a surgeon, I do need to tell it.
One of my seniors used to say that every surgeon has a graveyard hidden away somewhere in the dark recesses of his mind. He went on to say it was unfortunately normal, so long as you remember all the names engraved on the tombstones. …
If you’ve ever been sick, especially with anything serious, you quickly realize that doctors, nurses and their ilk are an unusual and precious resource.
First you have to find smart people with personalities willing and able to put up with a lot of guff in the service of their fellow man. Then they have to be willing to (usually borrow, and) spend tens or hundreds of thousands of dollars for …
A long time ago, I was very close to becoming a cardiologist. Really.
Even though my fascination with ID and microbiology started in medical school — and believe me, not much fascinated me in medical school — the fact that all the top residents in my program were going into cardiology made me feel that somehow I should be doing this too. Plus, the guy who was Chief …
Early in my career, a local defense attorney working with my hospital would occasionally ask me to review a case in which another physician client of her firm was the defendant. As Medical Director of Evergreen Hospital Emergency Department, I was comfortable with hospital records, knowing where to look in a record for information – both recorded and not recorded – that either helps or hurts a case. I found …
Most of us who write about health believe that knowledge can make a difference. But is the primary health issue facing us today a lack of knowledge? Or is it, instead, something I’d call the tenth-patient-of-the-day challenge?
Here’s what I mean: You pick up a chart and head to Exam Room B, reading as you speed-walk. Your patient’s blood sugar is running high again, she didn’t show at the smoking cessation …
People blame anesthesia personnel for everything. You name it, they blame us for it. They call us by the umbrella name “Anesthesia” and if there’s a problem, it’s always “Anesthesia’s” fault.
Got into the room late? Blame Anesthesia. (Even though the anesthetist’s been sitting at the bedside for twenty minutes waiting for the surgeon or the nurses to be ready.)
Patient craving ice cream when she woke up? Must be Anesthesia’s fault.
No …
Someone has gone and rained the facts down on what is generally considered a feel–good story in American medicine, the dramatic increase in female doctors in America.
In response to Dr. Herbert Parde’s “The Coming Doctor Shortage” article in the Wall Street Journal, Dr. Curtis Markel pointed out that there is a difference between the raw, gross number of physicians in America, and the effective number of practicing physicians. Not only …
Patients want to know why they can’t get a return call from their doctor’s office – here are six reasons why the calls have increased and physician offices are having trouble meeting the needs of their patients.
1. Medication questions and requests for a prescription change. The average number of retail prescriptions per capita increased from 10.1 in 1999 to 12.6 in 2009 (Kaiser Family Foundation calculations using data from …
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The scene was picture perfect, an absolute characterization of a tropical island paradise. White deserted beach, overhanging palm trees, crystal clear, gentle lapping waters, and a blood red sun sinking slowly into a Fijian ocean.
I found no pleasure in it. Perhaps it was the heat, or that my new wife and I had been travelling for six months? Or that we had been on many other tropical islands and amazing places in …
Recently a good friend asked me to recommend an excellent primary care physician in New York City. When no one immediately came to mind, I asked a couple of doctor-friends who trained in New York. One friend, a cardiologist, gave me two names—one was a rheumatologist, who also practices general medicine, and the other an infectious disease doctor by training. My initial reaction to my cardiologist friend’s suggestion that …
Do you cringe when you hear the phrase “office meeting”? Some medical practices meet too frequently and some seldom meet, but others have it just right – routine meetings with preparation, an agenda, and follow-up. Your practice can get it right, too.
And make no mistake, meetings are important. Medical practices, regardless of size, have a variety of positions that are not interchangeable, but do interact throughout the day.
To make …
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Most psychiatrists and primary care physicians who work in corrections long enough will end up being named in a lawsuit or having a complaint filed against them with their licensing board. So, from a risk-management standpoint, is it worth the potential hassle?
Yes, in most cases I think it is.
It is a fact that physicians who treat inmates are at greater risk of litigation. I don’t have specific figures to give …
One of the skills I really wanted to learn in med school was how to suture. It’s just one of those things that I felt like you’re supposed to know if you’re a doctor. How can you be a doctor if you don’t know how to suture?Anyway, by fourth year of med school, I had totally failed at my goal. I had already done a surgery rotation, but while …
Perhaps you’ve heard the news: psychiatrists no longer have time to listen to their patients. It’s all about writing prescriptions for medications and the days of “tell me about your mother” are long gone, or so we’re told. The current perception is that large volume practices where patients are seen in a matter of minutes are now standard and acceptable in psychiatry; that it’s how many — if not …
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Erik’s wife had warned him many times, “Stay off ladders dear, leave it to someone younger.” Erik though was a pretty spry 72 years old and had been cleaning the gutters for many years. He had a sturdy 25 foot extension ladder, had years of experience as an athlete, and wasn’t about to slow down for no good reason.
It was an unusually bright crisp November day in Seattle, when Erik …
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