Physician

Pain control in a patient with rib fractures and a spinal cord transsection

Physician
June 1, 2011

When I was called to see the patient after a motorcycle accident I expected the worst. The patient sustained a thoracic spine injury with cord transsection at T5 level as well as significant chest wall injury on the right side.

Multiple ribs were broken; some with a significant displacement. Managing patients with a significant chest wall trauma could be a nightmare. Pain control is only one of the challenges.

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The legal issues of doctors and chiropractors working together

Physician
June 1, 2011

by Jeffrey L. Cohen and Albert R. Meyer

Chiropractors and medical doctors (or D.O.s) have had a long and somewhat complex relationship.

Though they approach healthcare issues differently, there are many instances where they share care or even work together.  Such “M.D./D.C.” relationships are legally complex, but often prove to be rewarding in many respects.  Properly constructing the arrangements is critical, especially since government regulators and payers tend …

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Should doctors be addressed by their first name?

Physician
May 29, 2011

I was sitting next to a resident in the preceptor room yesterday.  He was calling a patient to discuss lab results, and introduced himself on the phone by his first name and last name … but not with “Doctor.”  (e.g., “Hi, this is John Smith from the Family Health Center.”)

I occasionally see the residents’ patients for urgent visits.  When I ask them who their regular PCP is at the office, …

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The three most useful words for a doctor

Physician
May 26, 2011

Here are the three most useful words for a doctor: “I don’t know.”

A close second would be “I’m not sure,” another three that have got me out of trouble more times than I can remember.  The older I get, and more experience I have, the more useful it becomes.

Pattern recognition is essential in effective medical practice.  So often patient complaints are vague and nondescript, and in the absence of physical …

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How managed care caused the mental health care crisis

Physician
May 24, 2011

by George H. Northrup, PhD

No one becomes a mental health professional—in my case, a clinical psychologist—for the financial rewards.

With comparable (or less) education, far more lucrative careers exist in law, business, or other health care specialties.  Psychotherapy tends to draw practitioners who are fascinated by the mysteries of the mind and who find satisfaction helping others in distress.   Money has typically been a …

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Pros and cons of private or hospital owned practice

Physician
May 24, 2011

Private practices are organized in a corporate model where the physicians are shareholders, or where one or more physicians own the practice and employ other physicians or providers.   Private practices are almost exclusively for-profit.  Physician practices are organized into corporations for the tax benefits as well as protecting the owners from liability judgments.

Hospitals can be for-profit, not-for-profit …

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Transfusing a Jehovah’s Witness during surgery

Physician
May 13, 2011

I was in practice about five years and was about to do a radical nephrectomy on a patient.

I met with the patient and his son in my office and the son informed me that he and his father were Jehovah’s Witnesses and that he didn’t want his father to receive any blood or blood products before, during, or after surgery. I asked the father if that was his wish and he …

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Why the ophthalmologist and optometrist conflict should concern patients

Physician
May 10, 2011

If you need laser eye surgery in the state of Kentucky, or a little cosmetic work around the eyelids, it now behooves you to ask your prospective surgeon the following question before signing the operative consent form:

“Say doc, did you go to medical school?”

Kentucky joined the company of Oklahoma earlier this year as the second state to conflate optometrists and ophthalmologists. Only ophthalmologists are the sort of doctors who graduated …

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Physicians coping after a medical error

Physician
May 10, 2011

A failed treatment, a surgical complication, a medical error, a patient death. When the going gets tough, even the toughest clinicians should get help.

Physicians and nurses who feel personally responsible for a medical error or a patient’s injury face an immediate quandary—their next patient. In the midst of your angst and guilt, do you suck it up and soldier …

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Recovery may be predicted with a perception of the inner pulse

Physician
May 6, 2011

An excerpt from The Inner Pulse: Unlocking the Secret Code of Sickness and Health.

by Marc Siegel, MD

The Pulse of Recovery

People are like stained-glass windows.  They sparkle and shine when the sun is out, but when the darkness sets in their true beauty is revealed only if there is light from within.
–Elisabeth Kübler-Ross

The inner pulse can keep beating—loudly—long after doctors, researchers, and their monitors predict …

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The exhaustion of emergency physicians, and its toll on patients and family

Physician
April 26, 2011

When I advise students about how to choose a specialty, I suggest that they seek out advice from physicians who are at least 10 years out of residency and leading the type of life they hope to have in the future.

It is difficult, and perhaps impossible, to anticipate  in your late 20s or early 30s what practicing a certain specialty will be like when you are 40, 50, or 60.

Find …

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