I am infinitely blessed by The Girl Effect. As I look back through the generations of my family, I see it rolling toward me, through me like a wave.
I am sure it started even before my grandmother stole her parents’ car with intent to drive by herself from Austin to Chicago to see the World’s Fair in 1924; I just don’t have much history to work with prior to that. …
American Medical News published an informative essay by Kevin B. O’Reilly on December 13, 2010, about errors in diagnosis and why doctors make them.
According to Gordon Schiff, MD, associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, “The problem of diagnostic errors has gotten short shrift in the broader patient safety movement.” The article focused on …
The results of the application of reductionism in modern biomedical research and practice has been nothing short of miraculous, but while wondrous for some things, reductionism alone is incomplete.
The basic premise of reductionism is that by breaking down (or “reducing”) complex biological or medical phenomena into their many parts, one is much more likely to understand a single cause and devise a cure.
Historically, the invention of the microscope, the defining …
Just the other day I was called to see a patient coming up to the Intensive Care Unit with a diagnosis of pneumonia. Upon my arrival the patient is “hanging in there” with the blood pressure in the 60’ and 70’s systolic.
This is a no-brainer situation – the patient is in sepsis and septic shock.
Early intravenous antibiotics and aggressive resuscitation is what this gentleman needs right now. Per the ER …
I recently finished another 5-week clinical rotation. This one was primary care (outpatient internal medicine +/- family medicine).
First a few words about primary care as a field: I found it to be both awesome and boring.
It was awesome because I was the “doctor.” I had essentially full responsibility for my each patient. From calling him in from the …
Working as a psychiatrist is very rewarding. It’s stressful in a unique way, and some people may look at me strangely for having an unusual job. But overall I really enjoy it. Here are some of the aspects of psychiatry that I really appreciate.
1. Being trusted. Psychiatrists meet people when they are at their most vulnerable points, and we are entrusted with extremely …
If one of your patients asked your opinion of another doctor whom you know to be incompetent what would you tell your patient?
Incompetence in a physician is a scary thing! Doctors deal with problems of life and death and try to heal you with dangerous tools. A doc that isn’t competent can be seriously dangerous.
But how do you know who’s on their game and who’s falling down on the job? …
A decade and a half ago, when I moved to Memphis, I proudly hung a sign outside an office I shared with another doctor. It had my name followed by an MD. I had started my own small business as a solo practitioner in medicine.
Over the years, the practice has grown. I now have several employees and my own office, with the names of several other doctors alongside mine on …
Coverage requests get rejected when the requested service does not fit within an insurance company’s initial guidelines for approval.
This happens for a number of reasons, but usually it comes down to poor documentation or inappropriate care, or in some cases care that is appropriate but can’t be supported in the literature. When a denial occurs, the physician or patient has several opportunities to appeal this decision. The first appeal is …
One of the benefits, or aberrations, depending on your point of view, of the fee-for-service model is that we surgeons are remunerated for correcting our mistakes and complications.
At first glance this seems wrong. But perspectives differ, and when a doctor has to deal with serious, undeserved complications and is self-employed he deserves to be compensated adequately. So what really is the difference between the two?
A complication may be described as …
“I have bipolar disorder. Can I be a doctor?”
It’s one of those questions to which there is no real answer. Being a doctor takes a long time, it requires reliability, diligence, and a willingness to learn things you may not want to learn and do things you may not want to do. It requires endurance and passion. You need to be tolerant of many things: arrogant supervisors, irritable colleagues, sick …
It’s a bit ironic that pilots, the people who spend the most time traveling above the magnificent landscape that is our planet earth, spend very little time appreciating the scenery.
That’s because they are trained to always be on guard for unexpected emergencies. While the passenger in a jumbo jet traversing the continent can admire the majesty of the Rocky Mountains, the desolation of the Great Salt Lake or the endless …
A reader recently asked, how does someone find a good psychiatrist?
Stated another way, the questions are:
I typed the question “How do I find a good psychiatrist?” in Google and got almost half a million results from around the world. I find it hard to believe …
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Looking back, some of my biggest medical mistakes have been times when I was reactive rather than proactive when faced with a clinical problem. A doctor may have to be one or the other depending on the circumstances, but knowing when and which approach to take is one of the harder skills of medicine, taking time and experience to master.
What do I mean? Here are some examples from my field.
Treating …
I am licensed to practice medicine and surgery in Georgia. But that doesn’t mean I should, or that you ought to let me—at least not the surgery part. I’m actually pretty good at carving a turkey, but that’s pretty much the only kind of surgery that I’m qualified to do.
Don’t let the license fool ya, I’m no surgeon. So what, exactly, does a doctor have …
An excerpt from The Color of Atmosphere: One Doctor’s Journey In and Out of Medicine (Chelsea Green Publishing, 2011).
We all make mistakes. To err is human—unless you are a doctor. This is a lesson that began in med school. If something went wrong, someone else was to blame. Attending physicians blamed the residents, who blamed the interns, who blamed whomever else was within range—med student, nurse, patient. We gave …
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A common complaint about modern medicine is the depersonalization of the patient and the loss of compassion.
So let’s take a look at compassion.
Compassion is derived from the Latin “cum” (together with) and “patior” (suffer). From the perspective of clinicians, compassion is defined by two concurrent emotions: (1) a feeling of deep sympathy and sorrow for another who is stricken by medical misfortune accompanied by (2) a strong desire to relieve that …
One of my best friends in med school was an O.B. nurse. Though she has moved almost all the way across the country and I haven’t seen her since I was in school, we’re still in touch and expect to be seeing each other at last in a couple of months.
By some coincidence one of my best friends now is also an O.B. nurse. I’ll call her Ziva (yes, I …
The New York Times has jumped all over a couple of recent scientific articles asserting that certified registered nurse anesthetists (CRNA’s) provide equivalent care as MD anesthesiologists. Already, it is legal in 15 states for CRNA’s to dispense anesthesia without the overarching supervision of a physician.
Furthermore, a study from the Lewin Group in California has demonstrated that CRNA-only models of anesthesia provision are far more cost effective that …
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I was sitting on one of the hospital’s nursing units having a difficult telephone conversation. Anyone working nearby could have easily discerned the situation from my end of the call.
Patient’s family member wants to keep aggressive care going for a comatose, terminally ill family member against the best advice of the medical team.
Having never had to make such a decision in my own life, I am left to imagine how …
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