Physician

10 things you might not know about the emergency department

Physician

July 22, 2015

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1. Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse.

Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to …

Why the Surgeon Scorecard is a journalistic low point for ProPublica

Jeffrey Parks, MD

Physician

July 22, 2015

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With much hype and fanfare, the independent investigative journalism outfit, ProPublica recently released their Surgeon Scorecard, assessing individual specialist surgeons who perform elective knee and hip replacements, spinal surgery, prostate surgery, and gallbladder removal surgery.

I had blogged about the impending release. My trepidation about the idea of a non-medical, non-scientific organization analyzing complex surgical data concerned issues such as …

There’s a good reason why doctors don’t send test results

Deep Ramachandran, MD

Physician

July 17, 2015

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Recently I read an article in the New York Times by Elisabeth Rosenthal. She’s the same author of the enlightening article, “My doctor charged me $117,000 and all I got was this lousy hospital gown.” That may not have been the exact title of the article.

Following that article she wrote a follow-up about the long and difficult ordeal …

A patient is angry with her emergency care bill. But here’s what she really got.

WhiteCoat, MD

Physician

July 17, 2015

Natalie Fuelner created a well-written article in the Bangor Daily News describing some of the tribulations many new parents go through with young children. One weekend, her toddler fell face first onto a metal patio table. Immediately, the toddler’s face is full of blood. The dad panicked. Natalie was a “trembling mess” on the inside.
Their physician neighbor wasn’t available to look at the child. …

A physician’s experience with a false positive test result

Justin Reno, MD

Physician

July 14, 2015

“Your wife has gestational diabetes.” My heart stopped when my wife’s physician called to tell me this. “I want you to tell her because it’ll be easier to give it some time and let it sink in. Tell her to call me if she has any questions.” But I had questions — about a million.

Let me give some background information. I’m …

Comfort may be the most important thing that physicians can provide

Amrapali Maitra

Physician

July 13, 2015

A hospital can be full of discomfort. My patients tell me that the food is unappetizing. The beds hurt their backs. The noise echoing through the hallways at night makes it impossible to sleep. And for those patients near the end of life, the treatments being offered may no longer be of benefit, causing more pain than good.

The answer to discomfort for those who are very ill is comfort care, …

The physician is the ultimate patient advocate

Kathryn A. Hughes, MD

Physician

July 13, 2015

“Only one rule in medical ethics need concern you — that action on your part which best conserves the interests of your patient.”
– Dr. Martin H. Fischer, German-American Physician and Author

“A physician shall, while caring for a patient, regard responsibility to the patient as paramount.”
– Principles of Medical Ethics, American Medical Association

“I pledge to pursue the practice of surgery with honesty and to place the welfare and the rights of …

A quiet day in the doctor’s office: And that’s the way it’s supposed to be

Rob Lamberts, MD

Physician

July 10, 2015

It’s been a very slow week in my office. Today we almost pitched a no-hitter, having only one patient come in toward the end of the day. Overall, we’ve been quiet in nearly every way: few phone calls, few patients stopping by, few appointments, few secure messages.

What’s wrong?

That was a trick question. This is exactly what should be happening when things are going …

The problem with medical TV shows. A surgeon sets the record straight.

Dr. Nikki Stamp

Physician

July 7, 2015

I never really watched medical shows, even before and during medical school. I watched maybe one season of ER, a couple of seasons of Grey’s Anatomy and House MD and maybe one episode each of Private Practice, Chicago Hope, Emily Owens MD and other random medical shows. The only medical show I made an exception for was Scrubs, because it was …

Poker face: The complex psychology of the patient-doctor interaction

David Jones, MD

Physician

July 6, 2015

Patient-doctor communication often has many facets, wrinkles, and twists. Medical school prepares a doctor minimally for the ups and downs of these patient interactions. There is no mannequin who can train each medical student how to deal with every personality, response, or even outburst by each patient. On the job training is sine qua non.

During and after medical school, it took …

There is no shame in honest work, no matter what the job description is

Erica McCaleb Camp

Physician

July 6, 2015

When my sister, Jessica, was a nurse anesthetist student at the University of New England, she had the opportunity to rotate at Johns Hopkins, and she seized it. She was young and fairly new to the medical world and so she did not recognize at first the name of the neurosurgeon with whom she would be working — Dr. Ben Carson. After receiving multiple comments from numerous people about how great it …

An inappropriate use of medical jargon: Words do matter to patients

Laura Withers, MD

Physician

July 6, 2015

My patient had suffered a terrible, crushing injury to his chest leaving many ribs and his sternum fractured, his lungs and heart badly bruised and his body on the edge between life and death. He was on a ventilator, the tube through his mouth into his windpipe pushed air into lungs that couldn’t draw for themselves. He was on constant medications for pain and to sedate him while we used …

Mad Libs for medicine. Do you think you can use these?

Edwin Leap, MD

Physician

July 5, 2015

Do you remember Mad Libs from when you were a child? A story is filled with blanks, and as you fill them in with inappropriate and ridiculous words, you laugh until you can’t see straight. You laugh until you can’t breathe, and your parents beg you to stop! Let’s be children again. Share these with the nurses, and give the shift a little levity.

Pain medication. You see, doctor, my pain specialist …

A physician enters rehab. What happens next should disturb you.

Anonymous

Physician

July 4, 2015

I’m a physician, and I’m adrift. I am pretty much lost at sea. I’ve often thought of writing this column, but afraid I’d be recognized, I’ve hesitated for years. Even now, I’ll most likely remain anonymous, because I’m in a vulnerable position. Let me preface my remarks with the reassurance that I’m not a bad person.

I developed dependence on opioids several …

The darker side of being a doctor

Joanne Intile, DVM

Physician

July 2, 2015

I recently read an article written by a human physician about her personal feelings and other people’s reactions to her decision to quit practicing medicine.

The author frames the article around how her choice was made after she recognized how detrimental her career was to her own health. The irony of a doctor abandoning her profession because it was causing …

Read more…

The darker side of being a doctor

Can a surgeon operate while sitting down?

Skeptical Scalpel, MD

Physician

June 30, 2015

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, …

A psychiatrist is burnt out and depressed. Here’s what she did about it.

Vania Manipod, DO

Physician

June 30, 2015

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, …

The best places for a doctor to practice: It’s more than money

Bob Doherty

Physician

June 30, 2015

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 …

Indian radiologists have more to worry about than teleradiology

Dr. Saurabh Jha

Physician

June 29, 2015

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 and axioms provide a glimpse into medical culture

Kristin Prentiss Ott, MD

Physician

June 28, 2015

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 …