Physician

Beauty in surgery: Traction and counter-traction

Physician
April 11, 2013

Next in a continuing series.

Traction and counter-traction: along with maintaining excellent exposure, that is one of the fundamental principles of operating. It’s Newtonian: equal and opposite. In nearly all forms of surgical dissection, there’s a need for some pull in the opposing direction: tissues that are a little stretched-out, that are under some tension, fall open more easily when dissected. Plus, it’s a form of stabilization, another obligatory …

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A memorable introduction to the family

Physician
April 10, 2013

Although I rarely get sick with the numerous strains of “bugs” that seem to go around our community this time of year, the week prior to my return to work for my next scheduled string of four shifts was spent mainly in bed, coughing and aching and whining about how miserable I felt. Fully recovered, though, I was excited to return to the emergency department to do my fair share …

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The best doctors teach their patients

Physician
April 8, 2013

The Oxford English Dictionary (OED) identifies the first use of the term “doctour”, as the year 1303 AD, shortened to “doctor” in the 1557 addition of the Geneva Bible.  The OED first defines doctor not as a caregiver or healer, not as a science researcher or expert and not even as one with an advanced educational degree.  The OED, the world’s foremost English language dictionary, defines “doctor,” 700 years ago …

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Blaming others for their health problems helps no one

Physician
April 5, 2013

I inherited motion sickness from my father’s side of the family.  I can’t sit in the back seat of a car for more than 10 minutes without becoming sick.  I take meclizine before every plane flight.

I inherited asthma from my mother’s side of the family.  Exposure to perfume, 90+ degree temps with 90+% humidity, or even a good laugh will all prompt me to cough.

These two maladies of mine have …

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The only thing that truly separates doctors from nurses

Physician
April 3, 2013

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Academic Medicine, a journal of the American Association of Medical Colleges, has sent out a recent call for articles addressing the 2013 question of the year: “What is a doctor?  What is a nurse?”  Thirty years ago this would have been an absurd question.  Not only would it have been absurd for doctors and nurses, but for patients too.  Roles were …

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Are physicians more afraid of death than the general population?

Physician
April 1, 2013

The cavernous hospital amphitheater in Tel Aviv, normally used to screen videos and new surgical procedures, was illuminated only by tea candles floating in decorative dishes of water on a recent Wednesday in January. Hundreds of doctors, nurses and other medical personnel filled the seats, as usual. But we had not come to learn the latest life-saving technique.

Dr. Ofira Ben-Tal, one of Israel’s leading hematologists, had lost her battle with …

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Clinical pearls that you don’t learn during medical training

Physician
March 29, 2013

Al Franken, the humorist-turned-senator, once published a book that was titled “Oh, the Things I Know!” Indeed, by the time we reach parenthood, it is truly amazing what we keep up there in that attic of a brain.

Here is a brief selection of things about the practice of medicine that I have had to discover for myself or never quite figured out, including clinical pearls, aphorisms, dictums, platitudes, mysteries and …

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Where can doctors publish literary writing?

Physician
March 29, 2013

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There are many ways to write about health, medicine, and health care. And there are many people – patients, caregivers, policymakers, pundits, thought leaders, and health professionals – in a position to do so.

Fortunately, the world also offers a similar and growing diversity of places in which to publish this sort of work.

My focus today is more, well, literary.

I know the word “literary” often …

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Why coroners should fill out death certificates

Physician
March 27, 2013

I happened to read an article in the Columbus (Ohio) Dispatch where Ohio coroners are complaining because some doctors, including emergency physicians, are refusing to sign death certificates listing a patient’s cause of death. The coroners are concerned because they are being “burdened” with hundreds of extra cases every year that they must handle. And if other doctors don’t sign off on the cause of death, sometimes it takes two …

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8 reasons why your practice needs to stay open during lunch

Physician
March 24, 2013

Most professional business enterprises nationwide understand that they could never expect to compete in the marketplace if they shut down their phones 20 – 25% of important business hours every day. Yet that is exactly what your medical practice is doing if you are shutting your phones down for a “lunch break”.

You might be wondering how important can this really be for a medical practice? Can’t patients just wait an …

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Medical malpractice stress syndrome: The ignored side of litigation

Physician
March 21, 2013

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In March 2008, prominent Denver business owner Leslie Fishbein suffered cardiac arrest and died after receiving trigger point injections with bupivacaine for chronic neck pain.  Ms. Fishbein owned a chain of high-end furniture stores.  She was well known within the community because of her starring role in television commercials promoting her business.  Her death drew tremendous media attention and heavy scrutiny for …

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I’m a part time physician, and I’m not sorry

Physician
March 20, 2013

I began the medical school application process 10 years ago.  I was 23, single and most of my role models worked full time.  I had no idea that a part-time medical career lay in my future.  Quite a bit has changed since the days of hoping and praying and crossing my fingers for a medical school acceptance letter.   In the past 10 years I have, at varying times, declared …

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Questions to ask before your CT scan

Physician
March 18, 2013

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The United States is higher in its use of computed tomography (CT) scans than any other industrialized country. There were about 3 million scans done in the U.S. in 1980. By 2007 that number had risen to 70 million. A number of articles published in medical journals over the past few years have reported that excess radiation delivered by these scans will …

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Violence and severe mental illness: 6 questions to ask

Physician
March 17, 2013

Recently one of our readers posted this comment:

“If any Shrink Rapper ever has the time and inclination it would be interesting to read about what you would do to fix the mental health system, particularly the issue of involuntary hospitalization, if you had unlimited funds and political resources. You’ve been in the trenches, it would be great to hear your thoughts.”

Over on Peter Earley’s blog I see that …

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Doctors: Pronounce the names of your patients correctly

Physician
March 13, 2013

I have it on good authority that it’s not easy being green. But I’m willing to wager that it’s a whole lot easier when you have a lovable name like “Kermit.” Imagine being green (or brown) with a name like “Ramachandran”? Growing up with a name like mine certainly had its disadvantages. While most neighborhoods have a local bully who kicks ass and takes names, in my case, he would …

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Working in an urgent care center: An assault on the soul

Physician
March 12, 2013

I recently received this email message from one of my residents who has moonlighted in a local commercial urgent care center. This message is reprinted with his permission just as I received it, except I removed the brand name.

Hey Dr. Young, I’m looking for some basic mentoring advice.  I’ve been moonlighting at ZZZ Urgent Care for about a year.  Not my favorite work, but oh well.  I don’t routinely prescribe antibiotics …

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Let no broken hip go unfixed: When a surgeon fails to communicate

Physician
March 10, 2013

She was 94-years old with advanced Alzheimer’s. She thought it was 1954 and asked if I wanted tea. Not a bad memory for someone in a hospital bed with a broken left hip.

She’d fallen at her assisted living facility. It was the second time in as many months. She’d broken her collarbone on the previous occasion.

Over the past year, she’d lost 30 pounds. This is natural in the progression of …

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