Physician

Mexico needs more pediatricians

Physician
March 21, 2012

Being a child in 21st century Mexico utterly differs from any other era. The last decade has been a constant whirlpool for Mexico. Political, cultural and economical changes have shaken the country to its core. Primary care physicians, particularly pediatricians, have a burdensome challenge at hand.

Problems like obesity have quickly emerged in all age groups. Obese children, childhood type 2 diabetes and sedentary lifestyles have invaded Mexican homes. Nutrition related customs …

Read more…

Does leaving against medical advice stick patients with a bill?

Physician
March 8, 2012

(All names and identifying features of characters in this story have been changed.)

Nora, a third year medical student, came to me in moral distress.

Ms. DiFazio, one of the hospitalized patients on her internal medicine rotation, was frightened to undergo an invasive (and expensive) medical procedure: cardiac catheterization.

The first year doctor with whom Nora was paired, Dr. White, vented to her:

“These patients come to us seeking our help and then refuse …

Read more…

Is it necessary for a doctor to examine you on each visit?

Physician
March 5, 2012

A tug-of-war is going on in medicine right now between the past and the future. The present is confused and very unsure of itself.

Though I could be writing about health care in the U.S and the looming Supreme Court battle over the new health care law, I’m actually raising a much more intimate issue: Whether your doctor touches (examines) you or not.

Many pundits have weighed in on whether the …

Read more…

Are anesthesiologists the last true generalists?

Physician
March 3, 2012

There’s been a great divide between the medical and surgical specialties ever since I can remember.   Surgeons believe internists perseverate too much when decisions need to be made.  Internists consider themselves the true intellectuals of medicine.  I suppose anesthesiologists like me fall somewhere in the middle–we work in surgery, but have to take care of all the medical problems the patient brings to the OR table.  Does that make us …

Read more…

Taking care of patients is a great honor

Physician
February 26, 2012

As my husband and I try and make a long term financial plan for paying off my almost $200,000 in loans from medical school, I sit here wondering, why did I pay 200 grand so that I can get peed on, pooped on, bled on, screamed at and sworn at? I’ve delivered a baby without gloves on (it was an emergency).  I’ve been kicked so hard I almost fell off …

Read more…

Doctors need to stop being so complacent

Physician
February 24, 2012

Four brutally honest declarations:

1. I can perfectly decide what is best for myself, my family, my patients, and my practice. I don’t need outside guidance telling me how to lead.

2. I decide what works best on my terms to practice the best medicine.

3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goals.

4. My goal is to make …

Read more…

Why maintaining a distance is necessary for doctors

Physician
February 24, 2012

You would think that for doctors, who work with life and death issues every day, the issues of our own frailties or the tenuous line between health and sickness for our own families would be, if not accentuated, then at least more immediate than to those who, say, do investment banking for a living. But the strange thing is that despite our easy familiarity with human mortality, it is not …

Read more…

Plastic surgery is part of the ENT surgeon repertoire

Physician
February 16, 2012

Do ear surgeons perform facelifts? Absolutely!

And we perform nose surgery and throat surgery, too!

A recent article in the New York Times presented a scathing editorial on complications caused by poorly trained surgeons.  However, the implication of the title “Ear surgeons performing facelifts,” is misleading and overlooks the fact that a large portion of training in the specialty of ear, nose and throat surgery includes plastic and reconstructive surgery of …

Read more…

Why an anesthesiologist would be needed for organ donation

Physician
February 13, 2012

I’ve only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case the heart had stopped beating. Death was clear.

Brain death is tougher to cope with, both clinically and psychologically. I imagine it would make anyone want to say, at some point, “Are you sure? Are you really sure? How do you know? How can you be sure?” Some times …

Read more…

5 ways to avoid a misdiagnosis

Physician
February 13, 2012

Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer.  There’s a tragic twist to the story: according to Fox Business News, Forstmann believes that for more than a year, he had been misdiagnosed with meningitis.

ABC News wonders, “How could such a misfortune befall a billionaire —- a man able to afford the best doctors, best technology and the most sophisticated diagnostic tests?”

They’re missing the point.  …

Read more…

Patients will understand an honest mistake if the doctor tells the truth

Physician
January 28, 2012

It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas.  I was assigned to a rotation in pathology where my job was to process specimens taken at surgery, dictate a gross description of the specimen and then place the specimens into the cassettes that would be used to make the permanent sections.  I was transferring a prostate biopsy, approximately 0.5mm x …

Read more…

Diagnosing an illness is an art

Physician
January 27, 2012

Diagnosis is the foundation on which all care and treatments rest.  If the diagnosis is wrong, most probably so is the treatment.  Diagnosing an illness is an art.  A diagnostician needs to be one part scholar, one part detective, and four parts artist.  He has to be a good listener, open minded, and capable of assimilating a large amount of sometimes confusing data into an accurate picture of a disease …

Read more…

Insider tips to surviving your hospital stay

Physician
January 24, 2012

Hospital stays can be traumatic for patients and their family members. I give you the top 10 ways to survive a hospital stay while maintaining your sanity.

10. Bring your own pillow. Trust me.

9. Bring a laptop computer or request one from the hospital. Hospitals all have free wireless these days and many will actually provide you with a laptop if you just ask.

8.  Bring an accurate and updated medication list …

Read more…

ADVERTISEMENT

Being treated like a celebrity when giving birth

Physician
January 24, 2012

Celebrity is an interesting phenomenon.

On a hot summer night in 1990, my chief resident and I were on call at Harlem Hospital. We were informed that a “guest” was coming to interview us. Hot, sweaty and looking haggard rather than glamorous, we wanted to choke our director when Spike Lee walked through the door with film crew in tow. Lee was there to film the infamous movie, Mo’ Better Blues. …

Read more…

Why the family meeting is important

Physician
January 24, 2012

“Are you saying, doctor, that mom’s not getting better?” Eleanor asked.

“I’m afraid so.” I replied.

“Someone should have mentioned this to me before.” she said, before returning her gaze to my shoes.

We were talking about Eleanor and Roger’s mother, Bertha, who had been hospitalized in our intensive care unit for three weeks. Bertha, 67, had been admitted with an exacerbation of congestive heart failure. Despite everyone’s best efforts, she’d steadily grown …

Read more…

How patients can remember their doctor’s name

Physician
January 8, 2012

“Do you remember my name?”

Like a broken record, I repeat this question again and again as I make rounds in the hospital. My patients’ universal answer, given with furled eyebrows and an apologetic look is “uh, no, I don’t remember”.

My response: “Don’t worry. It’s Dr. Tony Breu, but call me Tony.” Theirs’ (again with furled brow, but also a smile): “Oh, okay.”

In a busy teaching hospital, it is not uncommon …

Read more…

Requiring doctors to give orders on patients they have not seen

Physician
January 4, 2012

To meet Federal patient satisfaction goals, our hospital administration is requiring community based physicians to give patient admission orders before we have a chance to see the patient. Patients who self-refer themselves to the emergency department, are evaluated by the emergency room staff, and who are determined to require admission must be admitted by their community physician within 20 minutes of receiving a call from the ER staff advising the …

Read more…

Should healthcare providers hug their patients?

Physician
January 3, 2012

Imagine this scenario. You are a male health care provider and you complete an evaluation of a woman close to your age. You establish good rapport as you always do, she laughs at some of the same jokes you make with all patients, and she expresses delight that you are listening to her problems (unlike those other providers she says she has seen), feels you are helping her, and is …

Read more…

Advice for doctors who want to change careers

Physician
January 2, 2012

An interview by MedCrunch with Ashley Wendel, MA, CMC, PDC, a Physician Executive Coach and Healthcare Organization Consultant dedicated to helping physicians create meaningful and sustainable change that positively impacts their professional lives.

MC: Thank you so much Ashley for your time!

Ashley: Thank you, I’m really happy to share anything I can.

MC: You are a physician coach, what are the most common problems you encounter in your practice?

Ashley: Well, for many …

Read more…

What kind of shoes should you wear in the hospital?

Physician
January 1, 2012

I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet, which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me about this in my training.

What kind of shoes should you wear in the hospital?

There’s a lot of walking in the hospital, but there’s even more standing.  Running shoes don’t provide …

Read more…

236
pages