A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Daily, and often several times a day, I am asked by patients about my role as a physician anesthesiologist. Occasionally the answer involves reiterating to patients that an anesthesiologist is a physician. Once we get into the discussion, patients are also surprised to learn that …
A primer on the anesthesia care team model
“Doc, can I ask you one more thing?”
These words are classic symptoms for those patients suffering from the “one more thing” syndrome. We’ve all been there. The visit has ended, your hand is on the doorknob, and you’re about to leave the room. Precisely at that moment, your patient stops you and says he has one more thing to discuss.
You think to yourself, “No! I almost made it out of …
One more thing syndrome: 4 tips for doctors to stay on time
A dozen set of eyes stared upwards. The nurses ate their pizza and glanced back and forth between me and the dry erase board that I had recently filled with incomprehensible scrawl. I had given this lecture many times and said the words over and over again. And yet the response was always surprising.
“Why do you think physicians get angry and …
Why do physicians behave badly? Maybe because they’re scared.
Medical errors are estimated to be the third leading cause of death in America’s hospitals. Though some of these errors are beyond physician control, many are the direct result of physician action and inaction. I spend a lot of time thinking about how to reduce these errors and I (like many of my peers) lose sleep over the mistakes I witness.
When you ask patients what quality is most important in a …
What is the most important trait in a doctor?
I’m a law abiding blogger. Laws are meant to be obeyed. If an individual opposes a law in a free country, then he should operate within the system to modify it. I recognize that even in free societies, certain laws are so unjust and in violation of natural law that that the citizenry may be justified in relying upon other measures to affect necessary reform.
I’m not suggesting that an unwelcome …
Law and medicine are more intertwined than they should be
Knowing what to do when faced with a sick patient is relatively straightforward. We learned a lot of it in medical school, picked more up by experience, and usually have the opportunity to look things up quickly on the Internet. Even when faced with a brand new situation, we can usually fall back on our general knowledge of science and medicine.
But in today’s practice of medicine, that’s not enough. Physicians, …
Welcome to the world of metamedicine
It’s a seductive idea. We doctors possess knowledge and experience which can not only help people, but can save their lives. We get opportunities to be the right person at the right time to offer the right help that makes all of the difference. It’s one of the greatest things about our profession. It’s also one of its greatest traps.
I’ve heard many doctors refer to themselves as “healers,” as if …
Doctors are helpers, not healers
Last week, I took a 6-day vacation. Two days before and two days after, I put in a total of 32 unpaid hours of work which was cut short by a call from my daughter asking me why I am working during my time off. While away with my family, I ran into people of different walks of life and noted …
Doctors still work while on vacation
Recently, when my parents came for a visit, our conversations led me to realize something important: I have been a doctor for more than 20 years, and yet my parents have no idea what my daily life is like. It then occurred to me that if they have no idea, then surely my patients have no idea either.
So, if you’re a …
Dear patient:
I am writing to inform you of some recent changes to my practice. These changes have been implemented to improve the quality of your care.
I will no longer be able to see you for a 20-minute or 40-minute appointment. These will instead be shortened to a 10-minute or 20 minute-appointment based on your stated needs. For example, if you just …
Dear patient: Your 5-minute appointment is awaiting you.
As many of you picked up from the tone of my last article, I am feeling much, much better. As more time has passed from the disasters of six weeks ago when I lost my relationship and home (making me feel more physically ill than I had felt this entire time), my body has finally had a chance to recover. I also have benefitted from a …
8 ways to better support someone dealing with cancer
Doctors spend their 20s and 30s studying while most of their friends are at parties and enjoying their youth.
Doctors may amass up to $500,000 in debt for the honor of one day caring for you and your family.
Doctors delay childbearing and starting their own families so they can care for your family.
Doctors miss their own kids’ ballet recitals and baseball games …
Why you should love your doctor
I really hate it when a nurse practitioner is called a mid-level provider.
“Mid-level provider” isn’t even a legal or academic term. It is slang developed to demean or minimize a health professional, who is not an MD.
The term “mid-level provider” is primarily aimed at nurse practitioners (NPs) as well as physician assistants (PAs) and midwives. It is insulting to health professionals …
Stop calling nurse practitioners mid-level providers
During my third year of residency I trained for and completed an Ironman triathlon. I’ve discovered, despite its growing popularity, many people have no idea what a triathlon is and often nod at me in hesitant approval when I talk about this particular passion of mine. An Ironman triathlon is a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run, completed in succession, all in one day.
And it happens …
Learning from and living the triathlon lifestyle
Imagine this: You are sick. You are the sickest you’ve ever been. You want to die. You almost did die. You want to bury your head in your cozy bed for the next two years.
But you’re not in your bed. This bed has plastic for covers and sandpaper for sheets. You need to throw up every thirty minutes but you have to share a bathroom with someone you don’t know, …
Do everything you can not to get admitted to the hospital
For days, I have been trying to get long-term patient, Stan, on the phone; his blood work came back abnormal, and we need to repeat it. I called the number in our file a bunch of times. The odd thing is that sometimes it rings without stopping, sometimes it is answered by a machine, which immediately beeps and disconnects, and at …
When patients yell at staff, they end up hurting themselves
I met Madelyn for the first time last month in clinic. Six months prior, she was an otherwise healthy 14-year-old girl. One afternoon, Madelyn’s phys ed teacher led a gym class aimed at completing fitness and health assessments on all of the children in the grade. One at a time, each child was asked to step up and onto a scale …
When school boards fancy themselves health care providers
Here’s a doctor’s health tip for patients that I’ll bet you haven’t heard before.
If you’re a patient who walks into a hospital for an elective procedure of any kind — surgery, or a diagnostic test — and you find out that Joint Commission reviewers are on site, reschedule your procedure and leave. Come back another day, after the reviewers have left.
Why? …
When the Joint Commission is at the hospital, leave
Taking call is the worst thing about being a doctor. There, I said it. But wait! What about medical malpractice lawsuits? What about dealing with patients’ suffering or dying either from their illness, or far worse, relating to decisions you made or procedures your performed? Certainly these are far worse events than being on call.
Granted. However, these awful events are part of …
Should doctors be paid overtime for taking call?
I got a letter the other day from a local urologist requesting clearance for a patient of mine to have surgery. The doctor wanted to know whether there were any contraindications, from the standpoint of the patient’s cancer, such as bleeding, infection or poor wound healing, which would preclude local anesthesia, bilateral incisions, sharp separation, ligation, and electrocauterization of the vasa …
A perfect thank you note to an oncologist
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