Physician

Why doctors should attend residency graduations

Wes Fisher, MD

Physician

June 19, 2012

June in the United States heralds the month when residencies end and new ones begin. While much will be written soon about the dangers of entering hospitals this time of year (this story never seems to tire with mainstream media), I would like to step back and reflect on why doctors should consider attending residency graduations. I had the pleasure of doing so recently.

Excitement. With all of the dreary news of …

James Reason and the foundation of patient safety

Robert Wachter, MD

Physician

June 18, 2012

Professor James Reason is the intellectual father of the patient safety field. I remember reading his book Managing the Risks of Organizational Accidents in 1999 and having the same feeling that I had when I first donned eyeglasses: I saw my world anew, in sharper focus.

Reason’s “Swiss cheese” model, in particular – which holds that most errors in complex organizations are caused not so much by …

Marcus Welby, MD is still relevant today

Hans Duvefelt, MD

Physician

June 17, 2012

The year is 2012. A 58-year-old veteran Family Physician who has just finished a day with more human heartaches than clinical triumphs settles down among the pillows with his wife in front of his MacBook to watch a movie, delivered wirelessly over the Internet:

“The year is 1969. A 62-year-old veteran general practitioner who has just seen his health threaten to fail him, speaks passionately to a group of doctors about …

Does it matter if your doctor is board certified or board eligible?

Christopher Johnson, MD

Physician

June 16, 2012

Does your doctor have something on the wall that starts with “American Board of … “?

The terms “board certified” and “board eligible” are confusing to people not in the medical profession. It doesn’t help that more than a few doctors blur the distinctions to their own benefit. This post gives you a brief rundown of the distinctions at stake.

The first thing to understand is that anybody who has graduated from …

Clinician researchers meet the physician scientists

Vinay Prasad, MD

Physician

June 15, 2012

Recently our department of medicine grand rounds was on the subject of asthma. It began with a clinical vignette about a child with asthma, lasting three minutes, and, was followed by 47 more of intracellular cascades. The talk was like many others this year, and the speaker, who was introduced as a physician scientist, lived up to the part.

As someone who works in an academic hospital, I know many physician-scientists. …

Hide your health insurance status and pay cash instead

Dike Drummond, MD

Physician

June 6, 2012

It always has broken my heart to see a person bankrupted by the costs of their healthcare. I remember my outrage when I first learned the only people who pay full price for their medical procedures are the ones paying cash. Insurance companies use their market muscle and patient volumes to negotiate discounts for their patients that have always been unavailable to the uninsured, individual healthcare consumer.

If you have been …

The problem of conflicting professional medical guidelines

Juliet K. Mavromatis, MD

Physician

June 5, 2012

Guidelines for care increasingly help guide medical decision-making. If you’ve followed top health news over the past several years you’ve read conflicting statements about the utility of various medical procedures and tests. As a general internist I’ve devoured these reports with particular interest trying to wade through bias to formulate views that I believe will be of most benefit to my patients.

Recently I put together a talk about recommendations for …

How doctors handle fear will determine their ability to give care

James C. Salwitz, MD

Physician

June 1, 2012

There was a night when I was in training that all the decisions, disasters and chaos, which are the practice of medicine, caught up to me. In those dark hours, I felt practically despondent. What I had seen left me in tears and overwhelmed by the tasks in front of me.

At that moment a wise attending physician took a moment to sit with me. Rather than tell me how wonderful …

Patients are our best teachers

Michael Kirsch, MD

Physician

May 23, 2012

There are some patients we doctors never forget. They linger in our memories for various reasons. Often, it is their serious or unusual medical condition that stays with us. On other occasions, it is a zany or unique personality that we recall, even years later. Rarely, when the doctor-patient relationship becomes injured, then the patient may become unforgettable.

I remember a particular patient from 20 years ago for a very different …

Read more…

Patients are our best teachers

How we deliver bad news is critical to how families deal with grief

Kevin R. Campbell, MD

Physician

May 20, 2012

As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during my career. How a physician goes about this process can make an enormous impact in the lives of those affected by the news that must be delivered.

Precious little time is devoted to teaching this essential communication skill in the training of physicians today. I can remember back to …

Medical school and residency aren’t places for human growth

Paul E. Smith, MD

Physician

May 18, 2012

The end of my residency and beginning of my practice was the most wrenching experience of my life. I was woefully prepared for the transition. Full disclaimer: I was trained many years ago when residencies were acknowledged brutal demeaning processes. Things have changed considerably, but the psychological passage I endured still holds.

I think my process of becoming a surgeon was fairly typical, with the exception that there was no one …

The malpractice risk of volunteer medical coverage at sporting events

Shadowfax, MD

Physician

May 16, 2012

From Outside Online, an article about how physicians are increasingly hesitant to provide volunteer medical coverage at athletic events:

“Last year, 13 Americans died during running races, and another eight while competing in triathlons. While those numbers might seem troubling, the deaths are attributable mostly to the booming popularity of endurance sports—13 million Americans enter running races each year, and 2.3 million compete in triathlons. But the rising participation and the …

What does a perfect pediatrics practice look like?

Wendy Sue Swanson, MD

Physician

May 15, 2012

I had a phenomenal day in clinic yesterday. Imperfect for sure but inspiring, connected, and busy. I felt useful and like anybody else, that feels so good to me. Productivity can be defined in various ways and yesterday I fulfilled my personal definition. I wrote an email to a friend and cardiologist this morning where I said, “But I must say, it’s a sincere fortune to be a doctor some days. Yesterday …

Tips to improve your patient satisfaction scores

Donald Tex Bryant

Physician

May 14, 2012

Recently I was asked, “How can I improve my Press Ganey scores?” Presently this question applies mostly to hospitals as CMS is requiring hospitals to use the HCAHPS as a part of their quality reporting. Press Ganey can manage the HCAHPS for hospitals. Few physicians or physician groups presently survey patients for satisfaction; they should begin thinking about doing so in the near future as it seems likely that CMS …

Primary care requires more than knowledge

Tabor Flickinger, MD

Physician

May 11, 2012

“You are too smart to do primary care.”

I have heard this far too many times, directed at me and at others seeking career advice. There are many reasons for the shortage of primary care doctors in the U.S., but at least part of it is this. Smart, capable, successful trainees are discouraged from choosing primary care. It is perceived as a less prestigious pathway than specializing.

The knowledge base of primary …

No one told me that getting on with life after cancer would be so hard

Merry Jennifer Markham, MD

Physician

May 7, 2012

I met with a young patient recently, a woman who has been done with chemotherapy for lymphoma for close to a year. She was feeling well, and she had no symptoms of cancer, nothing that made her suspicious of a recurrence. After I examined her and reviewed her most recent CT scan and labs, I agreed. No recurrence. I wrote in my note, “NED,” the acronym for no evidence of …

How money influences our decisions as doctors

Ido Weinberg, MD

Physician

April 30, 2012

When you ask young medical students why they want to be doctors, you will probably get all sorts of answers. Some may say they like people and want to interact with them and offer them help. Some students will believe this is their calling. Others still may state they are intrigued by the scientific mysteries the human body is filled with. From my experience, not many medical students just starting …

When doctors are forced to accept malpractice case settlements

William Sullivan, DO, JD

Physician

April 27, 2012

Suppose your malpractice insurance company wants to settle a medical malpractice case against you – even though the case has no merit.

In many cases, insurance policy language may allow the insurance company to do just that.

In the 2011 case of Mohan Papudesu, MD v. Medical Malpractice Joint Underwriting Assn. of Rhode Island, the Rhode Island Supreme Court allowed an insurer to settle a case on behalf of the defendant physician …

Medical residents are abused more than Chinese factory workers

Anonymous

Physician

April 23, 2012

Medical residents have fewer labor protections than Chinese factory workers. While labor abuses at Apple’s factories make headlines, few people are as concerned about the lack of protections for doctors and medical students here in the United States. As a resident, I was subject to some of the worst abuses – intentionally misreported time sheets and gender-based discrimination – and after I complained, I was fired, so I sued the …

What separates a developed and a developing country?

George Lundberg, MD

Physician

April 22, 2012

How can you determine whether you are in a “developed” or a “developing” country? We used to call these latter “un- or underdeveloped” or “3rd world” countries, but those terms are no longer politically acceptable, considering the tinderbox of feelings about this topic.

If one objectively examines all 20 dozen or so of the world’s countries, a geographer would divide them into either north or south of the Equator. And if, …

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