Would patients be admitted, or people be allowed to come to work, in a hospital that had Legionnaires’ disease spreading through its HVAC system or cryptosporidium in its water supply?
When there is an unusual smell associated with headaches and nausea in a surgical unit or emergency department, do people continue to work there and show up for their next shift as though this is status quo?
It had been a long gloomy Fall day. When I got home, all I wanted to do was climb into bed and sleep and sleep and sleep. Emotionally, I was spent after a long day at work. But my husband and I had planned to go to services at temple that night – there was a guest singer that comes once a year, and I love his music. So, with …
From the notes I read, it seems that other medical specialties limit “social history” to whether or not someone uses tobacco, drinks alcohol, or uses drugs.
“Social history” is meant to get a sense of the context in which people live. Where do they live? Who do they live with? How did they come to live there? Where did they grow up? What sort of work do they do? How much …
“Wow, cool case,” was the response from the residents in continuity clinic on Monday morning as I told them about a patient I had seen over the weekend at our main campus urgent care. Ironically, or maybe more tellingly, I thought the same thing; “that was a cool case.”
The “cool case” was a senior in high school who was eagerly looking forward to her college career but woke up with …
Editor’s note: If you or someone you know is in crisis, call or text 988, or chat at 988lifeline.org, to reach the 988 Suicide & Crisis Lifeline in the U.S. It is free, confidential, and open 24 hours a day.
Sometimes there are no words. Not even a eulogy.
Then one courageous family writes this obituary. (This obituary was written by …
Many of the everyday coalface problems we face in health care are simply due to suboptimal communication. It could be the patient or family member who doesn’t know what’s going on in the hospital, the nurse who is confused about orders, or the doctor who doesn’t understand the reasoning behind the seemingly terrible administrative directive they are receiving.
Take it from me, as someone who has seen health care at close …
It’s been 21 years since Drs. Robert Wachter and Lee Goldman, in an article in the New England Journal of Medicine, first described a new delivery model called “hospitalists” – clinicians whose primary professional focus is the care of hospitalized patients. Since that time the healthcare system has seen rapid growth of hospitalist programs across a variety of specialties.
Practicing medicine with all of its responsibilities often reminds me of a black hole. It seems each time something new is added it gets pushed into the vast vortex of the black hole, hidden from those around you and jumbled with everything you are expected to do.
People around you see the world as you present it. They rarely get a glimpse through the pinhole to the expansiveness that is beyond …
As the national opioid crisis takes center stage, I want to make a case for the authority of the family physician in managing and treating this problem.
I am a family physician and have been treating patients with opioid dependence and addiction for 12 years. These patients comprise about half of my practice. The other half is representative of a typical primary care practice. I have patients who have been treated …
Every morning when I log onto our electronic health record, one group of messages are from patients with their self-recorded health information data that they’ve sent to me for review.
Here’s my home blood pressure over the past 24 hours. Here are my fingerstick glucose readings over the past 24 hours. Here’s my weight over the past 24 hours. Here is my depression score over the …
When you tell anyone in health care that “sedation” to the point of coma is given in dentists’ and oral surgeons’ offices every day, without a separate anesthesia professional present to give the medications and monitor the patient, the response often is disbelief.
“But they can’t do that,” I’ve been told more than once.
Yes, they can. Physicians are not allowed to do a procedure and provide sedation or general anesthesia at the …
If you’re thinking about a career in medicine, there’s a piece of technology you’ll come to know intimately. It’s small and sleek, with excellent battery life and remarkable durability. It’s not an iPhone; it’s not a Pixel. It’s a beeper. You will come to know, and to respect, this tiny black rectangular prism. It will govern your life. You will be at its mercy, yes, but it also offers you a chance at salvation. …
Finishing my 38th year of internal medicine ward attending, I wish I knew then what I know now. I estimate the equivalence of at least ten full years of ward attending; I think this meets the magic 10,000-hour number. Hopefully, these notes to myself will help some newly minted ward attendings. The job is quite difficult and multifaceted.
Understand the various responsibilities of the ward attending
It’s just after six o’clock on a Sunday morning in December. The barn animals have fresh hay and warm water. My wife and the dogs are asleep. The cats are gathered around me as I sit down to write. One of them has jumped up in my lap and is pawing and clawing my jeans.
The fire is roaring in the wood stove, but the 1790 room is still cold. I …
I’m now walking the second mile in another man’s moccasins, and it’s no more enjoyable than my first mile.
Many doctors cringe when they see a chronic pain patient on their day’s schedule or at least certain chronic pain patients. Some of that dread isn’t directly caused by the patient but rather the deluge of third-party administrative demands: workman’s compensation updates, disability applications, insurance forms, lawyers’ letters, etc.
As I walked into the room, I see my patient lying in bed, eyes closed. His wife of 50-plus years sat in the recliner next to him grasping his right hand. The holiday season was upon us. My patient has spent the better part of the last month in the hospital.
His wife was staring at the pretty scenery outside with her weary, tired eyes. It had started snowing this morning. …
I majored in history of religion in college and have always had an interest in the places various twists and turns of theology can lead people. One relatively recent wrinkle is what has been loosely termed “prosperity gospel” or “prosperity theology.” It’s built upon the basic notion good things happen to good people, and bad things happen to bad people. Of course, that’s a foundational viewpoint of much of Christianity in the …
I am honored to be a member of the medical profession. Being a physician is a great job and a highly rewarding thing to do. One of the aspects that I like most, unlike so many other desk or number jobs, is that you can never go home in this line of work thinking that you haven’t done something good with your day (if you do, there’s something seriously wrong).
It was a busy yet mundane morning. I was returning to work after having a few days off. I commenced my day by perusing patient details while sipping on some coffee and reacclimating to the customary hospital cacophony. Some patients were critical, some ready to be released. It seemed like the usual assortment of diagnoses. Next, I reviewed my calendar and strategized an action plan for the day.
When President Trump slurred his words during a news conference this week, some Trump watchers speculated that he was having a stroke. I watched the clip and, as a physician who specializes in brain function and disability, I don’t think a stroke was behind the slurred words. But having evaluated the chief executive’s remarkable behavior through my …
