When I was in residency, sexual assault exams were part of our training. We spent a lot of time learning how to ask the right questions, how to be gentle and empathetic, how to gather evidence appropriately and thoroughly.
While many hospitals now have SANE programs (Sexual Assault Nurse Examiner), I have never enjoyed the privilege of working with one of them. I have, for two decades, performed sexual assault exams on …
As much as I have given the “ologists” and other members of the dysfunctional U.S. health care system a hard time in previous posts, it’s only fair that I call out bad family medicine as well. I have a great example.
I recently saw patient who is relatively new to the area who had seen another family physician in my community. He is 39-year-old male, and his only significant potential health …
Since leaving medicine, I’ve been an entrepreneur and an independent artist. They are similar pursuits, and both have taught me about the experience of living in creative rather than reactive mode.
How do you know if you’re living in reactive mode? If you define and measure yourself based on external circumstances, and you believe you really are limited by what’s happening outside yourself, you are in reactive mode. Most of our …
Michael Davidson’s death was the result of a senseless act, and it has shaken our community to its core. We physicians are part of a profession that prides itself on healing and restoring lives, and it is difficult to accept an untimely and unjust death in any context. It is all the more incomprehensible that such tragic circumstances could exist as to result in such an irrevocable end to one …
As clinicians, we often forget or become desensitized to the image that society has of medicine and doctors. Alongside teachers and scientists, we are seen to be among the most trustworthy of professionals, yet our morale is low, with almost 50 percent describing it as “low” or “very low.” You can imagine, then, why I often describe medicine as a forest: …
I have to admit, I’ve been excited to see radiology slowly infiltrate into the mainstream of sports. Fifteen years ago, it was rare for the public to know when an athlete had an MRI. Now I hear people in the coffee shop saying:
“Man did you see Derrick Rose go down last night?”
“Yeah, we’ll just have to see what the MRI shows.”
We all accept that we can’t vote until we are 18 and can’t order alcohol — at least legally — until we are 21. We know that if we speed 60 mph in a 45 mph zone, we risk a traffic ticket or accident. We get used to these numbers and pretty much know the risks if we break them. However, the practice of medicine is becoming more and more …
My friend, Trent, is an auto mechanic. When he was growing up, he loved to work on old cars. He rebuilt his first one when he was fourteen — and drove it for 11 years. He loved finding problems and figuring out how to fix them. He never cared about getting rich; his goal was to make a decent living doing …
Loyal patients are the lifeblood of a medical clinic. And devoted patients are worth their weight in gold. It’s a lot easier to care for an established patient that lots of one-timers who never return. Beyond ease of workflow, the economic benefits are fabulous. A loyal patient panel will stay with you (and pay you) through sickness and in health …
Walking around the ER in Tiny Community Hospital, I had a few realizations. In medicine, we hold onto some things very tightly. We love tradition; we love the known. We don’t always know why, but we choose “the devil we know,” almost every time, no matter how pointy his horns.
For instance: “No cell phones.” First of all, has anyone ever seen a cell phone interrupt anything we do? No? Neither have …
In medicine, the seemingly simple questions become the complex ones.
“How’s it going?”
It is a question that is frequently asked whenever we encounter friends and acquaintances. In a given day, we ask this question many times out of courtesy and we expect to hear short, affirmative answers, such as “Things are good,” or “It’s OK” as we continue to walk to where we need to go since we are pressed for …
The Rübler-Koss model or 7 stages of grief is a series of emotional stages an admitting provider experiences when faced with an impending admission. The 7 stages are best remembered by the acronym DABDDAH, which stands for denial, anger, bargaining (or blocking), deflection (or delaying), depression, acceptance, and …
When I entered the profession of being a family doctor, like many aspiring physicians, I had a more altruistic vision of what it would be like. However, the reality of that picture over the last 10-years has resulted in frustration, disappointment, and, above all, the realization that health care has changed for the worse. It has become unaffordable for the masses and institutionalized for the benefit of corporate America, not …
In 2012, in a remote town of San Jose, on the southern part of Occidental Mindoro province in the Philippines, I met a little boy and his desperate, but courageous mother. The boy was just a few months past his first birthday. He was born with a facial congenital defect known as bilateral cleft lip, so commonly seen in …
“So, I told the doctor at the nursing home that I loved my father more than anything. Dad was my friend and the most wonderful man I had ever known. I wanted everything for him. But, I said, Dad was sick, weak, confused, and he never wanted to live like that. The next morning he was dead. That was OK by me.”
I once participated in a panel discussion about hospice, …
Primary care is a messy business. Nobody has just one simple problem, and no patient has all the typical symptoms for their diagnosis. Most don’t even tell us everything that’s going on. And most don’t follow their treatment plan completely. But this may be OK, since we often change our minds about what is right or wrong in the practice of medicine.
Knowing what constitutes success in front line medicine is …
The serious diagnosis is a polite middle-aged woman with a hopeful smile sitting on the side of the bed, with her husband in the chair across from her, as you carefully tell them what it means to have ovarian cancer.
The serious diagnosis is the teenager who just found out he has lupus nephritis — without any other signs or symptoms of lupus — and that he might be on hemodialysis …
In his State of the Union address, President Obama announced a precision medicine initiative “to bring us closer to curing diseases like cancer and diabetes.” The goal of precision medicine is to more accurately identify diagnoses and treatments based on a patient’s genetic information. This information will hopefully lead to better screening, earlier diagnosis, and more personalized treatment.
But it’s hard to imagine that patients will get this kind of medical …
In my last blog post I discussed how harmful physician “thought leaders” can be when they are dismissive of the value of other specialists’ care. I must have touched a nerve because a passionate discussion followed in the comments section. It seems that physicians (who spend most of their time engaged in clinical work) are growing tired of the leadership decisions of those who engage in little to no patient care. …
It is an oft-recited paradox that Americans like the men or women representing them in Congress while hating Congress as a whole. In fact, respect for Congress is near all-time lows. In what has to be seen as a bad sign for the medical profession, people’s attitudes towards physicians are beginning to look downright Congressional.
In 2012, in a remote town of San Jose, on the southern part of Occidental Mindoro province in the Philippines, I met a little boy and his desperate, but courageous mother. The boy was just a few months past his first birthday. He was born with a facial congenital defect known as bilateral cleft lip, so commonly seen in …
