The Institute of Medicine of the National Academies has released their long anticipated 500-page report, titled ,”Dying in America – Improving Quality and Honoring Individual Preferences near the End of Life.”
This is a critical addition to the ongoing conversation about health care in the United States and makes observations and conclusions, which we need to consider and understand. They conclude, as has been said before, that we waste precious resource’s …
Britain’s most prolific serial killer was a general practitioner (GP), Dr. Harold Shipman. He wasn’t England’s most famous murderer. That accolade goes to Jack the Ripper. The Ripper killed five women in the streets of Whitechapel. Shipman might have been responsible for over 200 deaths.
Shipman’s legacy to the medical profession was not just a permanent simmering of mistrust. He triggered the introduction of revalidation, Britain’s version of maintenance of certification …
My life changed dramatically when I started my new practice. The biggest change personally was a dramatic drop in my income as I built a new business using a model that is fairly new. That’s a tough thing to do with four kids, three of whom were in college last fall. OK, that’s a stupid thing to do, but my stupidity has already been well-established.
Recently, I wondered why Medicare could not control its costs using the investigative power of the federal government instead of releasing physician payment data and relying on journalists to do the work.
Two stories that appeared within days of each other raise a similar question about the private insurance industry’s methods.
The ear, nose and throat specialist who treated comedian Joan Rivers on August 28 has been identified as Dr. Gwen Korovin, a prominent New York physician who is known as a voice doctor to many entertainers and Broadway stars including Hugh Jackman and Julie Andrews.
With a physician who is an expert in airway anatomy at her side, and all the technologic …
I realized I was entering into a process the rules of which were entirely separate from normal human interaction when it hit me that news of the lawsuit was in the newspaper before anyone had had the decency to contact me. What kind of people act like that? Civilized behavior, respectfulness — in short, all the ways in which you’d think nice …
This is what I return to on my first day back from vacation.
Many of them were marked with a little red arrow, indicating a high-priority phone message.
Recharging with a little time off is a darn good thing, something we all need, and something which has been shown to help all of us be better at what we do. All of us, no matter what our jobs are. …
I have been following the progress of bedside ultrasound (using ultrasound as a diagnostic tool during my physical exam of patients) as it gets a foothold in standard medical practice since I first started learning to do it about 3 years ago. Every so often a study comes out which warms my heart as it proves that less (radiation, expense) is more in treating patients.
She was sick. Not sick like a high fever, body aches and a runny nose. Sick like she had spent the last half a decade in nursing homes as most of her internal organs failed. There was oxygen, and dialysis, and a colostomy. She propelled herself vigorously through the crowded halls in the custodial wing of the nursing home, her wheelchair a natural extension of her body thoroughly unhampered by …
If you are a physician like me who performs procedures, then rarely you will cause a medical complication. This is a reality of medical life. If perforation of the colon with colonoscopy occurs at a rate of 1 in 1,500, and you do 3,000 colonoscopies each year, then you can do the math.
Remember that a complication is a blameless event, in contrast to a negligent act when the physician is …
“Mr. Jones’ chest x-ray looks normal,” the intern said to me on morning rounds.
Mr. Jones just had a transhiatal esophagectomy (THE). The esophagus is the muscular tube that connects the back of one’s throat to their stomach. It can develop cancer or become completely dysfunctional because of benign processes, and therefore need to be removed.
A THE involves cutting out the patient’s esophagus, in Mr. Jones’ case for cancer, bringing the stomach up …
Not accustomed to visiting hospital executive suites, I took my seat in the waiting room somewhat warily.
Seated across from me was a handsome man in a well-tailored three-piece suit, whose thoroughly professional appearance made me — in my rumpled white coat, sheaves of dog-eared paper bulging from both pockets — feel out of place.
Within a minute, an administrative secretary came out and …
The Affordable Care Act (ACA), commonly known as Obamacare, increased the availability of FDA-approved contraception to women through cost-free coverage under the contraceptive mandate. With the exception of some religiously affiliated insurance plans and employers who are legally exempt, this mandate supports women’s access to comprehensive reproductive health care, including the most effective forms of contraception. However, an integral part of family planning was left out of the legislation: contraceptive …
It was my first day at my new job, practicing a new specialty. Having spent fourteen years as an ICU physician — including a four-year pulmonary/critical-care fellowship in this very hospital — I had just completed a palliative care fellowship. Now I was the hospital’s palliative care consult attending.
When I set eyes on the patient in room 1407, my first thought …
“All your patients will die. Maybe not today, but someday. The defining fact of life is that it ends. Only a fool would dedicate their career to fighting something that can never be beaten. Therefore, a doctor’s task cannot be to fight death. A doctor’s task is to heal when possible and prevent suffering always. Our calling is to support life. Fighting death may deprive patients of the opportunity to …
If I were punched by an unknown man in an elevator there would be little doubt that my assailant would be prosecuted. If the trauma were enough to cause me to lose consciousness, meaning I suffered brain trauma, my attacker would likely be charged with aggravated assault. No one would be surprised if he received jail time. No one would think twice if he lost his job. However, if I …
A thirty-five-year-old female presents to the emergency department on a weekend afternoon with the following chief complaint: “I want to give up custody of my son.”
The patient is well dressed — and so is her four-year-old son, who is sitting comfortably on the bed playing a video game on his mother’s cell phone.
According to the patient, she is a single mother with no support system. Her son’s father deserted …
As a recently retired physician, I still maintain an interest in medical research, though I have to ask myself: Why? Surely not just from the point of view of a potential future patient. But not from the point of view of a practicing physician either. Perhaps I keep up just from a lifetime of habit? Or is there something I miss about my old job?
The astronauts are halfway to Mars when suddenly one of them develops abdominal pain and requires surgery. What will they do?
According to NASA, a miniature robot capable of assisting in surgery has been developed, tested in pigs, and is soon to be trialed in a weightless environment. The robot, which weighs less than 1 pound, can be inserted into the abdomen via the umbilicus and controlled remotely.
