It seems that in the past few weeks, physicians across America have reached the breaking point.
Internist Daniela Drake wrote in the Daily Beast about how miserable it is to be a physician. She talked about the lack of respect, the lack of time to see patients due to increasing paperwork and the ever-present board certification processes.
Orthopedic surgeon Daniel Craviotto Jr. wrote “A Doctor’s Declaration of Independence” in the …
Remember personal responsibility? There actually was an era of responsibility when folks admitted when they screwed up and didn’t blame others for their own mistakes. I know this may seem incredible to the younger generation who simply assume that when something goes wrong today, it must be someone else’s fault. In today’s culture, this is not scapegoating, but the pursuit of justice. Welcome to the era of big victim.
A well-to-do patient recently boasted to me about an expensive insurance plan that he had purchased to “guarantee” that he had access to the best health care in the United States. Coverage included access to elite academic centers (all the usual suspects) and a private jet service for emergencies. He was utterly confident that his investment was worth the price, but I withheld my own misgivings.
It’s happened to me a couple of times already. But the question above was never asked. Rather I was informed later on that my conversation with a patient or family was recorded without my knowledge. Smartphones have made it all too easy for patients to secretly record conversations with their health care providers. Simply hit a button, lay it innocently down by your side in …
His wife thinks he looks like Tom Cruise. There is a resemblance, I can see him riding a motorcycle off the side of a burning building, jaw fixed, eyes on fire, ready to save the damsel … only he is not so short. Funny, brilliant and genuine, we have known each other for exactly two decades, sharing the growth of our families, the anxieties of middle age, and the vicissitudes …
About 25km outside of Sao Paulo, Brasil, in a small city called Barueri, lies the grave of my mother’s cousin. Henrique was the Brasilian version of Mr. T — a larger than life character, he spent his days on the pitch as the starting goalie of a local football club. “Senhor Henrique” was well known. He had three major trademarks:
His favorite words to opposing players were “tenho pena de tolo” …
In a voice confident and ringing with anticipation, Mr. A explained with meticulous detail how he determined which approach shot to hit to the second green on the Black Course at Bethpage State Park.
Only ten minutes earlier, when we first met, Mr. A had been weary, his face drawn, and his speech so quiet that the sound of the aortic balloon pump keeping him alive made it nearly impossible to …
People lie. Patients lie. Patients tell blank untruths, patients misunderstand truth, patients confabulate with the damage of a thousand fifths of vodka of yesteryear.
A core conceit of medicine posits that health care providers expect pure honesty from patients from first handshake on. Violating every social norm around encounters with strangers, we expect that patients with no grounds for trust reveal all.
Providing primary care to patients on the furthest margins of …
A few years ago I was engaged by the director of a residency program in my community to teach the program residents table manners. Now, you may wonder why medical residents need to know how to navigate a dining table gracefully. But good table manners are a must for professionals in any arena.
The director of the program stated that she felt some …
There was a time when doctors were doctors. There was a time when young men and women sacrificed the best years of their youth, learning to treat patients and conquer diseases, not to become typists, paper pushers, data-entry clerks, or to have hospitals, insurance companies, and the federal government dictate to us how to practice medicine.
After every mass murder, the question everyone asks is why it happened. How could anyone possibly be so violent, or so evil, or so out of control, or so crazy as to engage in the wholesale and indiscriminate killing of a bunch of people who are usually complete strangers?
In some cases, there are longstanding preexisting warning signs: a history of mental illness, substance use, isolation and/or estrangement; the repeated experience …
Chinese hospitals are recruiting 1,500 “guardian angels” to protect doctors from violent patient attacks. Patients who are angry about the Chinese health care system, medical expenses, long waiting times, and uncaring doctors have become more violent over the years, with violent attacks occurring every two weeks on average — according to state media — which in reality means that it probably occurs a lot more frequently …
For the better part of a decade, I practiced inpatient hospital medicine at a large academic center (the name isn’t important, but it rhymes with Afghanistan … ford).
I used to play a game with the med students and housestaff: Let’s estimate how many of our inpatients actually didn’t need hospitalization, had they simply received effective outpatient preventative care. Over the years, our totals were almost never less than 50%.
One of my most treasured stories as an ED physician belongs to a lovely couple who valued quality of life. It was a routine day in the ED when an elderly woman rolled through the ambulance doors on a cold, narrow stretcher, unaccompanied by family. She was placed in bed 5, which is where we met. She was frail and her memory was poor. The EMS run sheet reported “change …
Emergency departments in U.S. hospitals see copious patients who aren’t terribly ill, but don’t have insurance and need somewhere to go. I see some of these patients when I moonlight on nights and weekends at a local county hospital. Sadly, these patients run through a gantlet of expensive tests — I’m required by protocol to administer them. The reality is that 80% of what I see in the ER is “family …
I’ve always been a people watcher. Now I get paid to spy on folks. I have to ask detailed, personal questions. Sometimes I even snoop around patients’ homes.
In the 1930s nearly half of all patient visits were house calls. Now most patients are rushed through ten-minute office visits. But if I need to know what’s going on with a patient, I …
It’s been almost two years since returned to medicine after a three-year hiatus from practice. I recently finished the longest week of work I have had since starting this job. I had a family emergency and a conference all converge around the same week, and ended up cramming two makeup days into an already full schedule. It was long. It was incredibly tiring. I was very glad when I finally …
As I look back, I remember teachers. One taught to be compulsive and complete. Another, calm and humor in the face of chaos. Another believed in me and thereby taught me to believe in myself. One made me write and rewrite. Above all, there was a mentor who opened my heart and eyes to the need for compassion. That special teacher was Dr. Black.
This article is making the rounds among physicians on Twitter. Much of the information in the article, unfortunately, is accurate.
For some of the reasons stated there, I left the “traditional” health care system and pursued work at the “fringe.”
Part of this is due to my clinical interests: I like working at the intersections of different fields. For example, I like the intersection of psychiatry and hospital medicine, which is called Read more…
Having worked with radiologists a lot, I have great respect for their specialty. The job is indeed a very difficult one. Without seeing the patient (the most difficult part of what they do), they have to thoroughly comb through every image put in front of their eyes and give us their assessment of what’s abnormal and what’s not. Their interpretation will be one that other doctors will hang their hats …
