I started kissing patients in med school. And I haven’t stopped.
During my third year pediatric rotation, I used to stay up late at night in the hospital, holding sick and dying children. I’d lift them from their cribs, kiss them, and sing to them, rocking them back and forth until they fell asleep. One day the head of the department pulled …
I can’t always cure, but I can always care
“I don’t get no respect!”
-Rodney Dangerfield
He was a little guy, munching on the taco lunch that his mother had brought into my office for him, his younger sister and herself. I was a little miffed, I won’t lie, that the family knew they had an appointment with me right after lunch, but they decided to make the appointment itself lunch. I tried to concentrate on my interview questions and assessment, shredded lettuce …
How can our society regain respect?
By its very nature, medicine involves close personal contact with others. Communication with patients, families, staff and colleagues is essential to success. All physicians have different ways in which they communicate — some more effective than others. The best communicators are able to inspire, engage, and cultivate trust. Everyone is born with different skill sets and communication styles may vary widely.
Recently, I came across an article in Inc.com that discussed …
How charisma can improve patient care
Leana Wen’s Who’s My Doctor? campaign is an important step to help health care. She endorses a total transparency manifesto where physicians can describe their sources of revenue and other potential conflicts of interest. It’s an effort to build trust.
We can’t fix health care without patients’ help. A quick look at the numbers for chronic disease are compelling enough– half of Americans have at least one chronic disease, …
We can’t treat patients if they don’t trust us
I lost another patient to hospice last week.
She was 49-years-old. Three years ago, she was diagnosed with stage 3 cervical cancer. She was treated with surgery and chemotherapy and went into remission and stayed there until she died. After the chemotherapy, she stayed anemic. She was weak, didn’t take care of her insulin properly and didn’t eat. Her kidneys slowly lost function because of her noncompliance, her HgA1c climbed to …
Women in the Bronx get sick.
Pregnant women in the Bronx get really sick.
The patients of the Bronx live in a hard place that has some of the poorest zip codes in the United States. And if there’s anything I’ve learned from my medical training as a fellow at Montefiore — and now as an attending in maternal-fetal medicine — it’s that poverty can make you sick, not just theoretically, or …
Just the other day one of the medicine residents presented a case to me, and mentioned that in looking through the patient’s chart he noticed that the patient had undergone a prostate biopsy 1 month prior to this visit, with a follow-up appointment in urology scheduled next month. The result of the biopsy was positive for cancer, but that had not been communicated to the patient. His first instinct, he …
Patients must be given the results of their tests
I recently treated what looked like one of those unnecessary patients in one of our emergency departments. You know the ones. The ones that don’t need to be there because they should have gone somewhere else to receive care. She was a 28-year-old woman who presented with lower abdominal pain. Her pain started abruptly in her left lower abdomen. She had no nausea or vomiting or fever.
After my evaluation and …
Emergency medicine is a public service
As a practicing primary care doctor, I very much enjoy my career choice. I’m fortunate enough to be in a large multispecialty practice that is collegial and forward thinking. If I was in a smaller practice like other colleagues, I would not quite feel the same. Yet concern about how to make primary care attractive for both future doctors and those currently in practice has been something I’ve been occupied with …
Is saving primary care simply a matter of seeing fewer patients?
I’m sending a patient downtown to see a pancreatic expert. He’s a young man who didn’t fully appreciate the health risks of a former alcohol addiction. He’s been sober for well over a year, but alcohol toxicity can be unforgiving and permanent.
We don’t fully understand why some alcoholics develop cirrhosis and other complications while others seem to skate by without a scratch. While I want folks who have the strength …
A quiet, contemplative man of inaction can be the true healer
I am a primary care doctor who makes house calls in and around Tuscaloosa, Alabama. Most of my visits are in neighborhoods, but today my rounds start at a house located down a dirt road a few miles outside of town.
Gingerly, I cross the front walk; Mrs. Edgars told me that she killed a rattlesnake in her flowerbed last year.
She is at the door, expecting my visit. Mr. Edgars sits …
I spend more time checking boxes than talking to patients
We recently spoke with Jill Marshall, MD (name changed to protect identity), who works as an internist. “I unfortunately became a patient when I was 55-years-old,” she told us, “and I was diagnosed with breast cancer, a disease I had always feared I would get.”
Dr. Marshall was found to have multifocal disease and underwent a right mastectomy and lymph node dissection.
“Ever since I had seen mastectomies when I was in training, …
A doctor is humbled about chronic pain
There’s one question I get asked a lot: “I research my health problems on the Internet. Am I a hypochondriac?”
First, we should ban that word when talking about ourselves. No one wants to be called that, and doctors who use that word are committing malpractice. Everyone has some range of complaints and worries in life, often physical and mental together, and this is our job as doctors: to hear them …
Doctors who call patients hypochondriacs are committing malpractice
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Before you can even form a thought, emotions are influencing your judgments.
-Zimmerman and Lerner
It’s 9am on a Monday, and our palliative care team circles a table to prepare for the workday. Before us is a list of names, each representing a patient and his or her needs, support system and care team. Many are referred to us because they are suffering — be it pain, agitation, emotional distress, existential crisis …
Balancing emotions and reason at the end of life
This wasn’t just plain terrible,
this was fancy terrible.
This was terrible with raisins in it.
-Dorothy Parker
More and more of my clinic time is devoted to evaluation and treatment of depression and anxiety rather than sore throats, coughs, UTIs and sprains/strains. An outbreak of overwhelming misery is climbing to epidemic proportions in our society.
A majority of the patients who are coming in for …
We have lost all perspective about what is truly terrible
I get it. It’s not rocket science. But sometimes everyone in the field of medicine needs a bit of a refresher when it comes to keeping our patients happy.
After all, it’s a two-way street with medical providers and patients: we provide and support ways to improve and maintain the personal health of our patients while our patients provide and support the health of our careers and livelihood. We depend on …
3 tips to keep our patients happy
Do you have a medical, pharmacy or nursing license in several different states? Do you have a license in more than one health profession? Have you been notified that an investigation has been opened against you? Are you thinking about resigning your professional license or voluntarily relinquishing such a license? Then you must be aware of the following.
First, you should never voluntarily relinquish or resign your license after you know …
Don’t resign your professional license in the midst of an investigation
Just as elite athletes are born with amazing skill, elite surgeons and doctors in other procedure-based specialties are also equipped with innate abilities that others do not possess. Surgical skill is often difficult to quantify. Certainly, outcomes data can be obtained and reputations are formed over time. Years of training allow the truly gifted surgeons to develop their skills and perfect their craft.
However, all surgeons are not created equal. During …
Will video replays lead to safer surgeons?
I recently participated in a small conference devoted to “physician alignment in the academic medical center.” The meeting was sponsored by a health care consulting firm, and drew about a dozen participants from around the country. The title refers to ways in which academic centers figure out how to work with their traditionally autonomous if not completely independent physicians to advance the institutional mission. An informal format allowed us to …
Academic medical centers: Should we continue to feed the beast?
Recently, a family in my practice decided to move out of state, back to where they had lived before. When we said goodbye, the mother said that she was sad to change pediatricians. The pediatrician they would be returning to, she said, “only takes care of strictly medical things.”
Clearly, she meant that I take care of more than the strictly medical things. I was flattered, especially since this was something …
Going the extra mile for patients: How friendly is too friendly?
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