It is entirely clear that too few medical graduates go into primary care.
Although the number of family physicians is increasing modestly, there are very few internal medicine residents becoming primary care doctors. This year there will be only about 200 new internal medicine doctors entering the workforce from training programs, which will not even begin to cover the attrition of older and more efficient physicians, and due to improvements …
Have you ever gone to the doctor’s office and forgotten what you were going to say or felt like you didn’t have the answers to any of the doc’s questions? Have you ever gone in to an appointment thinking, “I have pain and I am sure an MRI will show the cause,” but your doctor seems to insist on asking you a million questions about your symptoms and doesn’t Read more…
Recently it was announced that Dr. Jack Kevorkian (also known as Dr. Death) died — ironically, not by suicide.
As a psychiatrist, one of the things I consider part of my job description is suicide prevention. Although many consider Dr. Kevorkian a civil rights activist for assisted suicide, I believe that there was a severe lack of ethics in his medical practice.
I don’t know anyone that works in health care that does not dread suspected child abuse.
On all levels it is horrible. Horrible that someone would do such a thing to a child, horrible for the logistical nightmares it can cause in treating the patient, horrible going though the whole mandated reporting process. It just sucks. Now, if it is obvious and you are totally sure it’s going on, you …
If nothing else, this post illustrates that surgeons are not that great with the whole bedside manner thing. I would like to think I’m an exception … but I still am a surgeon.
I make a point of communication with my patient. Obviously if he is a child, I use the same measure of effort in communicating with the parents. But few things irritate me more than some …
The Justice Department decided to weigh in on the topic of clinical guidelines.
As if to underscore Dr. Rich’s assertion that “guidelines are no longer guidelines,” the Federal government has raised the prospect of fining your doctor and/or sending her to prison for the crime of not strictly following guidelines of care.
Boston Emergency Medical Services recently debuted an ambulance with a mini-crane and reinforced stretcher to transport patients weighing up to 850 pounds. It cost $12,000 to retrofit the ambulance.
My problem is this: I think we need to do our best to provide medical care to all patients. But patients need to take some basal level of responsibility for their own health. If you’re saying that you …
Every now and then a tonsillectomy patient bleeds after arriving back on the ward after surgery. On this occasion, there was nothing remarkable in the event itself. What was remarkable was the efficiency of the response.
I got the phone call from the ward sister at 11:05 am, and immediately drove the short distance back to our local hospital. I checked on my patient in the ward, confirmed the bleed, …
Although the famous clip from Jerry Maguire is about a sports agent trying to negotiate a new contract for an entitled egotistical football player, every time I see it, it reminds me of work. Put a white coat on Tom Cruise, and transplant them from a shower room to an exam room, and it becomes a pretty accurate portrait of my daily conversations with patients.
Over the past year I have been involved in many discussions with doctors, healthcare executives, elected officials, plaintiff and defense attorneys and others about healthcare reform. Bottom line: There is no consensus what the future holds.
There is no question that reform is necessary to avoid absolutely bankrupting the country. However, the recent legislation is a work in progress, not yet an achievement. A change in congressional leadership could derail, …
A piercing and entertaining article in Harvard Business Review online, “People Are Not Cogs,” by Nilofer Merchant, author of The New How, offers keen insights worth considering by healthcare executives and physician leaders.
Merchant makes some incisive points about how industry has traditionally measured productivity and hence factored in the value of the individuals on the production line:
I rarely get sick and have no known disease. I’m fit as a fiddle for an aging male. I jog four times a week and have strong vital signs (blood pressure is 120/70). I have no family history of heart disease.
Besides complying with adult screening recommendations and vaccines, I only see a doctor when I have a persistent cold or sore throat. I fear going to a doctor because …
“We take our children to pediatricians for medical care — not moral judgment, not privacy intrusions.”
This quote by an NRA lobbyist troubles me. The statement reveals degradation in a sacred relationship – the physician-patient relationship.
This sentiment was prompted by a Florida pediatrician that refused to continue seeing a child after the parents refused to answer whether they kept firearms in the home. Governor …
Though there are few subjects as immediate to my experience as that described in Gardiner Harris’s article in The New York Times, “More Doctors Say No to Endless Workdays,” perhaps the truest indication of my opinion on the matter may be the fact that, upon first glance at the headline, I didn’t feel much need to read the rest of the article. More doctors say no …
The New York Times recently published an opinion editorial entitled “Squandering Medicare’s Money“in which Dr. Rita Redberg, professor of cardiology at UCSF, proposes that much of Medicare’s financial deficit could be reduced if the government did not spend “a fortune each year on procedures that have no proven benefit.”
To support her contention, Redberg cites several studies which indicate that many routinely performed tests and treatments …
My patient, whom I’ll call Jane, had a neurologic disorder that prevented her from emptying her bladder properly.
She required a permanent urinary foley catheter to help her urinate. Jane landed back at the hospital with yet another urinary tract infection – her third in one month. She had pus draining from her catheter and was infected with a multi-drug resistant strain of the bacteria Proteus. Our lab ran tests (sensitivities) …
This past summer, I had a few parents complain to me about our staff. The parents wanted to let me know that they were treated nicely by the staff, but they had noticed things from the employees that they didn’t appreciate. They mentioned that the staff seemed annoyed and irritated, even bored at times and a bit disingenuous.
I wanted to investigate the issue before I reprimanded the staff. Things …
Did you know that a growing number of doctors don’t even read the tests themselves? Another shocking aspect of this industry is that some doctors will order an MRI because it’s quicker than doing a full examination. Rushing to an MRI can oftentimes erase clinical correlation, that is, connecting the dots between pain and what the MRI shows.
I like to poke fun at real estate agents (please, forgive me if you are one, it is all in good fun).
My experience has been that, despite what I describe as my preferences, they always end up showing me what they have, even if it does not bear the remotest resemblance to what I need. This holds true for politicians, with this cardinal rule: always answer the question you want …
Editor’s note: This post was originally written this past winter.
Boston had another blizzard today. I was really worried about this one. It was supposed to snow hard, about three inches an hour from 3 a.m. to 12 p.m. with poor visibility, impassable roads, etc. I’ve driven home in snow like that, and I find it terrifying. Your car won’t do what you want it to, and worse, other people can’t …
