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Here’s why clinicians should give shadowing a try

Medical Education

October 2, 2015

How many of our conflicts could be handled better or averted if we had the opportunity to spend some time in the shoes of the person on “the other side”? When we experience a situation through another’s eyes, and when we understand their work and world, true empathy, understanding and trust can emerge.

This is certainly true in our hospitals, where the frenzy of patient care activities involves multiple roles — …

The surprising reason behind an early refill of alprazolam

Hans Duvefelt, MD

Physician

October 2, 2015

Theresa arrived in a cloud of noise and commotion.

She had called after four o’clock the day before, but I hadn’t noticed the new message in my electronic inbox before I left the clinic.

Her almost brand new alprazolam bottle and her pain pills were missing, and Theresa was reeling. As she walked down the hall to the exam room, I heard her explain to Autumn how she had been to Walmart …

The dystopia of modern medicine

Jordan Grumet, MD

Physician

October 1, 2015

He had been educated at the finest universities. He had graduated cum laude, or whatever the term is they use nowadays to signify distinction. His pedigree was squeaky-clean.

But as he haltingly entered the dark building at the end of an otherwise unexceptional suburban street, he felt more like a criminal than a scholar. His office was drab. Each room was glowing with the artificial light provided by an incandescent bulb. …

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The dystopia of modern medicine

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Want to become a doctor? Don’t be so sure.

Christopher Cai

Medical Education

October 1, 2015

Recently, my friend “Tim” told me that he no longer wished to become a doctor. He had already taken the Medical College Admissions Test (MCAT) and all his premedical course requirements. But a summer shadowing physicians whom he described as “always unhappy” convinced him to cut his losses.

“I worked hard the last three years,” he explained to me. “But I don’t want to be miserable forever.”

Medicine is a demanding and often …

Physicians must never lose their humanism

Cleveland Piggott, MD, MPH

Physician

October 1, 2015

“I’ll never forget the look in your eyes.”

Uh oh, I thought to myself.

“You had this look that you wanted to help but just didn’t know how,” said my patient.

Apparently I have very expressive eyes, and she was right. The event she was referring to was what we call a rapid response. This is when a patient’s status suddenly changes and the team wants her to be evaluated immediately. When I …

October 1, 2015: A day that will live in health care infamy

Rob Lamberts, MD

Physician

October 1, 2015

October 1, 2015 is a huge day to the medical community. It is a day that will live in infamy. It is the object of dread, of diaphoresis, of doom. October 1 is ICD-10 day. This view was further bolstered when I went to the CMS (Government Medicare) website; there was actually a doomsday countdown timer at the top of the page.

For those still unaware, ICD-10 is the 10th iteration of …

It’s time for physicians to regain their voice

Meeta Shah, MD

Physician

October 1, 2015

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When was it that we stopped respecting ourselves and our profession? When did we decide that quietly smoldering or complaining to one another is better than standing up as a single entity for what we know is right? How did we allow misconceptions and distrust of physicians to grow? For outside forces to dictate what is best for our patients and take …

Don’t land in the teaching hospital on a holiday weekend

Deb Discenza

Patient

September 30, 2015

“Don’t ever land in a teaching hospital on a holiday weekend, they always staff up with residents,” noted a close friend who was all too familiar with the inner workings of hospitals.

That statement sticks in my head heavily today as I prepare to visit my father’s year-old grave. My father, a man that was involved in the Department of Health & Human Services (HHS) and private sector research societies for decades, …

Bundled payments means the death of quality medical care

David Mokotoff, MD

Health Policy

September 30, 2015

A recent CMS proposal to bundle payments for doctors and hospitals for hip and knee replacements in 800 model centers has hit a roadblock. The five-year program would have begun January 1, 2016, and nearly 300 comments were received by CMS earlier this month. Apparently most of the comments were not, shall we say, favorable. Even the Federation of American Hospitals protested

For those who are unaware, “bundled payments” means that …

Don’t try to be your child’s friend. Here’s why.

Kathryn L. Moseley, MD

Conditions and Diseases

September 30, 2015

A piece of advice to all you parents reading this: Don’t try to be your child’s friend. Don’t get me wrong. You can be kind, you can be chummy, you can (and should) have fun with your kids — but you are not their friend.

I say this as a mom and a pediatrician who has seen way too many parents muck things up by trying to be a friend to their …

Doctors, parents, and spouses all rolled up into one person

Wendi Kitsteiner

Physician

September 30, 2015

As my husband’s pick-up truck rolls up the driveway, a long ER shift behind him, my four kids come running from wherever they are currently playing on our farm. My seven-year-old son was reading in a rocker on the front porch. His six-year-old brother was watching the new baby chicks scramble around our brooder. My four-year-old daughter was helping feed our ducks. And my two year old was getting into …

Is that bad? A difficult question doctors can answer in many ways.

Frederick Gandolfo, MD

Physician

September 29, 2015

Here is a question I get asked all the time by patients: “Is that bad?”

This is different than the similar, more appropriate question, “Is it bad?” which is usually asked after being given a specific diagnosis. For example, after a colonoscopy where a large polyp was discovered and removed I will tell the patient about the findings. He may ask, “Is it bad?” The answer is usually “No, the polyp …

Defining obesity: Disability or disease? Or neither?

Skeptical Scalpel, MD

Conditions and Diseases

September 29, 2015

In 2013, the American Medical Association recognized obesity as a disease. Dr. Peter Ubel, writing in his blog on the Forbes website, thought this was a bad idea. He feared that calling obesity a disease will result in people having less motivation to lose weight and cited a study which found that people who were told that obesity is a disease tended to be less concerned about their …

It’s time to remove EHR gag orders. For patient safety’s sake.

David Mann, MD

Health Technology

September 29, 2015

I recently read an article in Politico entitled “Doctors barred from discussing safety glitches in U.S.-funded software.” The article states that, despite massive public funding of electronic health records (EHR), the EHR corporations (including Epic Systems, Cerner, Siemens, Allscripts, eClinicalWorks and Meditech) routinely attach gag clauses to contracts with the hospitals and medical groups who purchase their systems. We are talking about gag clauses that prevent criticism by …

How to fix physician burnout? Start with a culture of acceptance and support.

Christopher Vercammen, MD

Physician

September 29, 2015

“Thou must be like a promontory of the sea, against which, though the waves beat continually, yet it both itself stands, and about it are those swelling waves stilled and quieted.”
– Marcus Aurelius

My reaction to this quote, which begins Osler’s Aequanimitas, has changed over the years. When I first heard it, I was filled with a sense of pride and anticipation. I would be that rock, for my patients, for …

ICD-10: No wonder why doctors are burnt out

Shirie Leng, MD

Physician

September 28, 2015

Attention graduates! If you’re looking for a career with a ton of job prospects, look no further than an international classification of diseases coder. This fun and fulfilling career will take you into new worlds of diagnosis, laterality, specificity, and nitpicky-ness as you dive into thousands of columns of numbers and qualifiers. You’ll even get to call doctors and harass them anytime you want. Sign up for your free brochure …

Medical Jeopardy is a terrible way to learn. Here’s why.

Jennifer Middleton, MD

Medical Education

September 28, 2015

Confession time: I despise presentations that involve the use of a PowerPoint Jeopardy! game. To be clear, I get uncomfortable when any game-like activity appears in a medical teaching presentation.

Not that I don’t think games can have an important role in education — far from it. Heck, I once worked on a presentation that turned our residency conference room into a giant Game of Life board with …

Legalize medical marijuana? See how a decision can affect this cancer patient.

James C. Salwitz, MD

Medications

September 28, 2015

What is not to like about medical marijuana? It treats pain, vomiting, fatigue, anxiety, depression, insomnia, seizures, muscle spasms, Crohn’s disease and allows many cancer patients to resume remarkably normal lives. It is not addictive. It does not interact with other medicines. It acts quickly and is easy to adjust. It can be consumed in numerous ways. It is safer than essentially any other drug: 1,500 Tylenol deaths in the …

Health inspectors should be trained to do what doctors do

Rocky Bilhartz, MD

Physician

September 28, 2015

This story is a great one.

It’s about a female dog with only three legs. Her fourth leg was amputated following a traumatic accident as a puppy.

Now, when she walks, she has a hitch in her step. And, when she hitches, she kicks the stump of her injured leg outward.

Step, step, hitch. Step, step, hitch.

One day, the female dog has puppies. And, her puppies do what all puppies do. They nurse. They watch. …

Just like driving lessons, parenthood is terrifying

Claire McCarthy, MD

Physician

September 27, 2015

I did something really death-defying with my daughter this summer.

I taught her to drive.

Truly, teaching a teen to drive is scarier than just about anything else we do as a parent. It’s scarier than giving birth, as there are usually skilled people around during labor who can take over if things go awry. It’s way scarier than first days of school or first dates, scarier than most illnesses and injuries …

Real physician voices, twice a week

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