(with a hat tip to “Who’s On First?”)
A guest column by the American College of Physicians, exclusive to KevinMD.com.
(Scene is the back office of a small primary care clinic. Lou is sitting at his workstation, looking at a computer screen. Bud walks by and Lou stops him …)
LOU: Hey, Abbott! I just saw …
What if Abbott and Costello were primary care physicians?
Thanks to the measles outbreak, the news is full of stories on vaccines and anti-vaxxers. The blogosphere and Twitterverse and all the other social media dimensions are buzzing with invective against ignorant unvaccinated savages and their backward science denial. For the record, I’m a pro-vaccine physician. My children have been and are vaccinated, despite being unsocialized homeschoolers.
I’ve had my own share of needles; Physicians are mandated to have hepatitis B, …
The sense of superiority by those who are pro-vaccine
They say that the path to hell is paved with good intentions. Few things in medicine illustrate that as well as how we’ve approached chronic pain management in the past 10 to 20 years.
The advances that we have made in medicine in the past few decades have been truly remarkable. But, unfortunately, pain is one of the ailments we still do not treat well. One of the difficult aspects of …
Will the pendulum of pain management swing too far?
It happens every once in a while in my practice: Parents ask if we can delay or skip certain vaccines, or spread them out.
According to a study just published in the journal Pediatrics, I’m not alone — in fact, 93 percent of pediatricians get asked the same thing.
Now, it’s important to point out that most families don’t ask for this. Most families are fine with the current vaccine schedule — …
To the parents who want an alternative vaccine schedule: Here’s what I say
The world of health care will likely look very different in a decade, owing to a variety of diverse factors including; medical breakthroughs, political reform and not least of all the tremendous advances in technology that are occurring at breathtaking pace. The traditional model of the doctor-patient interaction will also continue to change dramatically (as it already has over the last several years). The days of an unchecked paternalistic relationship …
Why we need less virtual medicine
Termites are endemic in southern California, and we’ve had spot treatments several times over the years at various sites in our house where little piles of sawdust have appeared as evidence of termite activity. Finally, it became clear that the termites were winning, and more aggressive treatment was in order: tenting. This is the process of hoisting a big, brightly-colored tent over the whole house and putting an end to …
How an eleven-pound cat precipitated domestic chaos and delayed surgery
The “age of the giants” has passed. The idea of larger-than-life doctors devoting themselves completely to patient care and sacrificing their personal lives in the process is giving way to an era of recognizing the limits to a physician’s work life.
This change in attitude has been advanced, in part, by Read more…
We must recognize the limits of doctors’ work lives
You’ve likely seen the Jimmy Kimmel “public service announcement” on vaccines. Over 3 1/2 million people have viewed it on Youtube so if you’re not yet one of them you’ll likely add to the tally now. The first 3 minutes of the monologue are spot-on, and they’re also very funny. Jimmy takes a stand against the “anti-vaxxers.” He mentions that some parents are more scared of “gluten than small pox” …
Were the physicians on Jimmy Kimmel professional?
“What would Spock think about the ‘husky’ designation?” That’s what I was pondering. I was wondering how the master of logic would justify and make sense of the clearly derogatory way I was feeling about myself.
“Fascinating,” I imagined him saying, and he would raise that patented eyebrow.
Then I looked in the mirror, furrowed my brow, took note of the barely present peach fuzz growing under my nose, and with all …
To your own Vulcan self: Be true
Physician burnout — and burnout in general — is at an all-time high. From this Wall Street Journal article by Dr. Sandeep Jauhar to a recent TEDx talk by Dr. Romila Mushtaq, the angst is palpable.
Sadly, as noted in this piece in the New York Times, the suicide rates of physicians and doctors-in-training increase every year.
The insurance companies’ complications, government involvement, and economic downturn have all added fuel to this fire of discontent. …
More humanity, less physician burnout
To the staff overseeing my medically-complex child,
My child has been in this world much longer than you expected; thus I’ve been in this relationship with you much longer than I expected. If I could break up with you and find someone new, believe me I would (I’m sure so would you some days). But that isn’t possible; we’re in a dysfunctional relationship. If we recognize this together and just come to an …
A message to those taking care of my medically-complex child
From new longer-acting drugs to promising gene therapy trials, much is changing in the treatment of hemophilia, the inherited bleeding disorder in which the blood does not clot. I will mark Hemophilia Awareness Month by discussing research and treatment progress, as well as remaining challenges.
1. Many more treatment products are being introduced, including some that last longer. In people with hemophilia, a “factor” — or blood …
5 things to know about what’s new in hemophilia
No physician, however conscientious or careful, can tell what day or hour he may not be the object of some undeserved attack, malicious accusation, blackmail or suit for damages … “
– Assaults Upon Medical Men. Journal of the American Medical Association, 1892
It’s happened again: A well-liked doctor is killed by his patient. Last year’s horrific death of a physician in our community, a …
ADVERTISEMENT
I have been doing emergency medicine for almost ten years — thirteen if residency counts, and I sure think it does. I face the same issues that cause my work colleagues, physicians and nurses alike, to burnout. I struggle with burnout myself, but I keep coming back. Many days (and nights), I ask myself why I continue to do what I …
Want your ER physician to leave happy? Do these things.
For many of the millions of low-income families seeking quality health care in the safety net, the quest can be bewildering. They may walk into a drab, disorganized and unwelcoming clinic, with the staff, signage, and endless medical forms all using unfamiliar language, with unexplained, lengthy waiting times, and with providers burying them in information they can’t understand. On a second visit, they may feel even worse when they end …
The health care safety net: Put patients first
As I travel around speaking about preparing for peace at the end of life, I have found that there are three pervasive myths about hospice that might cause you to inadvertently rob yourself or your family of a peace-filled end-of-life experience.
So, I am taking on the job of myth-buster to clear the air. Here goes:
Myth #1: Hospice is a place. While hospice can be a place, it is primarily a service. …
3 myths and 3 truths about hospice
The Centers for Medicare and Medicaid Services (CMS) has put its foot down, this time on the side of patients. Many hospitals charge you more for the same outpatient tests you get in your doctor’s office. Sixty-six different services are being targeted by CMS to leverage the playing field.
Are the tests really all that different?
We are not talking about inpatient tests that happen when you are sick enough to be …
Hospitals fight to charge you more
In 2010, I became a hospice volunteer.
My mother had died of a brain tumor five years earlier at age eighty-seven. I saw being a hospice volunteer as a way to express my gratitude for my mother’s compassionate hospice care and to help other caregivers to weather a loved one’s passing. And, as a former reporter and writer, I thought I could help people to write their life stories, if they …
A phrase as a metaphor for dying itself
The preferred route for a hysterectomy is vaginal. This means the entire surgery is done through the vagina with no incisions in the abdomen of any kind. The joke among surgeons is that it is a bit like taking a car apart through the muffler. While doing surgery entirely through the vagina may sound highly complex, it’s really just like any surgery. A vaginal hysterectomy done correctly it is an …
Surprise! When it comes to a vaginal hysterectomy, this insurance company gets it right.
I was talking to a colleague of mine yesterday. (At least I flatter myself that I am a colleague. He has a writing job at a prestigious magazine while I, well, don’t.) We were talking about the doctor-patient relationship, as is our wont, and he said something that stood out to me as the quintessential statement of patients’ expectations about doctors.
It …
Patient expectations lead to unhealthy relationships with doctors
Get free updates delivered free to your inbox.
