Is anyone else frustrated with the business of medicine? I guess that’s a stupid question. But really, when you were training to become a physician, what were your goals? For me, I wanted to have a career that was meaningful, interesting, and at the same time provided a good living for myself and my family. Growing up, I was always told to strive to become a doctor or a lawyer. …
Maybe medicine isn’t really a business after all
When you go shopping, everything has a price tag. Buying a new car is challenging, but ignoring dealership costs may result in sticker shock when you receive the first payment notice three weeks later. Few of us would ignore costs this way.
In actuality, this happens everyday in health care as we interact with medical professionals, have an examination, and are given treatment without knowing the price.
Headlines alert us how health …
What is the price of that medical test?
It should be easy, right? I mean, I am a professional with what feels like eons of training. So how can an oncologist with years of experience fail at perhaps the most important question a patient can ask, ”How long do I have, Doc?”
It’s not that I want to avoid the question. Well, okay, sometimes I do. It’s not the most pleasant of conversations to have. But really, I don’t …
The conspiracy of cancer prognosis
March is colorectal cancer (CRC) awareness month, so it’s an appropriate time to reflect on how to increase the number of people who get screened for this cancer that’s largely preventable through screening. Between 2005 and 2012, Kaiser Permanente, Northern California, doubled the percentage of our eligible patients who were screened for CRC.
So how did we do it?
We employ a combined screening model with fecal immunochemical test (FIT) outreach and …
How we doubled colorectal cancer screening rates
I’ll never forget the anxiety of the first day of medical school. I was excited. I was enthusiastic. I was overwhelmed. But all of these emotions were humbly interrupted by my profound, palpable sense of otherness. I was surrounded by one hundred and sixty-seven brilliant peers, many from high-ranking undergraduate schools and each of whom had countless accomplishments in their already rich pasts. They clearly, unquestionably deserved to be here. …
The effect of imposter syndrome on medical students
CNN recently released a report on picky eaters. This short piece featured the family of a picky pre-schooler, Harper O’Bamsawin. The brave O’Bamsawin family opened their house to the world, seeking solutions to improve their dinner table experience. The result, however, was an expose of common problems left unsolved.
As the camera revealed a typical meal in Harper’s home, it quickly became clear that Harper’s parents have fallen into …
Tips on getting your picky eater to eat
When I was a resident in emergency medicine, at what was then simply Methodist Hospital of Indiana, I was blessed with the opportunity to fly with Lifeline. While I am originally from West Virginia, where rural means mountainous, I came to love the beautiful, stark emptiness of Indiana as seen from the sky. And over time, I came to truly appreciate the small, rural hospitals that called us for help …
I was up helping my son for the majority of the night. He’s got a stomach bug (which he got from his brother) therefore I was up dealing with the enormous mess that comes with vomiting in the middle of the night. I know you know my woe. This is the second round of this bug at our house so I was clearly exhausted when 6am rolled around.
First thing I …
What to remember about children and caffeine
There is a disconcerting myth about single mothers that has been circulating in our society for some time. It was popularized in the Reagan Era as a denunciation of US social welfare policy and resulted in a pointed caricature of a woman on welfare, forever to be known as the “welfare queen” or the entitled single mother.
The narrative of such a woman goes something like this: Not only is she …
The myth of the entitled single mother remains as relevant as ever
Please let us know that we’re not alone. We realize that our doctors are not our friends, but telling us that the medical team will be sticking with us during this journey that we were never on board with, is an empowering message when we are at our most powerless.
Show us that you care about our child, too. We know that you identify our …
From a mother: What my child’s oncologist should know
Have you ever encountered an intrusive, insistent popup decision support screen while trying to take care of patients? Found yourself stuck in a dead end electronic hallway without egress? A situation where you had to choose an option that was inappropriate for your patient just to exit the screen?
This is the situation with my local medical institution’s “DVT Advisor,” a mandatory decision support screen for all patients.
DVT Advisor was implemented …
Can decision support tools actually harm patients?
Rob got a cat bite. Then a swollen hand. He goes to the ER, gets antibiotics, then develops itching. So he calls me for advice.
A few days later, I get this email: “The itching from the antibiotics went away as you said it would. But what is NOT poised to go away is the $624 bill from the ER for talking …
How to save hundreds of dollars on your medical bills
It looks like an airport lounge without the rolling suitcases. There are about 20 of us cancer survivor-types fiddling with our phones or reading the newspaper. A few of us are sipping delicious contrast fluid in preparation for a scan, but most of us are waiting to meet with our oncologists for follow-up or monitoring visits. All of us are between the ages of 20 and 70 and all of …
Chronic conditions don’t have normal business hours
ADVERTISEMENT
Hot oil splatters as thick fatty fish slips into the smoking pan, next to boiling rice and simmering garlic greens. Quickly golden, she flips the fillet and turns down the heat. Small feet pound down the stairs, drawn by the crackling aroma, but it’s a mother’s trap; she motions the child to set the table. One by one, the family gathers, as plates and utensils clatter onto the wood and …
To every cancer patient: You give us courage
When someone asks me what a developmental pediatrician does, I tell him or her that I treat children who have a variety of developmental problems, such as attention deficit hyperactivity disorder (ADHD). Without fail, that disclosure elicits some sort of an emotional reaction.
Many people have strong opinions about whether the disorder really exists. Parents are still being told, by family and so-called friends, that it’s “their fault,” and that all …
It seems lately that questions of medical ethics are coming up more and more in the news, things like the rights of patients to make decisions, definitions of futile care, and end of life care. The way to look at these things is not in a vacuum. All of us may have our own opinions about right and wrong, but the field of medical ethics is actually one that has …
Framing an ethical dilemma: 4 basic concepts of medical ethics
If knowledge is power, then content (in proper context) is king. Why am I online blogging, pushing content through my website and even interacting on Facebook, Twitter, Google+, Pinterest and many other sites? Because my patients are there. Increasingly, they are utilizing the Internet to self-diagnose; to look for “second opinions” from peers and friends; to research a physician, recommended treatment, or hospital; or to find the latest information on their …
Go where the patients are: Why this doctor is active on social media
8:00am Sunday: You glance over and notice an email from your boss while you’re eating breakfast and reading the paper. Ok, you think, I’ll respond later, maybe after my run.
8:10am: Ping! A text arrives. “I have a question about the project.” Ok, you think, it’s Sunday, but sure, I’ll get back to him after breakfast.
8:20am: The phone rings. It’s him. “I’ll need that slide for tomorrow’s presentation. How soon can you get it to …
Doctors need to stop working 24/7
I have been thinking a lot about cancer screening tests. It seems that there has been a constant stream of articles about screening in both the lay press and professional journals — as well as the inevitable stories in the lay press about the reports in professional journals — but this is more personal. I have had two recent experiences that …
Cancer screening comes down to personal preferences
Next in a series.
There is and will be a need for many more primary care physicians (PCPs).
Why?
There is a shortage now and it will be exacerbated in the coming years for at least three reasons. The population is growing, the population is aging and there will be more individuals with health care coverage as a result of the Affordable Care Act (“Obamacare”).
I believe that the need will be much …
Lack of listening is the core care problem in American health care
Get free updates delivered free to your inbox.
