“I’ll be back in a little while, Hon’. Will you be okay without me?” the frail old woman asked of her husband. She was standing at the front door and breathing heavily.
“I’ll be fine,” her husband replied from his wheelchair. His voice sounded as weak as his body looked – emaciated, scaly, and full of cancer. “I’m sorry I can’t come with you.”
The woman opened the front door. A gust …
A beautiful Valentine’s Day patient story
Originally published in HCPLive.com
by Owen Dahl and Altamash Rahman
“Her MA is very rude, uncompassionate. Dr. ABCD doesn’t return phone calls. They’re not helpful and not good with following up with the care plan for patients. We’re new seeing this doctor, but will never go back. I would not recommend this practice at all!!!!!!”
How would you handle a comment like this when …
How patient comments will affect your physician practice
Dr. Barth Green co-founded Project Medishare, which has worked in Haiti for two decades. He led the first team of U.S. physicians to Port-au-Prince after the earthquake and, together with the University of Miami’s Global Institute, spearheaded the development of a 240-bed tent hospital that is now the country’s largest functioning urgent care hospital. His group is working with the U.S. government to establish Haiti’s first rehabilitation hospital. Green …
The Haiti earthquake and its broken health infrastructure
Last month I saw a 65 year-old woman with a mass in her kidney in clinic for follow up. She had recently transferred her medical care to our clinic after her insurance changed.
She came with a few medical problems including high blood pressure, tobacco use and arthritis — diseases which are the bread and butter of primary care medicine — but she also came with a history of a mass …
Why cancer screening is not a black or white decision
I am very blessed. The hospital where I practice, while concerned with patient satisfaction, does not worship at its altar.
That is, so far our administrators seem to understand that people will occasionally be angry or unsatisfied, and that such dissatisfaction is within the realm of real life. We still have people storm out of the emergency department, prattling on about lawyers and lawsuits, promising to go to another hospital in …
How patient satisfaction scores can affect physicians
Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Condoms that don’t fit properly are more likely to break, slip off, and decrease the pleasure of both partners during sex, which may discourage their use and undermine their public health benefits, a survey found.
Ill-fitting condoms were reported by 44.7% of the men polled. They were more likely than …
Condoms don’t work all the time, and here’s why
I just finished rotating at a community hospital where one of the most interesting things I’ve enjoyed is stopping by the Doctor’s Lounge. I can always count on a getting coffee there and hearing some good conversation – doctors asking for input on interesting cases, laughing, sharing stories, both personal and professional, and catching up on each other’s busy lives. In fact, I ran into an old friend of mine …
Can doctors learn medicine from physician lounges?
A recent editorial in the Boston Globe addressed the dearth of primary care physicians. The piece concluded: “Federal funding for new residency slots should follow reforms that address the underlying reasons – principally money – that lead doctors to choose to specialize.”
Money is certainly important. But there is another obstacle to attracting primary care doctors that is more subtle, though perhaps equally important. Consider the following story.
Recently I had …
Value doctors as listeners to prevent primary care burn out
Originally published in MedPage Today
by John Gever, MedPage Today Senior Editor
Occurrence of some so-called “never events” in hospitals may depend partly on unmodifiable risk factors such as patient characteristics, undermining the rationale for denying Medicare payment for their treatment, researchers said.
Analysis of some 890,000 surgeries performed in 1,368 hospitals showed that patient age and pre-existing conditions such as weight …
Never events in hospitals depend on patient risk
by Lockup Doc
Physicians learn a lot about many different topics, both in medical training and in practice. However, there are some life lessons that we never learn as well as when we become patients ourselves.
When I was 13 or 14 years old, I regularly interacted with 2 different physicians with disparate interpersonal styles. Little did I know then that these seemingly meaningless encounters would indelibly shape my own beliefs about …
How doctors can improve patient interactions
Every now and then, I read and enjoy a book, but only later fully appreciate it as its lessons and insights slowly become apparent. Judging by the number of times I’ve said, “That reminds me of Gawande’s observations about ___” over the past month, The Checklist Manifesto is one such book.
In this short, deceptively simple volume, Atul (who I count as both friend and inspiration) discusses the …
Atul Gawande’s The Checklist Manifesto reviewed
Originally published in MedPage Today
by Liz O’Brien
Exactly whom are we honoring on Presidents (or is it President’s) Day?
A. George Washington
B. George Washington and Abraham Lincoln
C. All presidents
The answer is more complicated than you’d ever expect. Probably A is most correct, but if it were up to me, I’d pick C.
Certainly every one of these 43 men has earned the …
Why being President of the United States is a health hazard
by Felasfa Wodajo, MD
Over the last few months, a great deal of time has been expended on the “hot competition” between Apple and Google in relation to smart phones.
Much of this interest probably had to do with a partially imagined story of a once close friendship between Apple and Google, founded on their mutual enmity of Microsoft, now fractured on the rocks of competition and greed. While the truth probably …
Is Google Android or the iPhone the future of mobile smartphones?
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Originally published in MedPage Today
by John Gever, MedPage Today Senior Editor
Tube-feeding patients with advanced dementia — a practice whose effectiveness has been questioned by two widely cited literature reviews — is most common in larger hospitals and those run for profit, researchers said.
The odds of a feeding-tube insertion in a hospitalized patient with advanced dementia were about 50% greater …
Some hospitals tube feed patients with advanced dementia
The ER is the portal of entry to our hospitals now, for better and for worse.
On the plus side, this means that most patients being admitted to general medical and surgical services have a workup at least started and are triaged appropriately to their destination.
A good ER evaluation should answer the following questions:
1. What’s the nature of the illness?
Are we dealing with the heart, the brain, or an abdominal organ? …
How the ER is now used to triage every patient
Part two of a series. See also part one.
Previously I’d discussed how most of the time diagnoses are relatively straightforward. But what do doctors do when a diagnosis isn’t immediately clear to them?
Likely one or more of the following:
1. Revert to “novice” thinking. Which, in fact, is completely appropriate. We’re taught in medical school that approximately 90% of all diagnoses are made from the history, so if we can’t …
What doctors do when they don’t know the answer
Originally published in MedPage Today
by Crystal Phend
“I do not want my life to be prolonged if, to a reasonable degree of medical certainty, my situation is hopeless.”
“I want my life to be prolonged as long as possible within the limits of generally accepted medical standards, even if this means that I might be kept alive on machines for years.”
Check …
End-of-life decisions and making advance directive choices
Originally published in MedPage Today
by Emily P. Walker, MedPage Today Washington Correspondent
More that a year after the Institute of Medicine (IOM) issued a report calling for mandatory naps for medical residents, the organization responsible for implementing — or rejecting — the IOM’s controversial recommendation has yet to make a decision.
The Accreditation Council for Graduate Medical Education (ACGME), which has …
Forcing residents to nap may not improve patient care
Conflicted am I on reading of the strategy of a group of South Miami cardiologists who have written their patients complaining of the cuts to reimbursement, primarily cuts in imaging procedures. A tension emerges from within upon reading the following quote from a “healthcare expert.”
“I’m not at all sympathetic with the cardiologists,” said Robert Berenson, a doctor who was once in charge of Medicare payment policy and now is a …
Does your cardiologist deserve his salary?
by David Allen, MD
Should health care be controlled or provided by the government?
I believe that years of answering ‘yes’ to this question has been at the root of most of the problems in the American health care system. Let’s explore a few of these ‘yes’ answers:
Health care for the elderly must be provided by the government. By creating Medicare, the US government has massively and deleteriously affected medicine. …
Why Medicare and health care should be deregulated
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