Like many practicing general surgeons I read with interest the recent Finnish paper published in JAMA that attempted to challenge the long held surgical dogma that the best treatment of acute appendicitis is cold hard steel. The paper itself, in terms of design, was beautiful. This was no retrospective review of a series of case studies. This was a …
“There’s no crying in baseball!”
Over the years, my fellow surgery residents and I heard these words shouted countless times by Dr. Norris, a cantankerous elderly surgeon with whom we had the dubious pleasure of working.
Dr. Norris was a former Navy ship surgeon. He didn’t operate much anymore, but he fondly remembered the “good old days” when trainees spent days on end in …
I have been an emergency physician for 12 years. I have had the opportunity to learn from and try to emulate an impressive number of amazing clinical physicians. These doctors seemed god-like at first, but as my training and career progressed, I realized that they were mostly teaching me through their own experiences.
One of my favorite teachers had a humbling saying: “Good …
Recently I met a boy, a boy with leukemia, a young boy with comic-book worthy superpowers. This boy, this superhero, is one I will never, never forget.
When I entered the exam room, I was immediately struck by the sight of a young boy who should have been playing football with his friends at the park or jumping off the high-dive at the pool, but instead …
So, there I was yesterday, working frantically to keep myself above the water level of the rapidly rising swamp of patients. Navigating, haltingly, the onerous and demonic EMR. So I thought I ordered three nebulizers, but it was only one. The respiratory tech approached me and informed me that she would put them in, but only this time. That I’d have to …
It was only afterwords that I wondered if I had been condescending. The words had come out so naturally. We were sitting across from each other in the nursing home. It didn’t take a doctor to recognize that his leg was visibly less swollen. I had seen him walking down the hallway with the physical therapist. His face a mix of pain, …
For all the talk about patient-centered care and a new health care paradigm — which is, of course, the right way forward — the doctor-patient relationship will always remain relatively one-sided because of the nature of the profession itself. Essentially, patients come to doctors for help, and the knowledge transfer, advice, and guidance flows in one main direction.
But that doesn’t mean that …
We live in a time of great cynicism and skepticism. We seem to see only the mundane and boring in even the most interesting and spectacular things. The electrical rhythm of the heart that pulses through cardiac tissue and results in a coordinated muscle contraction that effectively ejects blood to the rest of the body for appropriate oxygen delivery is just … a …
I found out my mother was dying via text message: YOUR MOM HAS A BRAIN TUMOR IN HOSPITAL — DAD
When the neurosurgery PA wheeled the computer into the exam room to show us the MRI the next morning, I found myself silently uttering an unanswered prayer that the mass would be small, resectable, peripheral. It wasn’t.
“Oh my God,” Mom whispered. “I’m going to …
I’m not actually on TV, but there are days I feel like I’ve accidentally stumbled onto the set of a sitcom. When neighbors have never seen your husband in the light of day and friends joke that he is make-believe, then you might be married to a … well, you know the joke.
Being married to a busy physician can leave you playing …
Polycystic ovarian syndrome (PCOS) is becoming a significant problem in women’s health. Between 1 in 10 to 20 women have the condition, although more than 50 percent remain undiagnosed. PCOS is the leading cause of female infertility and women who do become pregnant have higher rates of miscarriage, preterm birth, and gestational diabetes.
Women with PCOS have a greater likelihood of developing diabetes, cardiovascular disease, and endometrial cancer than women without …
“Sometimes a simple, almost insignificant gesture on the part of a teacher can have a profound formative effect on the life of a student.”
– Paulo Freire
Think back to a moment when a teacher or “authority” figure gave you a compliment. We all have them, from kindergarten to high school to college and sometimes graduate school and work. The reason why many of you can recall such moments is that unlike …
The U.S. health care system is headed toward a profoundly digital future. Provider organizations around the country are adopting and updating their health information technology (HIT) infrastructures. Many have begun requiring that clinicians gain proficiency in electronic health records (EHRs) in order to provide clinical care. A proliferation of start-ups and HIT companies in health care is poised to disrupt (innovatively or …
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I’m a physician entrepreneur. In 1998, I opened my first clinic. My malpractice: $500 per year. Then I tried life as an employed physician. Hated it. So in 2005, I opened my ideal clinic. Best. Job. Ever. My malpractice: $1,230 per year. Want low premiums? Here’s how I did it.
A quick tutorial. New malpractice policies mature over five years. So the first …
The acronym “MI” has traditionally meant myocardial infarct, or heart attack. Recently it’s taken on a new, more salubrious meaning: motivational interviewing.
A growing number of docs are practicing this technique, which amounts to listening to patients to help them recognize their internal sources of behavior. Boston’s NPR affiliate, WBUR, describes typical MI interventions in which doctors, instead of demanding that patients stop smoking or drinking or overeating, gently …
The number of African-American physicians in academic medicine is dismal, and this leads to an abundance of problems. Academic hospitals (teaching hospitals associated with universities) generally do not have a proportionate representation of underrepresented minority faculty as compared to the surrounding population. According to a U.S. News & World Report article, the number of African-American faculty increased by 0.2 percent in ten …
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People can wear what they want in America. Whether you want to debut the latest vogue or your midriff rife with adiposity, you are free to do so. But just because you can, doesn’t mean you should. In the span of one week, I found two people — on two separate occasions — wearing white coats, each …
The drug test came back abnormal. There was THC present. I walked back to Mrs. Johnson and raised my eyebrows.
“What’s wrong?” she asked, not used to whatever kind of look I was giving her.
“Uh, you forgot to mention to me that you smoke weed.”
She blushed and then smirked. “Well, yes, I guess I forgot to put that down on the sheet. I don’t …
1. Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse.
Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to …
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With much hype and fanfare, the independent investigative journalism outfit, ProPublica recently released their Surgeon Scorecard, assessing individual specialist surgeons who perform elective knee and hip replacements, spinal surgery, prostate surgery, and gallbladder removal surgery.
I had blogged about the impending release. My trepidation about the idea of a non-medical, non-scientific organization analyzing complex surgical data concerned issues such as …
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