As an internist and geriatrician, I deal with elderly patients all the time. We always end up talking about end-of-life issues:
“Should I be resuscitated if my heart stops and I stop breathing?”
“Do I want a feeding tube or gastrostomy tube if I stop eating and require nutrition?”
“Should I be kept alive on machines and for how long if there is no reasonable hope of recovery?”
“When should we refuse tests for …
For a century, the white coat has been the symbol of the medical doctor. Today, the vast majority of medical schools in the U.S. begin with a white coat ceremony. There, the fledgling, future doctors stand together and recite a modified version of the Hippocratic Oath before being called up one-by-one to receive the white coats that they will wear throughout the upcoming trials and adventures of medical school. The …
On November 1973, I had an epiphany. My first week on my internal medicine clerkship, I realized that I had found my specialty: internal medicine.
Prior to medical school, I had worked with emotionally disturbed children in an inpatient hospital. I really enjoyed the experience, and learned a great deal. During my first two miserable years in medical school (I disliked how they taught the basic sciences and even more how …
Every health care system in the world is facing its fair share of challenges. Aging populations, the exponential increase in chronic diseases such as heart disease and diabetes, expensive new treatments—all at a time when most countries desperately need to curtail rising health care costs to save their economies. At the two extremes, we have fully public-funded (socialized) medicine versus entirely free-market (private) health care delivery systems. I’ve written previously …
OSH, or “outside hospital,” is one of those abbreviations that has crept into the lexicon of hospital jargon that merits additional scrutiny.
What are the implications of calling another health care facility “outside”; does that make your hospital the “inside” hospital? I suspect that it is, as many patient-related conditions are described, multifactorial. Or, if you like the band Fort Minor, “Remember the Name” (apologies to the band):
This is ten percent …
Reading about the opening of the Noah’s Ark Theme Park in Kentucky brings to mind the days when I worked as a physician in that state. I had moved from an academic position in Colorado and joined a large group of private practice cardiologists in Louisville. I found that people in Kentucky were different from those in Colorado. They were much more overtly religious.
As an interventional electrophysiologist, I would meet …
So, have you talked to your teenage daughter about sex?
Have you really talked to her about sex?
I’m not talking about the superficial birds and the bees conversation; I’m talking about using words like vagina, penis, and condom. Yes, those words!
As an obstetrician-gynecologist and a mother of girls, I know the challenges that our daughters face as they navigate their teenage years. I know how critical it is to have real …
“It’s strange how the worst day of your life often starts just like any other.”
– Joanna Cannon
I prepare for each clinic by reviewing the tests and scans of the patients who will be seen that day. Today, I am dismayed as I read a report for a longstanding patient. The news is not good; his scan shows that his cancer has returned.
Twenty years ago on a day like today, I …
A study published in JAMA Dermatology regarding women’s pubic hair grooming practices has people abuzz. This cosmetic act needs a formal medical name because “clamscaping” just doesn’t work on grant applications. Although why the authors couldn’t go with hair removal, I don’t know. The study wasn’t about styling, it was about removal. The study even made it into the New York Times. And yes, my first …
Every day, millions of women across the United States find themselves in predicaments confronting the quality of their appearance. And their makeup. While this may seem a non-issue in the emergency medicine world, it is something that you, as a female professional, or that your female colleagues, have no doubt encountered. Before walking out the door, you have to consider not just what means of transport to take to …
While visiting a family member in the hospital recently, I noticed the unkempt attire of one of the lab people coming in to draw blood. As she knelt down to better reach my family member’s arm, I noticed her scrub pants were frayed and dirty from her walking on them.
Shortly after I made note of this, one of her co-workers came in the room to see …
Cheryl lost her son Sean to suicide in medical school. Just a few months ago. Her only child. Cheryl didn’t know that medical students were at high risk of suicide — until her son was dead. Nobody warned her.
Rhonda lost her daughter Kaitlyn to suicide in medical school. Unable to recuperate from the pain of her daughter’s suicide, Rhonda died by suicide …
In my previous post, “Have physicians finally joined the working class,” I discussed the changes in the health care system regarding physicians roles in these systems. In this post, I propose two strategies that could help physicians regain some influence over their work and to participate fully not just in the execution of strategy from management but also have an input in creating it.
Building unions
There has …
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I have written about pain medicine, previously on this blog, and it generated some spirited responses. Let me be clear that I am completely against all forms of pain, whether foreign or domestic, physical, spiritual, psychic or even phantom. The medical profession has superb tools to combat and relieve pain, and physicians should utilize them, within the boundaries of appropriate use. We now have an actual specialty — …
“Medicine Purple is now rounding at Room 202.” The announcement rang throughout the hallways on the lower pavilion. It was an announcement I had heard many times before, but this time it was quite different. As I glanced in the upper right-hand corner of the electronic medical record of my first patient, the following glared back at me in all capital letters: “ATTENDING: COOPER, JOSEPH DAVID.” I had imagined the …
I am a professor of family medicine at the University of Minnesota Medical School. During their third and fourth years, students must complete a four-week clerkship in family medicine. The clerkship includes a “significant-event reflection” project, in which students discuss patient encounters that they’ve found especially meaningful.
Over nearly a decade as a facilitator for these groups, I have heard many powerful and emotional stories. I’ve often felt deeply moved–and admiring …
In my home, we have two conversations: politics and medicine. The most vociferous discussions are around their product, health care. We know doctors on the right and left, Democrat and Republican, boisterous blues, rebellious reds and garrulous grays. Respecting opinions and debate, we love ‘em all. However, no matter on what side of the aisle they stand, which lever they pull, they share one trait. All physicians are deeply conservative. …
I recently had the privilege of speaking to a group of high school students who were interested in becoming doctors. A large number of them were volunteering in my hospital, and their coordinator asked me if I could spare some time to chat with them about life as a doctor and what they should be doing to get into medicine.
I remember as if it were yesterday when I was their …
Dear future doctor,
Please remember. Remember what it feels like to be a patient.
Remember the pain, remember the anguish of the unknown, remember the detours of being referred from one physician to the next, and how you hoped that this doctor would finally be able to diagnose you and empathize with your suffering. Remember the agony of not knowing what caused the mysterious, writhing pain; however, at the same time being …
After finishing three years in medical school, I recently moved over to Stanford’s Graduate School of Business. I decided to pursue an MBA in addition to my MD and will graduate two years from now with both degrees.
I’m not alone. There are 11 MD/MBA candidates in my business school class, including nine from Stanford. Our cohort is part of a small but growing trend towards doctors obtaining business training. The …
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