The names of things often greatly affect our perception. In end of life lexicon, there is a movement underway to change the name of the medical order DNR (do not resuscitate) to AND (allow natural death). No change in the medical reality of what occurs, but a radical change in our emotional reaction to the each term.
DNR: “They withholding a medical intervention” (evoking negative feelings).
AND: “They are giving care that …
The following column was published on August 5th, 2012 in USA Today.
A patient once blamed me for causing him considerable anxiety because he had to wait several weeks before receiving the results of a lab test, which I had ordered. Many patients commonly have to wait days, if not weeks, before getting lab results from their doctor. The delay can affect patients’ health negatively.
For instance, one study looked at women who underwent …
Burnout is a constant threat for physicians. Research consistently shows an average of 1 in 3 doctors suffering from symptomatic burnout on any given office day. In my work with over stressed and burned out doctors, I have found that most of us work way too hard being the superhero to our staff, patients and families — and don’t have any fun at all. It doesn’t have to be …
“What would you do if you were your doctor?” Mary asked me. Mary is my physical therapist and she was trying to figure out why the rehab after my shoulder surgery was progressing so slowly. A month after my operation I was still in pain and still not moving the joint well.
Without hesitation I replied: “I’d come up with a differential diagnosis.”
Differential diagnosis is a two word summary of how …
Unless you’ve lately returned from a retreat at a remote Cistercian abbey, if you’re interested at all in women’s issues you’ve probably read Anne-Marie Slaughter’s recent article in the Atlantic, “Why Women Still Can’t Have It All.” The author eloquently tells how she left her dream job in the State Department as the first woman director of policy planning in order to return to her husband, her two …
As odd as this might sound, my mother was upset when I declared my intention to go to medical school.
It wasn’t the mountain of debt I was sure to incur since I’d already figured out how to get Uncle Sam to pick up the bill (a small deal that put me in a military uniform for a decade). It wasn’t the …
We all know that the use of baby oils and baking in the sun for hours on end is probably not a good idea. We know that increased sun exposure correlates with increasing skin cancer rates. We know that it can cause accelerated skin damage in the form of pigmentation changes, wrinkles, and increased skin laxity. Don’t believe me? Check out this picture! Truck drivers tend to get increased sun …
Does your doctor use a computer in the exam room? Some people think that computers are a great way to keep track of patient information. Others see some advantage, but problems in the implementation. There are also a few Luddites who oppose this change simply on principle. I’ve had good experiences, and bad experiences, and believe we have a long way to go before computers are as helpful as they could be.
There …
As a doctor, I appreciate that I am at an advantage when I seek medical care. Knowing terminology and basic medical principles helps a lot. In addition, when you’ve been practicing medicine for a while you get a feeling from how a doctor discusses options if the care seems valid or if a second opinion is in order. Other things I look for are board certification and a doctor …
If you pay attention at all to news about medicine, you must have heard about the tragic death of a 12-year old boy who was seen and discharged from the emergency department of the prestigious New York University Medical Center. He had developed sepsis from what appears to have been a small cut and the diagnosis was missed. When he eventually returned to the ED and was admitted, it …
Zumba, the Latin dance-inspired fitness craze, is a great way to burn calories, up to 500 per hour. It also gives you a good cardiovascular workout without making you feel like you’re exercising. This increasingly popular workout attracts a diverse crowd at dance studios and health clubs, including a sizable number of those 50 and up.
But for people who are out of shape, taking the first classes can be like …
“Dr. Fisher, can you teach our residents EKG lecture series?”
Naively, I said “Sure!”
What I didn’t realize is how hard this is to do today.
Much of this is not residents’ fault. They only have so many hours in so many days to attend lectures while caring for patients. Thanks to residency work-hour restrictions, those hours have become even fewer. To make matters much worse, through the year residents are torn to …
Full disclosure. I have 4 board certifications and dutifully do all of the required reading, continuing medical education (CME) and recertification exams to maintain my status (I am board certified in OB/GYN in both the US and Canada as well as board certified in pain medicine by both the American Board of Pain Medicine, ABPM, and the American Board of Physical Medicine and Rehabilitation).
I would never go to a non-board …
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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
As a critical care anesthesiologist, I care for patients when they are most vulnerable. Critical care patients require intravenous (I.V.) fluids and medications, frequently through central venous access. These are catheters inserted into larger veins with a special procedure. I believe managing I.V. lines requires procedural skills, …
You know the headlines. You read them and hear them and see them every day.
Someone gets angry at the system and shoots someone or several someones in cold blood, often having planned the act, gathered the necessary firepower and ammunition ahead of time, stalked the victims, checked the schedules and shown up at the right time to do maximum damage.
A family including mother and young children in a van are …
The patient had a large abscess surrounding his spleen. On a large screen in the middle of the operating room, I watched a surgeon drain the fluid collection and remove the organ with small metal tools.
I remember the surgeon navigating the complex anatomy with alacrity, handling the laparoscopic equipment with expert finesse, and quickly and confidently answering the battery of questions from the assisting medical student. To a young and …
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Whether you’re starting medical school or beginning your second year, this post is for you. Will probably work just as well for PAs, NPs and any other health professional student who hasn’t started clinical rotations.
Our former babysitter just graduated from medical school and the WhiteCoats are just as proud as her parents are. Then I started thinking, what advice would I give to students starting medical school?
Our first day of …
When President Obama turned 50 last year, he made an “informed patient request” for a PSA (prostate specific antigen) test. This is the blood test routinely used to screen men over 50 for possible prostate cancer. The President received his PSA test. But under ObamaCare, you may not be able to.
Now that ObamaCare has been upheld by the Supreme Court, all of its major provisions will be in force, …
Across the country, newly minted doctors have started their internships. The first night on call there won’t be an intern – anywhere in the country – who will sleep. Every new intern is absolutely convinced that the beeper is going to go off and they won’t know what to do. (You get over this by about the 2nd or 3rd call night, by the way).
Graduating from medical school …
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Student loan debt is at an all-time high at a little over 1 trillion dollars, a figure that now, for the first time ever, exceeds our nation’s credit card debt. Higher education has never cost more, the rate of rise of college tuition having exceeded in recent years the rate of rise of many other services. Perhaps as a result of this, as well as of the difficulty in obtaining …
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