It was another day in the intensive care unit. The night was clean and calm, ventilators beeping their expected melody, and the laborers of medicine went about their night shifts uneventfully, including me sitting with the obnoxious admission pager attached to my hip. The smoothness of it all shattered when the beeper started screaming – I picked up the phone and soon the emergency room physician was on the line.
“We …
We’re not going for sympathy here. Doctors as a whole enjoy less sympathy than many other professional groups (members of Congress enjoy the least, I would think), and that’s probably appropriate. They have high incomes and many prerogatives and rank highly in esteem polls as individuals, if not as a group. It’s not where they are that is causing the grieving, it is where they are coming from.
Let’s deal with …
Many doctors are now getting into movie production and making videos that are loaded onto YouTube. These videos are effective in attracting new patients and educating your existing patients. There are a few guidelines that you can use to create an effective script for each of your videos. These scripts can be loaded onto your computer in a PowerPoint format and will serve as poor man’s teleprompter to assist in …
I’ve talked to hundreds of people about the health care options and decisions they face at the end of life. It’s a challenging time and understandably many have little knowledge, while others have misconceptions, and some have bitter disagreements.
Here’s a basic primer for two common approaches: hospice and palliative care.
Hospice care
Two myths about hospice care are prevalent. First, many people believe hospice is provided in a place like a hospital. …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
As an anesthesiologist and pain physician, I understand the complexity of pain management procedures required for chronic pain disease. Chronic pain is a disease like others such as hypertension and cardiac disease. Several interventional pain procedures can be dangerous, even in the hands of the most …
“The question” comes in several forms: “Doc, what stage is my cancer?” “What is my prognosis?” “Can it be cured?” “Am I going to die?” “Have long have I got?” These tough honest words require courage. “The question” superficially asks for a simple answer. Time to live. However, in the real world of life and death, these questions and therefore the answers are far more complex and subtle.
Years ago we …
Would you rather your physician be an astute diagnostician or a compassionate and empathic practitioner? Of course, we want our physicians to be blends of these qualities. We want it all. We want them to be chimeras of Drs. House and Welby. But, is this possible?
I can’t say. I suspect that it is easier to cultivate soft bedside manners than it is to teach medical acumen, although the latter was …
Flavored water. Water with electrolytes. Tonic water. Sparkling water. Seltzer.
Grocery shelves are packed with so-called water options. But not every drink that bills itself as water is the real deal.
Many drinks labeled as water are loaded with sugar and empty calories. Even though these drinks have ‘water’ in their name, drinking them regularly may cause weight gain and may increase your risk of obesity.
And, that’s bad news because maintaining a …
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 …
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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 …
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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 …
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“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 …
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