Have you ever said, “I’m going to be perfectly honest with you” or something to that effect? Have you ever had someone tell you that they were going to be perfectly honest with you? Have you ever thought about what statements similar to these really mean? You should.
Trust is an earned commodity and hard to get back once lost. “Doc, I’m going to be perfectly honest with you” means that, …
Impersonal and self-absorbed as Manhattan may be, it’s still embarrassing to cry on West 32nd Street. I looked for a store, any store, and ducked inside. The pace of my steps and angle of my head as I buried myself into a back corner, thumbing through pants twice my size, gave me away. A store clerk walked over and asked if I was okay. I knew I’d have to meet …
If you are a second-year medical student, there is one thing on your mind at this time of year: Step 1. Although scary, there are things that you can do to help calm your anxiety and get your best score.
Set a goal
In my opinion, before you start really preparing for Step 1, you should have two things clearly in mind: where you are with your score and where you want …
A few months ago, I came out with a post on why I love my own doctor. Today I want to celebrate my patients, both past and present. For me, without the experience I have had over the past 14 years, I would not have enjoyed medicine quite as much as I do.
What I like the most about medicine is the ability to interact with people. That’s what clinical medicine is all …
Here’s something I read recently in a blog post (The Limits of (Neuro)science at Neuroskeptic) that started me thinking: “Will science ever understand the brain? … The notion that humans are complex and hard, while nature is easy, is an illusion created (ironically) by the successes of reductionist science. Some of the biggest questions facing mankind for eons have [been] answered so well, that we don’t even …
I eyed my chat screen with a good amount of suspicion. A friend of a friend who I had rarely spoken to had initiated a chat conversation with me with the opening line “How are medical school apps going?” The cursor blinked in anticipation.
I began to think about possible ulterior motives that she, another pre-medical student, could have had. Perhaps she just wanted to use me as a comparison for …
Full code is the universal default status for patients who haven’t chosen otherwise, but I suspect most physicians believe this policy is wrong. We know in our hearts we’re doing harm when we perform CPR on poor souls at the natural end of their lives, whose bodies can do nothing more than suffer.
Appropriately timed end-of-life discussions are the supposed answer, but for doctors, they are emotionally draining, interpersonally complex, and …
I recently came across two articles in the press concerning doctor-patient relationships and communication. I began to reflect on what makes communication between doctor and patient most successful and many questions surfaced.
In the New York Times, a new study published in Annals of Internal Medicine was referenced. In this study, the way in which doctors communicate non-verbally was examined. Non-verbal communication was often discordant to the message being relayed, particularly …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old man is brought to the emergency department after becoming disoriented, combative, and agitated earlier that day. He is accompanied by a friend, who states that the patient has a history of alcohol and drug abuse, including inhalants.
On physical examination, the patient is uncooperative and …
Being a child in 21st century Mexico utterly differs from any other era. The last decade has been a constant whirlpool for Mexico. Political, cultural and economical changes have shaken the country to its core. Primary care physicians, particularly pediatricians, have a burdensome challenge at hand.
Problems like obesity have quickly emerged in all age groups. Obese children, childhood type 2 diabetes and sedentary lifestyles have invaded Mexican homes. Nutrition related customs …
Today and for the next few years the weather of this industry will be dominated by pervasive, discontinuous change. Structures, revenue streams, relationships of every level: All are shifting in fundamental ways. Specifically, the weather will be driven by:
i) invention and propagation of new business models;
ii) shifting risk onto both the provider and the patient, accompanied by building of new risk-based relationships, contracts and alliances;
iii) smart primary care coming to …
There are an awful lot of reasons that led up to my eventual resignation from a career in primary care medicine. I don’t know that any one of them is more important than the other (it really just depends on which day you ask me). One that stands out for me though as a universal problem shared by millions is Managed Health Care, and the imposition it has posed on …
Looking back on the first three years of medical school, it’s hard to imagine living through the endless days of studying again. Weekends were spent cooped up in the library and there were countless holidays that I wasn’t able to spend with my family. Instead, they were spent memorizing indecent aspects of the human anatomy and performing DREs on strangers. There are better ways to get to know a person …
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Does muscle weakness improve after disc surgery?
For an NFL fan arguably the best thing that could happen to your team is to sign Peyton Manning and have him perform at or near his pre-injury level. The corollary is that one of the worst things to happen to your team would be to take a huge salary cap hit to get a Peyton Manning with such weak throwing arm that even …
If you really want to know what’s going on inside your colon, don’t show-up for a colonoscopy without a clean colon.
Many say that preparing for the colonoscopy is the worst part of the entire exam. But, it just so happens that it’s also the most important part.
If the prep is done right, it’s easier for your doctor to see not only big polyps but also flat polyps, which can be …
(All names and identifying features of characters in this story have been changed.)
Nora, a third year medical student, came to me in moral distress.
Ms. DiFazio, one of the hospitalized patients on her internal medicine rotation, was frightened to undergo an invasive (and expensive) medical procedure: cardiac catheterization.
The first year doctor with whom Nora was paired, Dr. White, vented to her:
“These patients come to us seeking our help and then refuse …
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After undergrad, and before starting medical school, I worked for two years as scribe in the emergency department. I followed emergency physicians and completed their charts as they saw patients. I would also remind the physicians of various tasks to complete, alert them of abnormal lab values and pull up x-rays to be interpreted.
One of the reasons I wanted the job was to gain experience in medicine, first as a …
Just when American healthcare system seems so dysfunctional that it seems impossible to imagine how it could be screwed up further, a decision is made that restores one’s faith in the creativity of Man. But before you run out of guesses as to which particular decision we’re talking about today, we’ll just blurt it out. We are referring to a recent decision by Washington State Medicaid to deny payment for …
A tug-of-war is going on in medicine right now between the past and the future. The present is confused and very unsure of itself.
Though I could be writing about health care in the U.S and the looming Supreme Court battle over the new health care law, I’m actually raising a much more intimate issue: Whether your doctor touches (examines) you or not.
Many pundits have weighed in on whether the …
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There’s been a great divide between the medical and surgical specialties ever since I can remember. Surgeons believe internists perseverate too much when decisions need to be made. Internists consider themselves the true intellectuals of medicine. I suppose anesthesiologists like me fall somewhere in the middle–we work in surgery, but have to take care of all the medical problems the patient brings to the OR table. Does that make us …
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