I noticed that my writing and conversations with others convey far less emotion than usual. My reserve for tolerating stress had reached maximum capacity, which I realized upon my first day back at work from vacation three weeks ago as exhaustion immediately erased any sense of relaxation from my trip. Perhaps I should have requested two weeks off instead of one? Either way, …
I would think that when physicians decide where to set up practice, there are things that they would want to think about other than how much money they’ll make. Yet if one reads Medscape’s current list of the best and worst places to practice, it would appear that money trumps everything else (although Medscape said it also considered factors like “cultural attractions”). What Medscape apparently did not consider …
Teleradiology has the same effect on radiologists as Lord Voldemort has on Muggles. It’s the feared end point of the commoditization of imaging, with Rajeev in Bangalore outpricing Rajeev in Chicago for reading follow-up CTs for lung nodules.
But despite the fears of U.S. radiologists, their counterparts in India have more pressing things on their mind.
“U.S. radiologists think that Indian radiologists are …
Idioms are expressions everyone understands as something other than what the literal words say. For example, when I talk about “putting all of my eggs in one basket,” everyone knows I’m not really talking about eggs.
We say things like:
It’s raining cats and dogs.
It was a piece of cake!
I heard it straight from the horse’s mouth.
We have a few idioms in medicine, too. If I talk about “hanging crepe” in a …
Below is a letter I have written to parents who are hesitant about giving vaccinations to their children. I don’t know how many it will convince, but I needed a respectful and informative way to follow up with parents who expressed concerns or declined vaccinations, and this is what I now share with them after such visits. This is written not …
Twitter is a communication platform, and, therefore, it is a neutral medium. It’s not the medium itself, but how you use the medium that makes Twitter “good” or “bad.” In my five years of being an anonymous and five months of being a named individual on Twitter, I have come to realize that different people use Twitter for different purposes. In …
Question from a reader: “What are your feelings about when a patient breaks up with you? I love love my doc, but …”
Patients “break up” with me all the time. Well, not all the time, but it’s not uncommon. There are many reasons, some of which are under the patient’s control, and some which are not. Moving across the country is …
I’m a family physician in Eugene, Oregon — a sweet town where folks are pretty darn friendly. I still do house calls. Patients often surprise me with gifts. And nearly every appointment ends in a hug.
Kindness is contagious.
I like to return the favor. So every few weeks I celebrate “patient appreciation day.” I thank patients with balloons and chocolates. Why? For …
In case you were wondering — robots won’t replace anesthesiologists any time soon, regardless of what the Washington Post may have to say. There will definitely be a place for feedback and closed-loop technology applications in sedation and in general anesthesia, but for the foreseeable future we will still need humans.
I’ve been practicing anesthesiology for 30 years now, in the …
In the world of health care, we face a lot of questions and challenges. Hospital administrations across the country are grappling with these and always on the lookout for solutions. As far as raising the standard of health care quality, there’s been great progress over the last several years in the areas of patient safety, adhering to best practices, and trying …
There’s a simple way to define value. Ask why we exist.
Imaging exists because clinicians are uncomfortable with uncertainty. Imaging exists because emergency physicians feel that being 98 percent correct about the absence of pulmonary embolism is not good enough. Radiologists exist because imaging is not an assay on a Western blot with a 100 percent accuracy. Radiologists exist because information is …
A patient undergoing a colonoscopy pressed “record” on his smartphone before being sedated, hoping to capture instructions from his physicians after the procedure. What he heard instead was shocking: “In addition to their vicious commentary, the doctors discussed avoiding the man after the colonoscopy, instructing an assistant to lie to him, and then placed a false diagnosis on his chart.”
The incident cost his …
In the last several shifts I’ve worked in the ED I’ve had more people stop and compliment me on my care. I’ve heard the usual, “Do you have a private practice?” compliment and, “I’ve been here a lot and you really took the time to hear what I was saying, I appreciate that.”
Kudos are nice. They are what makes a tough …
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I have received many questions on this topic from medical students so I thought I would share my thoughts on choosing the right medical specialty for you. I hope you find this helpful.
1. Relax. The medical degree offers more flexibility than any other graduate degree. Even if you realize your selected specialty no longer fits you there are multiple areas your degree …
Being related to a famous person is somewhere between a cruel joke and a minor distraction. My father was immensely talented and worked very hard at his writing, but the degree of his success was a fantastically unlikely bit of luck. There are lots of talented, hard-working artists who don’t make it.
The important thing in overcoming mental illness, whether or not …
Here’s a question for you: Which causes more deaths, motor vehicle traffics accidents or firearms?
I asked a bunch of people that question, including a bunch of doctors, and everyone said that motor vehicles did, by a lot.
According to the Centers for Disease Control and Prevention (CDC), in 2013, 33,804 people died from motor vehicle traffic accidents — and 33, 636 died from firearms.
They kill the same number of …
Quintessential Messi. One moment he is standing over the ball, in a seemingly harmless position at midfield, the next thing you know you are picking the ball out of the back of the net. How did this come to pass? How did things change so rapidly? When you watch it the first time, it’s disorienting. It makes no sense. How does …
Desiree wrote in, “My 15-month daughter and a few other kids at her daycare were just diagnosed with hand-foot-mouth disease. I would like to hear how common it is, what treatments (or ways to soothe) you find helpful, and how you would differentiate this from measles or chickenpox. For example, my little one has blisters all over her body, not just H-F-M. …
Recently I’ve been asked to write about rural surgery, what it’s like, what’s good about it. Everything has its ups and downs.
First of all let me say that whatever your job is, the money you get paid to do that job is for the crappy part, and every job has a crappy part. The trick is to find a job that …
A recent series of articles in the Washington Post and a segment on NPR have caused quite a stir. The articles are about what we have called for decades shaken baby syndrome. It can be fatal. We now use the term non-accidental head trauma. This term replaced the older one because it is more specific; children can be …
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