Not accustomed to visiting hospital executive suites, I took my seat in the waiting room somewhat warily.
Seated across from me was a handsome man in a well-tailored three-piece suit, whose thoroughly professional appearance made me — in my rumpled white coat, sheaves of dog-eared paper bulging from both pockets — feel out of place.
Within a minute, an administrative secretary came out and …
The simple truth is that radiology reports can be hard to read, especially for those without a medical background. The combination of advanced medical technology and the wonderful subtle intricacies of the human body often result in a final document that more closely resembles a William Faulkner novel (translation: difficult to understand!) than Dr. Seuss. The goal is to try to …
Why do so many seemingly great technologies fail to penetrate the health care system?
I hope the following five answers shed some light on the realities of technology adoption in health care.
1. Many new technologies don’t address the real problem
Tech entrepreneurs often take a backward approach to invention. They start by discovering a nifty technology. Later, they figure out how people can use it.
This technique often teaches entrepreneurs a tough lesson: Technology …
“All your patients will die. Maybe not today, but someday. The defining fact of life is that it ends. Only a fool would dedicate their career to fighting something that can never be beaten. Therefore, a doctor’s task cannot be to fight death. A doctor’s task is to heal when possible and prevent suffering always. Our calling is to support life. Fighting death may deprive patients of the opportunity to …
In my mind it’s no wonder the American Academy of Pediatrics has a statement against spanking. Spanking, in the simplest form, is the act of hitting a child, using physical force to try to get a different outcome. Thing is, spanking is an ineffective discipline tool in the long run and research shows it’s damaging to a child’s mental health. …
The case
A thirty-five-year-old female presents to the emergency department on a weekend afternoon with the following chief complaint: “I want to give up custody of my son.”
The patient is well dressed — and so is her four-year-old son, who is sitting comfortably on the bed playing a video game on his mother’s cell phone.
According to the patient, she is a single mother with no support system. Her son’s father deserted …
This evening, I read a post written by a woman who finds herself feeling alone, depressed, desperate, and afraid of losing herself as she goes through medical school.
This post is my response to that woman.
Dear colleague and friend,
You are not alone.
You are far from home. You are far from your family. You are far from the desert, the open …
I have a patient who is a full blown sufferer of health anxiety. He firmly believes he has full-blown AIDS after a single extramarital sexual contact (non-genital) one month prior with a woman not known to have HIV. (Reality check: The other person didn’t have HIV, the specific contact as described was ridiculously unlikely to have transmitted the virus had it been present, and AIDS takes months to years to develop …
“He’d feel okay about not replacing the pacemaker’s battery when it ran down, he said. But turning it off, he said, would be ‘too active.’ Later he would tell me that it would have been “like putting a pillow over your father’s head.”
These are the words of Katy Butler in her book Knocking on Heaven’s Door – The Path to a Better Way of Death in which she writes about her …
Wendy Davis, gubernatorial candidate for Texas, has a new memoir Forgetting to Be Afraid. In it she describes terminating two pregnancies. One termination appears to have been in the second trimester for fetal indications and the other she describes as an ectopic pregnancy. She writes, “The only medical option was to have surgery to terminate the pregnancy and remove the affected fallopian tube — which …
Everyone involved in health care, and particularly hospital care, has witnessed a sea change over the last decade. Things that were never even thought about, let alone formally taught to frontline doctors and nurses, have now come to the forefront.
Chief among these is the drive towards improving patient satisfaction and delivering a more optimal hospital experience. True, a large part of this is due to federal incentives and tying reimbursements …
The Canadian health care system is often held up as an example to model or to avoid at all costs in the debates on health care in America, and elsewhere. Yet there are a startling number of misconceptions — on both sides of the partisan divide — about how the Canadian health system actually works, often from experts who should know better. Here are the facts.
1. Doctors are self-employed, not …
Ever wonder what a “gomer” is? While certainly passé and unprofessional, does it shed light into the frustrations both doctors and patients have with end-of-life care? Emergency physician and author Brian Goldman explains the origins and use of such medical slang in his book, The Secret Language of Doctors.
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Value-based health care is antithetic to patient-centered care. Value-based health care is also diametrically opposed to excellence, transparency and competitive markets. And value-based health care is a shrewdly selected and disingenuously applied misnomer. Value-based pricing is not a health-care innovation. Value-based pricing is why a plastic cup filled with tepid beer costs $8 at the ballpark, why a pack of gum …
7:00 a.m. Lights on.
Coffee, black and a banana. Paperwork. 27 patient visits, 3 emergencies, 35 phone calls. Lots of computer time. Some laughs and a few tears. Paperwork. Last family meeting. Coffee, black. In between: Thursday.
Was not completely successful in explaining to my frantic patient with the multi-page lab printout, how the problem was not that her tests were bad, but that the computer had used the wrong “normal” range …
Dear NICU nurse,
I couldn’t have done what I do without you, and the time to thank you publicly for all the ways you have helped me is more than overdue.
Thank you for teaching me how to handle 500 grammers when I was a medical student and had no clue. This showed me your tolerance and good nature.
Thank you for speaking up …
While running several times over the past week, I have thought carefully about our profession. I cannot imagine having chosen any other profession than medicine, nor any specialty other than internal medicine.
But that is me, is it you?
A medical tweeter than everyone should follow @medicalaxioms had these tweets recently:
If you become a doctor for wealth or prestige, you are going …
We are, I trust, all but universally familiar with the knee-jerk, or patellar, reflex. A doctor taps the patellar tendon with a rubber mallet, and our leg kicks forward in response.
The reaction is famously unthinking. In fact, it is literally so. What makes a reflex a reflex is that the brain is substantially uninvolved. The stretch of a tendon by the mallet …
My patients lie to me every day. Some tell me that they have been taking their medications regularly when they haven’t. Some say that they have been eating a healthy diet and exercising for at least 30 minutes every day and don’t know where the extra pounds are coming from. Some lie that they are using condoms every time they have sex, that they have quit smoking, and if they …
Dr. Michael Pappas hates it when a nurse practitioner is called a mid-level provider: “Stop calling nurse practitioners mid-level providers.” So do I, though my reasons are a bit different. In order to understand them it will be necessary to revisit those dark ages, a time when such individuals were few and the roles played in the drama we know …
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