So, there I was yesterday, working frantically to keep myself above the water level of the rapidly rising swamp of patients. Navigating, haltingly, the onerous and demonic EMR. So I thought I ordered three nebulizers, but it was only one. The respiratory tech approached me and informed me that she would put them in, but only this time. That I’d have to …
Why should physicians have to enter orders in the computer?
It was only afterwords that I wondered if I had been condescending. The words had come out so naturally. We were sitting across from each other in the nursing home. It didn’t take a doctor to recognize that his leg was visibly less swollen. I had seen him walking down the hallway with the physical therapist. His face a mix of pain, …
Let patients know when you’re proud of them
For all the talk about patient-centered care and a new health care paradigm — which is, of course, the right way forward — the doctor-patient relationship will always remain relatively one-sided because of the nature of the profession itself. Essentially, patients come to doctors for help, and the knowledge transfer, advice, and guidance flows in one main direction.
But that doesn’t mean that …
Patients can teach doctors these 5 things
We live in a time of great cynicism and skepticism. We seem to see only the mundane and boring in even the most interesting and spectacular things. The electrical rhythm of the heart that pulses through cardiac tissue and results in a coordinated muscle contraction that effectively ejects blood to the rest of the body for appropriate oxygen delivery is just … a …
Superhero doctors are what we aspire to be
I found out my mother was dying via text message: YOUR MOM HAS A BRAIN TUMOR IN HOSPITAL — DAD
When the neurosurgery PA wheeled the computer into the exam room to show us the MRI the next morning, I found myself silently uttering an unanswered prayer that the mass would be small, resectable, peripheral. It wasn’t.
“Oh my God,” Mom whispered. “I’m going to …
A mother with terminal brain cancer. Her daughter brings her home.
I’m not actually on TV, but there are days I feel like I’ve accidentally stumbled onto the set of a sitcom. When neighbors have never seen your husband in the light of day and friends joke that he is make-believe, then you might be married to a … well, you know the joke.
Being married to a busy physician can leave you playing …
I’m not a single mom. I just play one on TV.
Polycystic ovarian syndrome (PCOS) is becoming a significant problem in women’s health. Between 1 in 10 to 20 women have the condition, although more than 50 percent remain undiagnosed. PCOS is the leading cause of female infertility and women who do become pregnant have higher rates of miscarriage, preterm birth, and gestational diabetes.
Women with PCOS have a greater likelihood of developing diabetes, cardiovascular disease, and endometrial cancer than women without …
You might be missing a PCOS diagnosis. Here are 10 reasons why.
“Sometimes a simple, almost insignificant gesture on the part of a teacher can have a profound formative effect on the life of a student.”
– Paulo Freire
Think back to a moment when a teacher or “authority” figure gave you a compliment. We all have them, from kindergarten to high school to college and sometimes graduate school and work. The reason why many of you can recall such moments is that unlike …
Being an attending means being a teacher. Take that job seriously.
The U.S. health care system is headed toward a profoundly digital future. Provider organizations around the country are adopting and updating their health information technology (HIT) infrastructures. Many have begun requiring that clinicians gain proficiency in electronic health records (EHRs) in order to provide clinical care. A proliferation of start-ups and HIT companies in health care is poised to disrupt (innovatively or …
Strong ethical principles should guide EHR implementation
I’m a physician entrepreneur. In 1998, I opened my first clinic. My malpractice: $500 per year. Then I tried life as an employed physician. Hated it. So in 2005, I opened my ideal clinic. Best. Job. Ever. My malpractice: $1,230 per year. Want low premiums? Here’s how I did it.
A quick tutorial. New malpractice policies mature over five years. So the first …
How I got 86% off my malpractice insurance. Now, you can too!
The acronym “MI” has traditionally meant myocardial infarct, or heart attack. Recently it’s taken on a new, more salubrious meaning: motivational interviewing.
A growing number of docs are practicing this technique, which amounts to listening to patients to help them recognize their internal sources of behavior. Boston’s NPR affiliate, WBUR, describes typical MI interventions in which doctors, instead of demanding that patients stop smoking or drinking or overeating, gently …
How motivational interviewing can relieve patients’ suffering
The number of African-American physicians in academic medicine is dismal, and this leads to an abundance of problems. Academic hospitals (teaching hospitals associated with universities) generally do not have a proportionate representation of underrepresented minority faculty as compared to the surrounding population. According to a U.S. News & World Report article, the number of African-American faculty increased by 0.2 percent in ten …
Analyzing the deficit of African-Americans in academic medicine
People can wear what they want in America. Whether you want to debut the latest vogue or your midriff rife with adiposity, you are free to do so. But just because you can, doesn’t mean you should. In the span of one week, I found two people — on two separate occasions — wearing white coats, each …
Doctors shouldn’t wear their white coats in public. But some still do.
The drug test came back abnormal. There was THC present. I walked back to Mrs. Johnson and raised my eyebrows.
“What’s wrong?” she asked, not used to whatever kind of look I was giving her.
“Uh, you forgot to mention to me that you smoke weed.”
She blushed and then smirked. “Well, yes, I guess I forgot to put that down on the sheet. I don’t …
A patient fails a drug test, but stays in this doctor’s practice. Here’s why.
1. Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse.
Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to …
10 things you might not know about the emergency department
With much hype and fanfare, the independent investigative journalism outfit, ProPublica recently released their Surgeon Scorecard, assessing individual specialist surgeons who perform elective knee and hip replacements, spinal surgery, prostate surgery, and gallbladder removal surgery.
I had blogged about the impending release. My trepidation about the idea of a non-medical, non-scientific organization analyzing complex surgical data concerned issues such as …
Why the Surgeon Scorecard is a journalistic low point for ProPublica
In the news recently has been a complaint filed by over 60 Asian-American groups, alleging discrimination in admissions at Harvard. They point to such statistics as this: in 2009, among accepted applicants to the Ivy League, the average SAT score on a 1600 point scale for Caucasians was 310 points higher than Hispanics …
Asian-American discrimination: Is medical school next?
Recently I read an article in the New York Times by Elisabeth Rosenthal. She’s the same author of the enlightening article, “My doctor charged me $117,000 and all I got was this lousy hospital gown.” That may not have been the exact title of the article.
Following that article she wrote a follow-up about the long and difficult ordeal …
There’s a good reason why doctors don’t send test results
Natalie Fuelner created a well-written article in the Bangor Daily News describing some of the tribulations many new parents go through with young children. One weekend, her toddler fell face first onto a metal patio table. Immediately, the toddler’s face is full of blood. The dad panicked. Natalie was a “trembling mess” on the inside.
Their physician neighbor wasn’t available to look at the child. …
A patient is angry with her emergency care bill. But here’s what she really got.
“Your wife has gestational diabetes.” My heart stopped when my wife’s physician called to tell me this. “I want you to tell her because it’ll be easier to give it some time and let it sink in. Tell her to call me if she has any questions.” But I had questions — about a million.
Let me give some background information. I’m …
A physician’s experience with a false positive test result
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