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
A hospital can be full of discomfort. My patients tell me that the food is unappetizing. The beds hurt their backs. The noise echoing through the hallways at night makes it impossible to sleep. And for those patients near the end of life, the treatments being offered may no longer be of benefit, causing more pain than good.
The answer to discomfort for those who are very ill is comfort care, …
Comfort may be the most important thing that physicians can provide
“Only one rule in medical ethics need concern you — that action on your part which best conserves the interests of your patient.”
– Dr. Martin H. Fischer, German-American Physician and Author
“A physician shall, while caring for a patient, regard responsibility to the patient as paramount.”
– Principles of Medical Ethics, American Medical Association
“I pledge to pursue the practice of surgery with honesty and to place the welfare and the rights of …
The physician is the ultimate patient advocate
I hear this fairly often: Women telling me they asked their GYN for an IUD and were told that they couldn’t because they had never had children. Their GYNs are wrong and unfortunately it’s not just a few who think this way.
A study from last year tells us that 32 percent of OB/GYNs think that women who have never …
What to do when your doctor says you can’t have an IUD
It’s been a very slow week in my office. Today we almost pitched a no-hitter, having only one patient come in toward the end of the day. Overall, we’ve been quiet in nearly every way: few phone calls, few patients stopping by, few appointments, few secure messages.
What’s wrong?
That was a trick question. This is exactly what should be happening when things are going …
A quiet day in the doctor’s office: And that’s the way it’s supposed to be
After the last elective case of the day, the neurosurgeon I was shadowing told me that he was on overnight call that evening, and that I could stick around to observe more surgeries if I wanted to. “Yes,” I responded. “Absolutely yes.”
My fascination with surgery stems from its ability to provide immediate results to a patient by cutting out, repairing, reshaping, or …
A neurosurgery case that this medical student won’t forget
The transition between the basic science years and the clinical years in medical school are jarring, mystifying, exhilarating and thought-provoking. Recently, I did an hour conference with approximately 30 medical students. About half started their clinical year five weeks ago, while the remainder have only three weeks left before they finish the year. They gave me permission to share our discussion. We focused on their (and my) observations about the …
10 thoughts on the transition to a third-year med student
Manny Alvarez is a 23-year-old college student with the misfortune of having not just a devastating cancer — but the wrong devastating cancer. The chemotherapeutic agents shown to be highly active against his specific tumor cells are FDA approved for the treatment of leukemia, but not for the stunningly rare kind of sarcoma with which Manny has been diagnosed. Nothing is …
There are only 3 ways to allocate health care resources
The scalpel hits the skin immediately, splaying it open with one smooth swipe. Two more swipes through yellow globular fat and I hit the glistening white fascia layer. If this weren’t an emergency, I would stop to carefully cauterize the small bleeding blood vessels in the fat layer, but there is no time for that now. I nick the middle of …
You’ll be shocked to see what an emergency C-section is really like
I never really watched medical shows, even before and during medical school. I watched maybe one season of ER, a couple of seasons of Grey’s Anatomy and House MD and maybe one episode each of Private Practice, Chicago Hope, Emily Owens MD and other random medical shows. The only medical show I made an exception for was Scrubs, because it was …
The problem with medical TV shows. A surgeon sets the record straight.
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