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Poker face: The complex psychology of the patient-doctor interaction

Physician

July 6, 2015

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Patient-doctor communication often has many facets, wrinkles, and twists. Medical school prepares a doctor minimally for the ups and downs of these patient interactions. There is no mannequin who can train each medical student how to deal with every personality, response, or even outburst by each patient. On the job training is sine qua non.

During and after medical school, it took …

There is no shame in honest work, no matter what the job description is

Erica McCaleb Camp

Physician

July 6, 2015

When my sister, Jessica, was a nurse anesthetist student at the University of New England, she had the opportunity to rotate at Johns Hopkins, and she seized it. She was young and fairly new to the medical world and so she did not recognize at first the name of the neurosurgeon with whom she would be working — Dr. Ben Carson. After receiving multiple comments from numerous people about how great it …

An inappropriate use of medical jargon: Words do matter to patients

Laura Withers, MD

Physician

July 6, 2015

My patient had suffered a terrible, crushing injury to his chest leaving many ribs and his sternum fractured, his lungs and heart badly bruised and his body on the edge between life and death. He was on a ventilator, the tube through his mouth into his windpipe pushed air into lungs that couldn’t draw for themselves. He was on constant medications for pain and to sedate him while we used …

Mad Libs for medicine. Do you think you can use these?

Edwin Leap, MD

Physician

July 5, 2015

Do you remember Mad Libs from when you were a child? A story is filled with blanks, and as you fill them in with inappropriate and ridiculous words, you laugh until you can’t see straight. You laugh until you can’t breathe, and your parents beg you to stop! Let’s be children again. Share these with the nurses, and give the shift a little levity.

Pain medication. You see, doctor, my pain specialist …

A physician enters rehab. What happens next should disturb you.

Anonymous

Physician

July 4, 2015

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I’m a physician, and I’m adrift. I am pretty much lost at sea. I’ve often thought of writing this column, but afraid I’d be recognized, I’ve hesitated for years. Even now, I’ll most likely remain anonymous, because I’m in a vulnerable position. Let me preface my remarks with the reassurance that I’m not a bad person.

I developed dependence on opioids several …

The darker side of being a doctor

Joanne Intile, DVM

Physician

July 2, 2015

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I recently read an article written by a human physician about her personal feelings and other people’s reactions to her decision to quit practicing medicine.

The author frames the article around how her choice was made after she recognized how detrimental her career was to her own health. The irony of a doctor abandoning her profession because it was causing …

Read more…

The darker side of being a doctor

Can a surgeon operate while sitting down?

Skeptical Scalpel, MD

Physician

June 30, 2015

A loyal reader alerted me to news of a lawsuit brought by an obstetrician in South Carolina who is suing a hospital for suspending his privileges. He had performed a cesarean section while sitting on a stool because he had a foot fracture secondary to diabetes. Several witnesses said that the doctor “had been unable to properly view the surgical field, …

A psychiatrist is burnt out and depressed. Here’s what she did about it.

Vania Manipod, DO

Physician

June 30, 2015

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, …

The best places for a doctor to practice: It’s more than money

Bob Doherty

Physician

June 30, 2015

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 …

Indian radiologists have more to worry about than teleradiology

Dr. Saurabh Jha

Physician

June 29, 2015

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 and axioms provide a glimpse into medical culture

Kristin Prentiss Ott, MD

Physician

June 28, 2015

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 …

A letter to parents hesitant about vaccines

Brian Elkins, MD

Conditions

June 28, 2015

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 …

So you want to change doctors. Here’s how to do it right.

Lucy Hornstein, MD

Physician

June 26, 2015

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 …

Did you forget to thank someone? It’s not too late.

Pamela Wible, MD

Physician

June 26, 2015

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 …

Should I become an anesthesiologist? Read this first before you decide.

Karen S. Sibert, MD

Physician

June 25, 2015

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 …

Want to solve health care problems? Ask the right questions.

Suneel Dhand, MD

Physician

June 25, 2015

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 …

It’s time for radiologists to stop hedging

Dr. Saurabh Jha

Physician

June 24, 2015

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 secretly records his colonoscopy. It cost this doctor her job.

Admin

Video

June 23, 2015

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 …

How to improve patient satisfaction in the emergency department

Angelo Falcone, MD

Physician

June 20, 2015

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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