The ear, nose and throat specialist who treated comedian Joan Rivers on August 28 has been identified as Dr. Gwen Korovin, a prominent New York physician who is known as a voice doctor to many entertainers and Broadway stars including Hugh Jackman and Julie Andrews.
With a physician who is an expert in airway anatomy at her side, and all the technologic advantages …
Joan Rivers’ death: What went wrong?
Michelle wrote in: “We trained my 3-year-old son approximately 3 months ago, and it’s been great. He’s been having virtually no accidents. The problem is that he’s terrified of making ‘dirty’ on the toilet. He does it in his pamper at night when he’s sleeping. He’s very verbal about it, and tells me that he’s scared to let the dirty come out. It’s really difficult to deal with because there …
When your child doesn’t poop: Solving the constipation death spiral
I have been following the progress of bedside ultrasound (using ultrasound as a diagnostic tool during my physical exam of patients) as it gets a foothold in standard medical practice since I first started learning to do it about 3 years ago. Every so often a study comes out which warms my heart as it proves that less (radiation, expense) is more in treating patients.
An article came out in the …
Emergency room doctors can safely use bedside ultrasound
Medical students are repeatedly taught the importance of the physician-patient relationship. We are told that to be a good doctor we must strive to exhibit compassion, empathy, respect, professionalism and confidence all while applying our medical knowledge to figure out a diagnosis and treatment plan. If you add in the pressure of doing this within a 15-minute visit, all while answering questions faster than an Internet search, it can get …
Vulnerability is a virtue in medicine
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 …
How hospitals discourage doctors: A step by step guide
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 …
An insider guide to reading your radiology report
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 …
Health care fails to adopt technology. Here are 5 reasons why.
“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 …
A twisted argument against end-of-life care
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. …
Don’t spank your children. Do these 5 things instead.
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 …
“I want to give up my son”: Is that child abuse?
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 …
Responding to a medical student in pain
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 …
How do you know when a hypochondriac is really sick?
“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 …
Deactivating a pacemaker: Is it euthanasia?
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 …
Abortion or ectopic pregnancy? When politicians confuse medical terms.
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 worst-case scenario: When patient satisfaction goes too far
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 …
5 things people get wrong about Canada’s health system
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.
What is a gomer? And why should you know about it?
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 …
Value-based care: Bad for doctors, bad for patients?
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 …
What’s it like to be an oncologist? This is just one day.
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 …
Appreciate your NICU nurse: A letter from a neonatologist
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