A recent article on American Medical News titled “Medical charting errors can drive patient liability suits” led with a case involving a bad outcome after coronary artery bypass surgery. The plaintiff’s attorney alleged that the doctors did not review the patient’s lab results or x-rays because they did not specific say so in the medical record.
The article quoted a defense attorney who said, “By the time [the doctors] are deposed, …
1. When your doctor looks into your eyes with a flashlight, shut your eyes tightly so he can’t see your pupils. Later, when your doctors asks you to shut your eyes tightly to test your eyelid strength, look at him like he’s speaking in tongues and keep your eyes open. If he whips out his flashlight to look at your pupils …
14 ways to drive your doctor crazy during a physical exam
Online dating is a bad idea for teens — especially young teens.
That’s why it wasn’t particularly responsible of Seventeen Magazine to publish a blog in which “dating blogger” Isabelle Furth floated the idea of using sites like Match.com to find dates. To be fair, she had concerns about the idea, and she’s in college, so theoretically old enough to make these decisions. But college kids don’t read Seventeen. Middle school …
Why online dating is a bad idea for teens
Not long from now, the last cancer will be defeated, and even today most with the dread disease survive. However, many still fall. This leaves us with one of the toughest questions of life. How long do you continue to fight, when death is certain? When does striving become vain hope which drains quality and creates only suffering? What makes struggle worth the …
How long do you continue to fight when death is certain?
Folks must think than all doctors know all things medical. I know this is true by the questions that I have been asked over the years. While my expertise spans hemorrhoids to heartburn, I am routinely queried on medical issues well beyond the specialty of gastroenterology. When I can’t answer questions about a new medicine for hypertension or if an MRI of …
Does your doctor know ACLS? Does it matter?
A while back I was working in pediatric urgent care and had occasion to do something I have done many times since starting out in medicine. I called a consult. The reason, like many consults, was an abnormality on a study that required a specialist’s opinion. I paged the resident on call for this particular specialty.
When they called back I was treated, right from the get-go, to some serious attitude. This was a legitimate …
Calling a consult: Disrespect from specialists hurts patients
I am a fourth year medical student that attends an institution that does not have a department of family medicine.
Currently there are only 10 such allopathic institutions in the country. When I tell colleagues and friends that I intend to enter family medicine they say, “oh primary care?” While yes, it is true that family physicians obviously practice primary care, I am disheartened that my colleagues do not know or …
I am an orphan: A medical school without a family medicine department
An attending once told me, “You can’t please ‘em all.” And it’s true. Sometimes in medicine, you just have to keep your head up and remember the bigger picture of why you are in this field.
A few months ago I did my internal medicine sub-I, which is a rotation medical students take in their fourth year when they are expected to perform on the same level as an intern. I’ve …
You have to develop thick skin in medicine
With immigration reform under hot debate, it’s important to remember that all of us except the Native Americans are foreigners. It’s what has made our culture so diverse. People from foreign countries ideally bring the best of their cultures to the US and enrich us all with the diversity of life. This advantage lessens considerably when those visitors want to enter fields in which understanding of endemic American culture is …
Foreign medical graduates are not the primary care solution
Emily Oster has a book coming out entitled Take Back Your Pregnancy. In preparation for the book launch, as most authors do, she wrote a nice piece in the Wall Street Journal about decision-making, risks, and how some of what OB/GYNs recommend during pregnancy isn’t always evidence based.
In particular, she mentions listeria, a bacteria that is a food borne illness with potentially devastating outcomes during pregnancy. Osher quotes the risk …
Putting the fear of God into people is bad medicine
I’ve been traveling around the United States working as a locum tenens (in Latin, “place holder” – a more elegant name than “temp”) physician. We’ve all heard of traveling nurses, but more and more physicians are also “living la vida locums,” as it were. There are actually over 100 agencies who find/provide temporary physician coverage for hospitals who need to fill gaps in their full timers’ schedules. You can find out more about …
A comprehensive locum tenens guide for physicians
High fructose corn syrup, that sweet over-produced commodity of agribusinesses everywhere, has been linked in two miserable ways to bees and honey. The first discovery was made almost two years ago, and the second only 2 months ago. First, most of the “honey” available for purchase in supermarkets is not really honey, but instead an ultra-filtered impostor often produced in China, and …
The disturbing link between high fructose corn syrup and honey
Patients are becoming more and more adept at taking control of their own health care, and this often involves seeking a second opinion of their presumptive diagnosis. However, in far too many cases in which cancer or precancerous conditions are diagnosed, the consultation is at the level of another treating physician, without confirmation that the patient’s pathologic diagnosis is correct. In cases where clinical management decisions and prognosis hinge on …
Why you should consider a second opinion from a pathologist
In my over three decades of family practice, I have come to the conclusion that we, as doctors, should provide non-medical people with as much medical information as we can. Not as much as we think they should have, or information just related to the problem at hand, but as much as we can provide. Period.
I started practicing when many still debated whether we should tell a patient if he …
How much information should doctors give to patients?
Most social media guidelines for physicians, most recently from the American College of Physicians and Federation of State Medical Boards, suggest that doctors separate their personal and professional identity.
Until physicians are better educated on how best to act professionally on social networks, keeping their online personal lives private is more likely to keep them out of trouble.
But is it time for that recommendation to be revised?
In a recent JAMA perspective …
Should doctors separate their personal and professional identities?
I just left the most unusual conference I have ever attended. First, it was small: 25 invited participants. Second, it was all women. Third, it was all women who have done amazing things …make that “trailblazing things.” They were journalists at major news outlets, retired military officers from the highest ranks, senior leaders (in some cases, the most senior leader) at major federal and state health care agencies, Fortune 500 companies, large …
The broken window theory in health: Examples of graffiti we can fix
The intestines, particularly the large intestine, are teeming with bacteria. They are piled on each other as dense as the above photomicrograph shows. The huge majority of them are what we call friendly bacteria: they live inside us, feeding off the rich stew of food we eat, but cause no disease. In fact, their presence is important to our health because they crowd out bacteria that cause disease — the …
C difficile in children: Do probiotics help?
In the Boston marketplace, Partners Healthcare is is replacing 30 years of self developed software with Epic. Boston Medical Center is replacing Eclipsys (Allscripts) with Epic. Lahey Clinic is replacing Meditech/Allscripts with Epic. Cambridge Health Alliance and Atrius already run Epic. Rumors abound that others are in Eastern Massachusetts are considering Epic. Why has Epic gained such momentum over the past few years?
Watching the implementations around me, …
Boston hospitals go Epic: Hear from a holdout
Monday afternoons are always the same. I pick up the kids from their grandparents. We drive home with their backpacks and a carton of home made food. We park in the garage, and carry all the contents of the car into the house. As the kids unload, I push the recycle container to the front for street pickup the next day.
Occasionally, I stop and socialize. Yesterday, I waited at the edge …
The demand apathy that doctors increasingly face
It occurs to me there are several keys to being an excellent physician. One must love science, enjoy hard work, have the courage to make tough decisions, carry a modicum of intelligence and suffer angst at receiving 94% on an organic chemistry test. In addition, the very best physicians, those we admire and to whom we flock, have a secret weapon. They do not care.
I do not mean that they …
The very best physicians do not judge their patients
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