A few months ago I wrote a post about the 159 page digital fax that I received, containing records for a patient’s recent lengthy hospitalization.
I’ve now discovered something even more time-consuming and annoying: a 202 page paper record mailed to me by a major medical system. (I won’t name names right now; suffice to say this system uses Read more…
My workflow for going through old paper charts
I have it on good authority that it’s not easy being green. But I’m willing to wager that it’s a whole lot easier when you have a lovable name like “Kermit.” Imagine being green (or brown) with a name like “Ramachandran”? Growing up with a name like mine certainly had its disadvantages. While most neighborhoods have a local bully who kicks ass and takes names, in my case, he would …
Doctors: Pronounce the names of your patients correctly
I recently received this email message from one of my residents who has moonlighted in a local commercial urgent care center. This message is reprinted with his permission just as I received it, except I removed the brand name.
Hey Dr. Young, I’m looking for some basic mentoring advice. I’ve been moonlighting at ZZZ Urgent Care for about a year. Not my favorite work, but oh well. I don’t routinely prescribe antibiotics …
Working in an urgent care center: An assault on the soul
She was 94-years old with advanced Alzheimer’s. She thought it was 1954 and asked if I wanted tea. Not a bad memory for someone in a hospital bed with a broken left hip.
She’d fallen at her assisted living facility. It was the second time in as many months. She’d broken her collarbone on the previous occasion.
Over the past year, she’d lost 30 pounds. This is natural in the progression of …
Let no broken hip go unfixed: When a surgeon fails to communicate
A resident is a person who has an MD, meaning they have completed 4 years of school, but they are not yet qualified to actually do anything. An MD is just a piece of paper saying you did your time in the lecture hall/lab. Residency is where you learn how to be a doctor. The term “resident” originates from the old days in which newly-minted doctors were actually living at …
When it comes to medical residents, patients have a choice
There are surprising misconceptions about what family physicians actually do in practice.
Americans maintain a fond respect for the classic image of the family physician, making house calls with black handbag in tow. They admire the Marcus Welbys of the world. While this classic image is endearing, it should not be confused with the 21st century family doctor. The modern family physician is trained to engage in the adaptable world of health …
You may be surprised at what family physicians do
Health and health care are hot topics lately, and not just for journalists and bloggers debating Obamacare. Suddenly – or so it seems; in fact the trend has been building for years – people from all walks of life want to read about medicine.
Within medicine, a majority of journals now have essay, viewpoint, or perspectives sections. Not only are such sections frequently …
Medical journals that accept stories and essays from physicians
As trauma surgeons we often have to disassociate ourselves from the stories that surround our patients so that we can focus on their life-threatening injuries. It’s also how I personally cope with the devastating injuries to the patient and the aftermath left for the family. Sometimes, though, I am caught off guard and my defenses aren’t strong enough.
A middle-aged man was brought in one evening after being hit while riding …
When doctors dissociate themselves from the stories of their patients
The gall, you might think to yourself as you click on this link in disgust.
Before you write that brutal retort which I may/may not deserve, some simple disclaimers before we tackle this subject:
5 reasons why you shouldn’t go into medical school
A version of this column was published on February 3, 2013 in USA Today.
I’m seeing more patients than ever consume so-called “energy drinks,” a rapidly emerging class of beverage which promise to increase energy, improve alertness, and boost attention span. The energy drink business is booming, with more than $12 billion sold last year, eclipsing established beverage categories like iced tea …
Why energy drinks should be considered stimulant drugs
My first night shift in a stretch of 7 was almost over. It was 6:15am and I had to keep moving otherwise the minute I would stop, my eyelids would drop like two ton shades and I’d fall asleep. That never makes for a good drive home after a night shift.
“Got time to see one more?” asked Jenny the nurse.
“Do I have …
The baby had a seizure: Why was the mother smiling?
There’s a lot nurses can learn from doctors.
There I said it.
But I’m not talking about clinical ability or medical knowledge. I’m talking about expectations. I’m talking about basic behaviors that dictate a predictable response.
Nurses don’t feel valued. Much of this is warranted, but I argue that some of it is self-inflicted. I said this once to a colleague and she responded, “But that places the blame on the nurse.”
I disagree. …
What can nurses learn from doctors?
There are plenty of things we don’t know about health and illness. Sure, we know a lot more than we did fifty or a hundred years ago—but every day, still, I have questions that aren’t yet answered. I read a dozen or so journals each month. (I know. Nerd.) Each one has at least ten or so good quality studies—good, …
Sending your child to the chiropractor: Be very careful
There are an estimated 15,000 medical apps presently on the market and is expected to grow 25% per year according to one study. There are issues which are common in the development of these apps and other categories of apps. However, some technical and non-technical issues are unique to the sector. As someone who does not design apps, …
5 reasons why mobile health apps fail
Former Boston Red Sox closing pitcher Jonathan Papelbon may have opened up a can of worms with his remarks about his frequent use of the injectable anti-inflammatory drug Toradol (ketorolac) during his time with the Red Sox.
Papelbon, who now plays for the Philadelphia Phillies, told ESPNBoston.com that several Red Sox players were frequently injected with the drug:
“It was kind of …
Toradol in sports: A culture change is needed
Radiolab recently aired a show called “The Bitter End” that discusses the end-of-life care preferences of physicians and non-physicians. Physicians are much more likely to decline “heroic” measures, such as CPR, mechanical ventilation, feeding tubes, etc. This comes as a surprise to the hosts and, presumably, to other non-physicians. It’s a good show. I recommend it. (Full disclosure: I like Radiolab.)
In the show, Ken Murray argues that …
Why physicians tend to decline CPR and other heroic measures
During a routine office visit, I was discussing activities and extracurriculars with a bright 10-year old girl. She loved talking about her dance team, gymnastics, and her new hobby of horseback riding.
Towards the end of our conversation, however, she said something that surprised me: “And, I am addicted to Pinterest.”
I turned to her mother, who was also in the exam room, and asked, “Did you know she is on Pinterest? …
4 reasons parents should enforce the age restriction on social media
“Discrimination against heavy people, by the general public and medical professionals, might be a greater health and social problem than any extra pounds they may be carrying” argues UCLA Professor Abigal Saguy, PhD, in a provocative essay in the Washington Post.
“Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their …
Stop blaming patients for not doing enough to stay healthy
Let’s talk a little about health accountability. Two news items have provoked the following rant: why is it always someone else’s responsibility?
The first item was on NPR. The FDA, reacting to the epidemic of prescription drug abuse in this country, is offering incentives to the pharmaceutical company that can come up with a less addictive painkiller. Such a drug would be a gold-mine for that pharma company because it could …
Make patients more accountable for their own health
Young children are naturally petulant, noisy, and self-centered. We’re all born with ourselves in the center of the universe, an impression reinforced by parents who must cater constantly to their young babies. But babies become toddlers, and toddlers become children. Sometime during this transition, parents have to teach their children that they are part of a family. For a family to function …
Teaching children how to behave: 5 essential principles
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