What can nurses learn from doctors?

Physician
March 1, 2013

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. …

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What can nurses learn from doctors?

Toradol in sports: A culture change is needed

Meds
February 23, 2013

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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 …

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Toradol in sports: A culture change is needed

Why physicians tend to decline CPR and other heroic measures

Physician
February 22, 2013

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 …

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Why physicians tend to decline CPR and other heroic measures

4 reasons parents should enforce the age restriction on social media

Social media
February 21, 2013

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? …

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4 reasons parents should enforce the age restriction on social media

Stop blaming patients for not doing enough to stay healthy

Physician
February 20, 2013

“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 …

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Stop blaming patients for not doing enough to stay healthy

Make patients more accountable for their own health

Physician
February 20, 2013

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 …

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Make patients more accountable for their own health

Teaching children how to behave: 5 essential principles

Physician
February 19, 2013

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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 …

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Teaching children how to behave: 5 essential principles

Advice for parents in medical school or residency

Physician
February 19, 2013

Being a single mother in medical school and residency isn’t a piece of cake. But, being a single parent in this world isn’t a piece of cake, either, and being a medical student and / or resident isn’t a piece of cake. Foregoing medical school isn’t necessarily the answer to any of that.

Here is some general advice I will share with parents, single or otherwise, who are facing decisions about …

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Advice for parents in medical school or residency

My first year as a locum tenens physician

Physician
February 18, 2013

Locum tenens (literally “place holder”) is professional work done to fill in where help is needed. It is what I have primarily been doing for the last year, and has been an interesting ride.

When I decided to leave my practice related to losing a couple of partners and wanting to update my knowledge base and re-evaluate my career, I decided to do locum tenens work. I had always thought that …

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My first year as a locum tenens physician

Is the history and physical examination worth performing anymore?

Physician
February 17, 2013

Would it be silly to ask, “Is the history and physical examination worth performing anymore?” especially in this era of high-technology medicine? Does it matter if the diagnosis is made by the bedside in contrast to CT or echocardiography? Someone did ask, and the answer is intriguing and was debated. Let’s look at the data.

Four hundred and forty-two consecutive patients were admitted from the emergency department to an …

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Is the history and physical examination worth performing anymore?

5 ways to adapt to an evolving healthcare workforce

Physician
February 15, 2013

Once upon a time a doctor first attended 3 or 4 years of college, then finished 3 or 4 years of medical school, trudged through 1 to 8 years of residency training to hang out “a shingle,” and finally begin to practice medicine, usually in solo practice.  Those days are long gone.  Time has expanded—schooling and training are longer.

Breaks are taken between and during this once but no longer traditional …

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5 ways to adapt to an evolving healthcare workforce

6 tips for getting your doctor to listen to you

Physician
February 13, 2013

Have you ever gone to the doctor and felt like he wasn’t listening to you? Have you tried to tell your story, only to have him interrupt with a checklist of questions: do you have chest pain, shortness of breath, fevers, cough, and so forth? Have you ever felt ignored, and left thinking that your doctor never understood why came to him in the first place?

Studies show that Read more…

6 tips for getting your doctor to listen to you

You’re still a doctor, even if you’re not on call

Physician
February 13, 2013

Christmas morning at 1:30 am the phone chimes away. What the … I’m not on call.

“Please call Dr. Dred for patient Selma, perforated colon at local ER,” read the text message.

Why are they calling me, I’m not on call. Dr. Young is. Maybe something’s happened and they can’t find him.

So, I called. It was just as reported. There was a fifty year old female with abdominal pain for three days, …

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You’re still a doctor, even if you’re not on call

Doctors are the canaries in the coal mine of medicine

Physician
February 12, 2013

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Back in the day, coal miners always carried a canary with them in a small cage whenever they would go down in the mine. The canary is a very talkative bird, always singing and tweeting in a constant background noise. Canaries have one more characteristic important to a miner.

When there is bad air in the mine, the canary’s sensitive lungs will cause …

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Doctors are the canaries in the coal mine of medicine

A virtual office visit for your cold is not a good idea

KevinMD
February 10, 2013

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A version of this column was published on January 13, 2013 in USA Today.

Like many other primary care doctors across the country, I’m seeing my fair share of patients with runny noses during this winter season.

I recently saw a patient for a sinus infection whom asked, “Why did I have to come in to see you? Couldn’t you have given me an …

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A virtual office visit for your cold is not a good idea

Law enforcement and medicine: The ties that bind both professions

Physician
February 6, 2013

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Sometimes, I feel like I belong in law enforcement. There was a time in my life that I seriously considered a career where I would haul in the bad guys and make society a better place. Of course, every American male youngster fantasized that he would one day drive the Aston Martin, get the girl, defuse the bomb, and sip on a …

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Law enforcement and medicine: The ties that bind both professions

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