by Tricia Pil, MD
This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and third, the version put forth by the hospital.
FRIDAY
Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of …
Generally, I find my practice works best when I get paid in dollars. They’re convenient. They can be transmitted electronically between bank accounts. Mary and Annie like them. I can spend them by swiping a credit card.
But, in a remarkable effort to win the “Let’s See How Stupid I Can Sound” award, a Nevada candidate for U.S. Senate has proposed ditching the idea of paying doctors in money, and going …
The role of autopsy in the medical profession is difficult to overestimate. Western medicine takes its roots from comparative studies between patient’s symptoms and the findings on autopsy.
Participation in an autopsy was one of the most valuable lessons from medical school and residency. If you participated in the patient’s care, there is no greater educational tool than witnessing the postmortem exam. It is especially true if the cause of death …
One of the biggest emergency room problems is contacting patients after they leave.
Patients sometimes leave false contact information — which makes it difficult for the emergency room staff should problems arise after the visit.
The issue was illustrated in a piece from msnbc.com. Many times, results like blood cultures or x-ray findings take time to return. And if there’s something that needs to be acted upon, contacting the …
An excerpt from How to Survive a Medical Malpractice Lawsuit: The Physician’s Roadmap for Success.
by Ilene R. Brenner, MD
The most important part of your case is upon you: the pretrial deposition. If you do a poor job, you can ruin your case and make a defensible lawsuit become indefensible.
So what is a deposition? It is the sworn testimony of a witness taken before trial, in a location …
by David Edelman, MD
Heartburn and acid reflux disease are common problems affecting women of all ages. The problem develops when acid in the stomach backs up into the esophagus. There is a muscle known as the diaphragm that separates the chest from the abdominal cavity. When you eat or drink, the food goes from the mouth down the esophagus, through the diaphragm and into the stomach. …
A letter from a pre-medical student honoring her gross anatomy cadaver.
Letter to the other side
by Hana Low
Thank you for donating your body to science and medical education. It’s so generous to give yourself to those you will never meet. I hope you’re having a good time, up there or wherever you are.
Working with your body has made me acutely conscious of the dangers in my everyday environment. I have to …
My husband and I recently traveled to Wuhan Medical School in the Hubei Province in central China.
Our medical school has partnered with Wuhan to help inform their curricular reform efforts. We spent 4 days touring the hospitals and teaching facilities, meeting students and faculty, going on rounds, and giving talks. Although the language barrier was challenging, we had incredible translators who worked to translate every slide we spoke …
by Dr. Whoo, MD
I have met several women who have completed residency and maybe even practiced beyond that, but decide to quit and stay at home with kids. I wonder – why would a woman who has gone through all of that training just quit? It would seem like the hard part is behind them and I am perplexed by their decision but, of course, I …
In family medicine it has been common to keep a “Problem List” in patients’ paper charts. Usually placed on the left hand side, on top of the Medication List, it has given doctors like me an instant thumbnail sketch before considering the specifics of each patient’s visit for that day.
A typical Problem List would include diagnoses like diabetes, hypertension, high cholesterol or rheumatoid arthritis. It would list prior surgeries, like …
Are emergency departments solely responsible for the bulk of unnecessary tests?
Most would like to believe so, but emergency physician Edwin Leap says that’s not the case.
He cites an instance involving a primary care doctor and hospitalist:
Local physician, who does not admit to the hospital, sees patient in the office. Patient has uncontrolled hypertension and is having some chest pain and shortness of breath. Local physician contacts hospitalist. …
by Steven Knope, MD
For the last several years, writers in the New England Journal of Medicine and the Journal of the American Medical Association have authored doomsday editorials about the prognosis of primary care medicine. There has been much discussion about the fact that internists and family practitioners cannot keep pace with rising overheads and falling reimbursement under the traditional third-party payment system.
Paraphrasing a recent …
by Charles R. D’Agostino, MD
We’ve all seen the headlines –- “Primary Care Physicians Becoming a Scarce Breed”, “Wait Times for Appointments Increasing”, “Primary Care in Crisis” –- and have heard the pundits pontificating on the deteriorating state of primary care.
But rarely do we hear what’s happening from physicians on the front lines, those actually seeing patients. Consequently, with direct access to the primary care trenches, replete with an overworked …
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Bret Michaels continues to be monitored in the intensive care unit after suffering a subarachnoid hemorrhage.
According to his road manager, “further testing this week will help locate the source of the bleeding.”
What exactly does that entail?
As I mentioned previously, aneurysms are responsible for the majority of brain bleeds. Finding that source is critical. Angiography, or …
by Crystal Phend
Physicians don’t know much more about complementary and alternative medicine than their patients do, according to a new survey.
Most healthcare professionals who answered an online survey of Drug and Therapeutic Bulletin subscribers said their profession was just as poorly informed about herbal medicines (75.5%) as the general public (86.3%).
And almost half of respondents rated their own knowledge about herbal medicines as “quite” or “very” poor (36.2% and 10.4%, …
Our state of South Carolina is a delight. From wonderful people to beautiful landscapes, from a vibrant Southern culture to excellent food like shrimp and grits, it’s a place I’m thrilled to live. But we do lack a few things. And one of the most striking is adequate mental health care.
The state budget, like so many state budgets, has been trimming anything and everything. And of course, mental health coverage …
Patient satisfaction, as I wrote previously, is being increasingly focused upon.
Doctors are often pressed for time, and appear rushed — which can potentially lead to unhappy patients.
I saw this small study showing that the simple act of sitting down while talking to patients can have a profound effect. Many doctors I know already do this, but now there’s some data to support sitting.
According to the study, performed at …
When her gynecologist told her she had high blood pressure, Marie had a simple solution: switch doctors. After all, she had gone to him for a different problem, and this was the first time he had ever checked her blood pressure.
“He said, ‘Oh my God, you’re like a bomb waiting to explode.’ I said, ‘I didn’t come here for that, I came here for something else,’” she explained.
Two years later, …
by Michael Kirsch, MD
Does anyone out there know why President Obama underwent a virtual ‘colonscopy’ (VC) instead of a conventional colonoscopy earlier this year?
In my gastroenterology practice, we do not offer colon cancer screening to 48-year-old individuals, unless special risk factors are present. Of course, maintaining the president’s health is in the national interest, so I understand why professional screening guidelines might not apply to him. For …
The daily appointment schedule is often a sore spot in everyone’s day:
* Patients aren’t completely satisfied because they can’t get an appointment when they want one.
* Physicians feel they’ve lost control of their day when the flow is not running smoothly and they fall behind and patients complain.
* Nurses and medical assistants are frustrated at the hodgepodge of types of appointments that get scheduled seemingly without any consideration for timing …
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