“Hey doc, all I need is this referral.”
I’ve been encountering more of this lately. A patient who has not been seen in the office for months to years (well beyond when they were supposed to come back for a follow up visit) walks in and requests a “referral” for a specialist visit but they can’t be bothered with actually being seen and evaluated in the office or to be compliant …
Why patients don’t value primary care doctors
Patient handoffs increase the risk of medical errors.
As I wrote recently in USA Today, as residency hours are restricted, more of these handoffs will take place. It’s imperative that this source of error be minimized.
Vineet Arora, associate director at the University of Chicago’s Internal Medicine residency, is one of the nation’s authorities on patient handoffs. She recently made a video for the incoming interns about the …
Patient handoff video that every medical intern needs to see
Difficulty with sleep is one of the most common patient complaints presenting to the primary care office.
Chances are, you will suffer from difficulty with insomnia at some point in your lifetime. It can be distressing, and cause difficulty with functioning during your wake hours. The first thing you may want to do is to run to the doctor for a prescription for a medication to help you sleep.
However, you don’t …
8 insomnia tips to help you fall asleep without drugs
Malpractice and heart catheterization have been in the news recently.
A spicy concoction for sure. An epidemiological study published in an online subsidiary of Circulation addresses the role of three major medical issues facing cardiologists today: malpractice, heart catheterization, and medical costs.
It is hard to get more controversial.
Heart catheterization, the invasive assessment of the coronary artery lumen, has always been a hot-potato topic. The “percent-normal” was the buzz word when I …
Heart catheterization worries that every cardiologist face
Should you friend your doctor on Facebook?
It’s a question that’s gaining increasing relevance as Facebook increases its social networking dominance.
I’ve touched upon the issue in the past. So has the New England Journal of Medicine.
Washington, DC physician Katherine Chretian gives her take on the issue in a recent USA Today op-ed. She is an expert of the Facebook-medicine intersection, having authored a JAMA study on the …
Facebook friends with patients can violate HIPAA privacy laws
On a recent Saturday, I rounded in the hospital. I met up with Zainab, the president of the minority premed association for the University of Chicago, who asked to shadow me. While she was doing research at the hospital, she had not ever rounded in the hospital before. It was Saturday so our team was mostly off so it was just me and my very capable resident who is about …
Tips for students who want to shadow doctors
A video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, MD.
The average physician salary in the United States is $146,000 — which is undeniably a lot of money at face value.
But it’s a lot less when you factor in the overhead costs that doctors incur. And that’s not including the medical school debt which, on average, exceeds $150,000.
This clip shows how the take home pay of …
Doctors make far less money than most people think
A primary care resident wrote in one of the journals recently about making the limited time she has with each patient matter the most.
How refreshing, I thought when she concluded that time ultimately is an absolute and finite resource. We often feel as if we are battling time as much as we are battling disease, and we sometimes have trouble admitting when we are losing either one of those battles. …
Primary care doctors at a competitive disadvantage to midlevels
by Diana E. Lee
One member of my health care team is a migraine specialist in another state. Since we don’t have many opportunities to work together in person, we generally try to pack a lot into my periodic two-day visits.
Last time I was there I had an experience that has left me feeling guilty all these months later.
My doctor, who I respect and admire greatly, asked if I was interested …
Don’t let a doctor make you feel uncomfortable
by John Gever
Emergency department patients with chest pain may safely be evaluated in the waiting room when necessary, researchers said.
Among 303 patients triaged to waiting-room evaluation in a prospective study, no acute coronary syndromes were missed and adverse event rates overall were lower than among 804 patients who were assessed in conventional monitored beds, reported Frank Scheuermeyer, MD, of St. Paul’s Hospital in Vancouver, British Columbia, and colleagues online in …
Can chest pain patients be evaluated in the ER waiting room?
As we have established repeatedly on LesliesList.org, prescription prices can vary a lot from one pharmacy to another.
But did you know that some pharmacies will actually match a competitor’s price? This could save you a ton of cash, but you have to know how, and whom, to ask for this service. Pharmacy retail chains all have different policies. I spoke to a pharmacist recently at each of the seven top …
Ask your pharmacy to price match prescription drugs
Regular exercise has been shown to be helpful in the prevention and management of a variety of clinical neuroscience conditions including: Alzheimer’s disease, Parkinson’s disease, major depression and anxiety disorders. However, motivating people to get involved in a regular exercise program is a significant challenge. Wii Sports and Wii Fit Plus may provide the motivation edge for some patients to start and maintain an exercise program.
The Wii video game system …
Wii Sports and Wii Fit Plus exercise equivalents
I walked into Room 35 to find a three year-old lying on the hospital cot. Her father sat alongside her bed, whispering softly to her. The patient appeared quite tired, wiped-out even, and if it weren’t for her complacent eyes tracking my every move, I would have thought she might be sleeping.
She was visiting our ER because, after a few days of cough and congestion, she had developed a fever. …
Treating a child with fever and leukemia
If you have spent anytime with a palliative care team in a hospital you will know of their efforts to essentially blacklist Demerol (meperidine) from use in the hospital.
Some hospitals have removed it or restricted it from the formulary all together. In medical culture, Demerol has been a go to opioid peri-OR and mostly favored by surgeons. The drug has been purported to be less likely to cause billiary spasm, …
Demerol used to treat shivering in patients
by Todd Neale
The recent stroke suffered by Delaware’s attorney general Beau Biden, who is 41, has highlighted the fact that people of all ages are vulnerable, despite seemingly good health.
A statement from Timothy Gardner, MD, medical director of the Center for Heart and Vascular Surgery at Christiana Care Health System in Newark, Del., where Biden was initially treated, said he had suffered a “mild stroke,” although it remains unknown whether …
Causes of stroke in young adults
With healthcare reform dominating the news recently, MRI and other imaging tests have become the (misguided) targets of many critics.
Although MRI makes up only one-half of one percent of total healthcare expenditures, it is easy to demonize since the average healthcare consumer can understand imaging much easier than the diagnosis related groups (DRGs), hospital facility fees or insurance contracts that have a much greater impact on the cost of health …
Clinical judgment and when neurologists should order an MRI
What is “MRI Abuse”? This is when the health care provider orders MRIs (Magnetic Resonance Imaging) in excess or for the wrong reasons. There are many causes of MRI abusive behavior but most evolve out of a significant misunderstanding of how to properly utilize this diagnostic tool. MRI imaging has a high sensitivity to detect anatomic abnormalities, does not expose the patient to high doses of radiation like a CAT …
MRI abuse can be dangerous and expensive for patients
Though I’ve never lost a friend or family member to suicide, I have lost a patient.
I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret …
6 reasons why people commit suicide
If a person tries to commit suicide, could that be considered as a statement that this person wishes to die and does not want aggressive treatment to save his or her life?
Not from a legal standpoint, and not if you are living in the United States.
A middle-aged man with a long standing history of depression decides to end his life. He puts a large caliber gun straight to his forehead …
Patients who attempt suicide and withdrawal of medical care
I believe in the peak oil theory.
Think about it, in a closed system nothing is infinite. Since oil is a product of millions of years of decay, unless we use it at the same rate that is it produced, we will run out. I do not have a crystal ball any more than anyone else I know, so I will not hang my hat on when, but will commit to …
How the oil shortage will affect hospitals and healthcare
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