An awkward encounter with a hypochondriac
A warning about examining your friend’s medical condition. Brad Nieder is a physician and comedian and can be reached at the Healthy Humorist.
An awkward encounter with a hypochondriac
Some very old-school medical methods
CPR was first endorsed by the American Heart Association in 1963. When I took a Red Cross Life Saving Course in 1965, we learned about the “chest pressure arm lift” form of resuscitation which worked about as well as burning incense. I began working as an orderly in a community hospital in 1967. You probably remember that I was famous as the guy who first popularized wearing gloves when inserting …
Some very old-school medical methods
Gun violence in America is a multifactorial problem
Let me warn you — I own guns. I love to shoot. And I’m a strong supporter of the Second Amendment. This may seem hypocritical coming from a doctor, but don’t shoot me figuratively speaking, of course — before I make my case. Any mass killing is a horrifying event. Any senseless death is riveting. Obviously, this goes without saying, but as a doctor whose purpose is to save lives, …
Gun violence in America is a multifactorial problem
Women in surgery: a tweet to action
In early April 2017, a cover of The New Yorker depicting four medical providers sparked a movement within surgery. Women surgeons claimed this illustration as a rallying cry; recreating it proudly with colleagues in the operating room and sharing their images on social media tagged with #NYerORCoverChallenge and #ILookLikeaSurgeon.
We were in our fourth year of general surgery residency when we became the …
Women in surgery: a tweet to action
Here’s what’s wrong with time-based billing in the hospital
Consider this hypothetical addendum to a hospital discharge summary:
”ADDENDUM @10:56 a.m: In considering the accurate billable discharge time involved in this case (as I have recently been instructed by hospital coders that I must record the exact time required for a patient discharge, rather than simply “greater than 30 minutes” or “less than 30 minutes”), I feel I have stumbled upon a troubling quandary, having failed to note the exact …
Here’s what’s wrong with time-based billing in the hospital
Physician well-being must be the standard of medicine
I’ve interviewed many doctors on my podcast The Doctor’s Life. They share their stories of how they came to medicine and how they developed into the physicians that they are today. There are three common themes in these “origin stories”:
The first is that many of the doctors were mentored by a physician who inspired them to pursue medicine. The second is that they were “called” …
Physician well-being must be the standard of medicine
Independent practice: Nurse practitioners respond
Shortly after the publication of “Independent practice: Both nurse practitioners and physicians should be outraged,” the nurse practitioner (NP) leadership responded with a press release, denouncing the concerns that were cited, calling them “rhetoric.”
But in contrast to this criticism from the political end of the NP spectrum, I was inundated by emails from working NPs across the country in support of the article.
Since …
Independent practice: Nurse practitioners respond
The human touch in medicine: good or bad?
Humans need human touch
Patients sometimes need a shoulder to cry on. When I say that, I normally mean it on a completely figurative level.
However, at times, it needs to be interpreted differently. There are instances in a medical encounter where an actual shoulder could be of service — a physical crutch that takes off an emotional load — and that’s when the popular adage can be beneficially carried out in …
The human touch in medicine: good or bad?
Fight gun violence with science
It is well known that smoking cigarettes negatively impacts health and leads to an increased risk of stroke, heart disease, lung cancer and death.
No one debates this anymore. But it wasn’t always this way, and it didn’t come easily.
In the 1940s, almost half of the population in the United States smoked, and the tobacco industry was subsequently incredibly powerful and politically active. It spent millions of …
Fight gun violence with science
The fall of the digital rectal exam
For almost 20 years, the value of the digital rectal exam (DRE), a long time staple of the complete examination of the trauma patient, has been questioned. Performing a rectal examination on all trauma patients is no longer advocated except for a few specific indications.
As recently as two months ago, trauma surgeon Michael McGonigal blogging at the Trauma Pro reinforced the message. Because a rectal examination is so uncomfortable …
The fall of the digital rectal exam
The art of medicine is slowly being pushed out. Is that a good thing?
One late evening on pediatrics call, a frantic young couple brought in their few weeks old baby. She had spiked a fever which refused to go down and was fussier than normal. The cause of her symptoms could have been anything — at best, a mild respiratory infection, in which case we would simply watch her and manage her symptoms, but at worst, it could be meningitis, an infection attacking …
The art of medicine is slowly being pushed out. Is that a good thing?
Lunch shouldn’t be so controversial in medicine. But it is.
In some circles of medicine, going long periods of time without eating a meal is considered a rite of passage and one’s ability to forgo his or her basic metabolic needs is considered a badge of honor. In other circles of medicine, there are gourmet lunches of kale salad and lobster bisque being delivered by pharmaceutical company representatives on a daily basis.
No one in either circle seems quite comfortable with …
Lunch shouldn’t be so controversial in medicine. But it is.
Sexual assault in the emergency department: What can you do?
It has been documented that 1 in 3 women will experience rape in her lifetime, and this is most common in women under the age of 25. Over 95 percent of victims of sexual assault are women worldwide, while in North America estimates place that at 85 percent. These are the assaults we know about — generous estimates say that, at most, 10 percent of rapes are reported to police …
Sexual assault in the emergency department: What can you do?
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Physicians: What are your endpoints in personal finance?
Every physician, especially those who work in oncology, have read their fair share of clinical trials. In order to advance the field of medicine, you need to test new drugs against the current best treatment, or the standard of care.
Some trials succeed, and we make progress in our fight against cancer, or hypertension, or HIV. Some trials fail, and these new treatments are discarded.
When designing a clinical trial, you need to …
Physicians: What are your endpoints in personal finance?
Reflections on school violence: a psychodynamic perspective
The mental health community must increase its clinical acumen regarding complex psycho-pathology consisting of the avoidant personality, social impotence, and related rage. School violence has taken on epidemic proportions since two disturbed adolescents masterminded Columbine and became role models for the mentally ill young men who drive the new culture of school shootings.
While the profile of the school shooter has evolved over the last couple of decades, it’s worth considering …
Reflections on school violence: a psychodynamic perspective
Emergency physicians are glorified secretaries with medical degrees
We had a pretty busy shop when I was in residency. So busy, in fact, that we had three secretaries working simultaneously — one for paging, one for order entry, and one for admissions. I haven’t been back there in a long time, but I hope the secretarial staff has grown commensurately with the volume and acuity of the ED. But from what I’ve seen around the country in my …
Emergency physicians are glorified secretaries with medical degrees
A new directive for National Healthcare Decisions Day
Other than taxes, the only other certainty in life is death. People don’t like to pay taxes or think about dying. But on April 16th, National Healthcare Decisions Day (NHDD) reminds people to complete their advance directives. Like a passport, an advance directive permits an individual to proceed from one world to another with an easy stamp of approval. Without the proper paperwork, patients at the end of life are …
A new directive for National Healthcare Decisions Day
11 physician finance lessons from The Greatest Showman
I love movies. Not the artsy types that win awards; I most enjoy the big, expensive popcorn blockbusters that take you away to a different time and place. However, as our income and wealth has grown, we’ve maintained a few of our “cheapskate” habits from when we were poor. One of these is we see almost all of our movies at the “dollar theater,” a second-run theater where the entire …
11 physician finance lessons from The Greatest Showman
America leads the world in high tech care and health care costs
Why is U.S. health care so costly compared to other developed countries? A recently published report provides some insights.
In a study of 11 countries, Harvard researchers found that while the United States has the highest health costs relative to its GDP, its use of services is average. More specifically, the U.S. ranks lower than nearly every other country in doctors’ visits, hospitalizations, hospital days, and consultative services.
The difference is …
America leads the world in high tech care and health care costs
The momentum to treat in America is unmatched around the globe
An excerpt from At Peace: Choosing a Good Death After a Long Life. Copyright © 2018 by Samuel Harrington, MD. Reprinted with permission of Grand Central Publishing. All rights reserved.
The momentum to treat in America is unmatched around the globe or throughout history. As a result, we spend twice as much on medical care as the next most …
The momentum to treat in America is unmatched around the globe
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Past Week
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The insurance maze that single-payer health care would end
-
The conflict of interest that discloses as nothing
-
How to reassure patients: 5 steps beyond normal tests
-
The real risk of medical tourism complications is distance
-
AI in prior authorization: 3 contract questions for 2027
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How to build a dementia care pathway, not a referral sheet
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Past 6 Months
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Why CDC opioid guidelines get the overdose data wrong
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Retirement isn’t the end of medicine, it’s a second act [PODCAST]
-
Sensory processing in autism and the brain’s volume control
-
What maternity care deserts cost a town
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Why medicine needs a national physician license now
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A cold cost $945. The cost of primary care is broken.
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Recent Posts
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The real risk of medical tourism complications is distance
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5 competencies the future of medical education requires
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AI chatbots and psychosis: Families see the harm first
-
Hearing screening in primary care is a single question
-
After-hours charting isn’t a backlog. It’s a team problem.
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Autism behavior therapy needs a physician in the room
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