“You need to get here now!” The nurse whispers anxiously. It’s after midnight. One of our hospice patients has just died at home, and her husband is threatening to shoot himself when the funeral home shows up.
“Has the funeral home been called?” I ask.
“No.”
“Does he have a gun or weapon?”
“We’re out in the country. There are deer heads on the wall.”
I try not to stereotype, but deer heads are a …
This social worker has no fear
The internet is an amazing source of information and misinformation. How do you know if what you are reading is accurate?
Be a skeptic
Last summer we were inundated with alarmist headlines about “dry drowning” after the tragic death of 4-year-old Frankie Delgado, who died days after an apparently harmless dunk under water while swimming off of the coast of Texas. While this child’s death was heart-breaking, the …
Truth or hype? How to tell the difference in medical news.
I had the honor and privilege of rotating for three weeks on the transplant service where I experienced a lot of great medicine, surgery and the ethics that intertwines them. One late night on service I had the opportunity to travel to a different hospital and help the team harvest a liver and kidneys from a donor. Never had I seen anything more amazing than what I witnessed that night …
When you learn about a person’s story, you can’t ignore it
When I was an intern the Durham VA Hospital, there was a sign taped to the ceiling of one of the workrooms. It said in big, bold letters: SUBDURAL HEMATOMA/PULMONARY EMBOLUS. This was to remind all house officers, at work in the middle of the night, about likely diagnoses for mysterious or confusing diagnostic puzzles. When you slapped your head in desperation and looked up, you would see the answer. …
Who knew I went to medical school to save my own life?
Hypertension, or high blood pressure, is a leading cause of heart disease and stroke that has escalated to alarming rates in recent years, affecting nearly 1 in 3 adults in the U.S. In an attempt to reduce its prevalence, the Eighth Joint National Committee (JNC-8) released a set of hypertension management guidelines. However, various concerns arose regarding the recommendations and as a result, the American College of Cardiology (ACC) and …
The role of telemedicine in monitoring blood pressure
Patients have a lot of choices when it comes to physicians. Making sure your online profile is up to date, complete, and contains these five items will improve the chances that a website visitor will become a patient.
Create a personal connection. Having good rapport with patients is important, and that process starts before patients ever walk in the door.
How often have you seen a physician bio that only contains a single, …
5 must-haves for great physician online profiles
Those of you that follow me know that I write and speak often on the topic of physician burnout. About a year ago, after my grandmother passed away, my extended family and I got together for a few days. One night, my cousin and I got to talking about my work, and he pressed me on a question that so many have asked me before, “What makes physician burnout different than that which every other profession experiences — and if …
If physicians are burned out, why don’t they just quit? Here’s why.
There is an accepted storyline in American health care that is so ingrained in our culture that it is almost beyond question. It goes like this. The chief culprit underlying the high-cost, low-quality American health care system is the traditional fee-for-service payment model, which rewards physicians for the volume of services they provide with no consideration for the quality of care being delivered.
The answer, the story goes on to say, …
The bureaucratic myth harming American health care
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 67-year-old woman is evaluated during a routine examination. She has a history of hip and knee pain related to degenerative joint disease. The joint pain is now well controlled with diclofenac, which was started 3 months ago. A previous trial of high-dose acetaminophen was not effective. She does not have any gastrointestinal …
MKSAP: 67-year-old woman with degenerative joint disease
A partial excerpt from What Patients Want: Anecdotes and Advice.
To complement posts regarding what doctors wish their patients knew, here are some things that I as a patient wish doctors knew:
We’re not here for the magazines. We’re here because we’re sick, which often means we’re scared too.
We’re often embarrassed. You’re wearing clothes. We’re wearing a paper sack. Please be aware of that.
We know germs can thrive in …
Here are some things that patients wish doctors knew
Two years ago I fielded a call from a surgeon I knew of but had not met. Raised locally, she had left the state for undergraduate school, returning to Texas for medical school and North Texas for her fellowship. Heavily recruited, she wanted to stay close to home and her family, and accepted a position with a group of surgeons practicing at one of the area’s stellar hospitals.
But she wasn’t …
For medical school graduates, the entrance strategy is more important than the exit strategy
“Wouldn’t it suck if you made it all the way through residency and then got cancer at the end?” my buddy Ron, a fellow medical student, and master of dark comedy, joked. I winced at the thought. God has a funny way of foreshadowing.
Three-quarters of the way through pathology residency I noticed my feet were starting to itch, especially at night. It was a deep itch. I scratched so hard …
How cancer transformed this physician
I’m about two-thirds of the way through my 3rd year of medical school, and I have hit my wall. I have become so fed up with the set up of medical school. I think a decent amount of this comes from the fact I am on my 6th week of an eight-week surgery clerkship (an area of medicine that I literally have zero interest in). I’m tired of waking up …
Is apathy needed to survive medical school?
As part of the interview for my book, I asked about the role that mental health plays in healthcare. Responses were unequivocal: It plays a vital role. All of these doctors have patients who are depressed, anxious, traumatized, or otherwise in need of mental health services. My doctor interviewees frequently added comments about lack of access to mental health services and insurance interference.
Refusal to pay is a big problem, according …
A consistent and clear picture of significant barriers to mental health care
When it comes to physicians burning out, for the most part, it is assumed that work is the primary cause. After all, physicians work long hours, have demanding schedule, and have to deal with the endless politics that comes with medicine. However, I often encounter burned out docs (many of who wear multiple hats outside of the home) who would claim themselves that work was not their primary cause of …
Physician burnout: When work is not the cause
The contrast between the first two years and last two years of medical school are unparalleled to any other graduate field of study. You progress through a period of relentless studying through case-based, team-based, and lecture-based curriculums for two years with very little, if any, patient interaction. Afterwards, the script flips and you’re staring nervously at your first patient trying to channel interpersonal skills that sat on the backburner during …
How to unite medical students in the preclinical and clinical years
Medical school rotations afforded me incredible opportunities to bolster not only my knowledge base but also my patient-related skills. The following information has helped me provide better patient care; hopefully, it can be of some benefit to you as well.
1. Safety and no violence are not synonymous
During one of my outpatient rotations, I was interviewing a teenager who had come in for a routine annual checkup. Ten minutes into the …
3 medical student tips to improve patient communication
I began practicing cardiology a decade ago caring for a cadre of young adults with congenital heart disease. I got to know their families (parents often still accompanied them to office visits), and I learned about their lives in addition to their hearts. “How do you remember the patients so well?” trainees often asked me. “Because I remember their story as a person and then the medical journey follows,” I …
Building our care team made me lonely
If you’re a physician-parent, no doubt you’re familiar with the helplessness associated with the phone call informing you that your child is sick — and needs to be picked up within the hour. You know, the one that coincides with when you were about to start a procedure or a time where there’s no backup available to take over your responsibilities. Murphy’s law.
Many of us have nannies exactly for this …
You’re a physician and a parent. Which comes first?
Somehow, I made it to my 4th year of medical school before I saw my first code blue.
I had no experience in emergency medicine before medical school, and my chosen specialty is about as far from critical care as you can get. It wasn’t until my rotation in the emergency department that I got the chance to absorb what it means to care for an emergently sick patient.
I was on …
A code, a trauma, and our fragile humanity
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