Many years ago, three doctors formed an internal medicine practice and were proud of the thousands of patients they accumulated. They were fine physicians and very dedicated to the masses who walked through their clinic doors. They saw patients in…
Many years ago, three doctors formed an internal medicine practice and were proud of the thousands of patients they accumulated.
They were fine physicians and very dedicated to the masses who walked through their clinic doors. They saw patients in the office, rounded at two hospitals, and visited a number of nursing homes. This was truly a full-service practice.
Around 2005, Dr. A was starting to fatigue. He was well into his …
Ask babies with fever how they feel, and they’ll say … well, they probably won’t say anything, because they’re babies. But ask older kids, and they’ll look at you funny, and maybe say “Why are you asking me?” Kids these…
Ask babies with fever how they feel, and they’ll say … well, they probably won’t say anything, because they’re babies. But ask older kids, and they’ll look at you funny, and maybe say “Why are you asking me?” Kids these days, am I right?
Fevers make kids feel bad. Achy and miserable and bleh. So for comfort, I think it’s a good idea to treat fever in a child who’s uncomfortable. …
That’s the question sticking in my mind after reading a recent report about a local radiology practice opening a large mammography center in an upscale shopping mall in Long Island, New York. Let’s face it: Medical care is changing. And…
That’s the question sticking in my mind after reading a recent report about a local radiology practice opening a large mammography center in an upscale shopping mall in Long Island, New York.
Let’s face it: Medical care is changing. And with changes come new ideas. Some will work, some won’t. The thought of getting a mammogram while on a shopping trip may just be what the doctor ordered …
The concept of “First, do no harm,” which is embedded in the oath that kicks off the careers of most new doctors in America, has become something of a surrogate for the practice of medicine. But it’s something of a…
The concept of “First, do no harm,” which is embedded in the oath that kicks off the careers of most new doctors in America, has become something of a surrogate for the practice of medicine. But it’s something of a false promise. Doctors routinely cause their patients harm. The oath we should be taking is, “Help others with …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 37-year-old man is evaluated for a 2-year history of low libido, loss of morning erections, fatigue, and decreasing muscle mass. His medical history…
A 37-year-old man is evaluated for a 2-year history of low libido, loss of morning erections, fatigue, and decreasing muscle mass. His medical history is otherwise unremarkable. He takes no medications.
On physical examination, vital signs are normal. BMI is 35. The remainder of the examination, including genital examination, is normal.
This quarter, during the block of our human health and disease course dedicated to learning about the pulmonary system, I conducted one of the scariest “academic experiments” of my life: I stopped going to class. What did she do with…
This quarter, during the block of our human health and disease course dedicated to learning about the pulmonary system, I conducted one of the scariest “academic experiments” of my life: I stopped going to class.
What did she do with all that free time? one might be wondering. Instead of spending hours every week watching the lectures I missed going to in person and reading textbooks (I saved all of that …
For years, health care reform has pursued the holy grail of higher quality at lower cost. I’ve always believed it’s achievable, and now it’s needed more than ever. The U.S. health care system is failing. Costs continue to increase faster…
For years, health care reform has pursued the holy grail of higher quality at lower cost. I’ve always believed it’s achievable, and now it’s needed more than ever.
The U.S. health care system is failing. Costs continue to increase faster than our nation’s ability to pay, and the quality of our outcomes lag those of most other industrialized nations. People increasingly ask me what concrete steps could make a difference. The …
He had been in for a physical the day before. Like so many people, he seemed to have this need to run half a dozen minor bodily symptoms past me, while I worked my way through the agenda of screening…
He had been in for a physical the day before.
Like so many people, he seemed to have this need to run half a dozen minor bodily symptoms past me, while I worked my way through the agenda of screening colonoscopy, whether or not to test his PSA, calculating his ten-year cardiovascular risk, talking about alcohol use, screening for depression and so on.
I imagined it like a scene from the hit television show "House, MD," only I had no "MD" after my name, and my striking discovery had come not from the accumulated wisdom of years of experience but from a whopping…
I imagined it like a scene from the hit television show “House, MD,” only I had no “MD” after my name, and my striking discovery had come not from the accumulated wisdom of years of experience but from a whopping five hours scouring the internet. In my exhilaration, I was perhaps a bit delusional, for I was convinced I had single-handedly cracked a mystery case that had left an entire …
I occasionally dip my toe into the constant Internet flame wars over the generous term "vaccine skepticism," and the less generous "vaccine denial." If you’re looking to see one of these quickly, Twitter always has some ongoing vaccine fireworks. The…
I occasionally dip my toe into the constant Internet flame wars over the generous term “vaccine skepticism,” and the less generous “vaccine denial.”
If you’re looking to see one of these quickly, Twitter always has some ongoing vaccine fireworks. The character limit of Twitter tends to compress the exchanges into hurled invectives, only occasionally punctuated by futile pleas for calm. Many quickly devolve into exchanges between posters of what they believe to …
Illness is a disappointing and frustrating time. Nothing could be worse than a sickness which suddenly jolts you out of your daily routine, and forces you to confront a harsh new reality. That’s something that physicians should always remember as…
Illness is a disappointing and frustrating time. Nothing could be worse than a sickness which suddenly jolts you out of your daily routine, and forces you to confront a harsh new reality. That’s something that physicians should always remember as they go about their hectic work days. Doctors see patients at extremely low points in their lives.
The vast majority of physicians, and indeed all other health care professionals, are among …
Recently, a new mother of twins in Columbus, Ohio, sent a text message to her doctor: “Adam and I would like to introduce you to Ava Jain Cullum and Piper Jain Cullum. Their middle name was a no-brainer since we…
Recently, a new mother of twins in Columbus, Ohio, sent a text message to her doctor:
“Adam and I would like to introduce you to Ava Jain Cullum and Piper Jain Cullum. Their middle name was a no-brainer since we are so thankful for the huge role you had in getting them into this world … Both girls are doing fantastic. We are over the moon excited to have them in …
While Thomas Jefferson may have written that “All men are created equal” in our Declaration of Independence, nothing could be further from the truth when it comes to health care in the United States. As a physician, I have pledged…
While Thomas Jefferson may have written that “All men are created equal” in our Declaration of Independence, nothing could be further from the truth when it comes to health care in the United States. As a physician, I have pledged to ease suffering and heal those who are sick. However, I find that my job has become increasingly difficult over the last several years. The Affordable Care Act (ACA) has …
I remember, when I was a kid, that my grandmother would spend time at our breakfast table reading the newspaper. Not cover to cover, mind you -- she seemed to always focus her attention on the obituaries. Sometimes she would…
I remember, when I was a kid, that my grandmother would spend time at our breakfast table reading the newspaper. Not cover to cover, mind you — she seemed to always focus her attention on the obituaries. Sometimes she would look up and tell anyone sitting around her about the death of someone near her age …
During my salad days, I — like a lot of physicians — thought I could take on the world. Despite working in a smaller, community hospital, our ER saw a lot of the same type of orthopedic trauma I saw…
During my salad days, I — like a lot of physicians — thought I could take on the world. Despite working in a smaller, community hospital, our ER saw a lot of the same type of orthopedic trauma I saw during residency. And my young partners and I took virtually every case that came in except spinal trauma. We did this whether we were on unassigned ER call or not …
An excerpt from The Devil You Know. “Dr. McGill!” I look up and see seventy-one-year-old Herman Katz hurrying across the waiting room with outstretched arms. Herman Katz is the bane of my existence. During my short stint at the VA,…
I look up and see seventy-one-year-old Herman Katz hurrying across the waiting room with outstretched arms. Herman Katz is the bane of my existence. During my short stint at the VA, I have had him in my examining room dozens of times. Or maybe it just feels like dozens of times. Although I think it actually has been dozens …
I can’t quite describe the feeling of sitting in the audience of my medical school graduation this past month. Among the rows of students anxiously awaiting the graduating class, I felt like an anomaly. When the newly minted doctors came…
I can’t quite describe the feeling of sitting in the audience of my medical school graduation this past month. Among the rows of students anxiously awaiting the graduating class, I felt like an anomaly. When the newly minted doctors came down the aisle, my heart skipped a beat.
The truth is I should have been in that processional. I should have been an MD by now. No, I didn’t flunk out …
Innovative technologies and shifting public expectations are altering the practices of many industries, particularly those that provide a service. Medical practices should take heed and recognize these trends or risk losing patients and market share to others more open to…
Innovative technologies and shifting public expectations are altering the practices of many industries, particularly those that provide a service. Medical practices should take heed and recognize these trends or risk losing patients and market share to others more open to adopting new strategies.
How does one differentiate a high-performing medical practice from another that’s falling behind? And what are the forces that drive the discrepancy? What strategies can your practice implement …
I once participated in a discussion about a research study that was drawing data from charges submitted to Medicare and patient outcomes. The head of the project was referring to the financial data as costs, and I simply asked, “Isn’t…
I once participated in a discussion about a research study that was drawing data from charges submitted to Medicare and patient outcomes. The head of the project was referring to the financial data as costs, and I simply asked, “Isn’t this really charges, what Medicare is being charged by the hospital?” The response was a sort of non-answer, and then the person concluded, “It probably doesn’t really matter whether we …
Do you have to go to a top medical school in order to accomplish your dreams? Premedical students ask these questions often. It’s really a subset of the larger question which is “How do I choose which medical schools to…
Do you have to go to a top medical school in order to accomplish your dreams? Premedical students ask these questions often. It’s really a subset of the larger question which is “How do I choose which medical schools to apply to?”
But back to the rankings. In the Internet age, information is ubiquitous, and there’s always a new med school rank list being published by some authority. These rankings, in …
