I’m becoming an amateur archeologist. The hilltop where we live is strewn with arrowheads and bits of Native American pottery shards. I have slowly, surely, trained my eye to find them. There is little flint here; so most of the pieces I find were made of quartz. (Hard to work with, but remarkably beautiful and almost always a brilliant white.)
My kids and I walk the red-clay paths and look down …
Archeology skills work in medicine
I am very blessed. The hospital where I practice, while concerned with patient satisfaction, does not worship at its altar.
That is, so far our administrators seem to understand that people will occasionally be angry or unsatisfied, and that such dissatisfaction is within the realm of real life. We still have people storm out of the emergency department, prattling on about lawyers and lawsuits, promising to go to another hospital in …
How patient satisfaction scores can affect physicians
The cell-phone is a wonderful device. Even I, somewhat Luddite about certain technologies, find it delightfully useful for things like calling my wife when I lose the grocery list, calling my wife for directions and calling my wife to remind me of what I was supposed to be doing. I’m not really a fan of texting, though my wife and oldest son seem to communicate that way quite effectively. It’s …
Texting and cell phone use are becoming more common in hospitals
We have a new EMR system. I like it because I type well. I’m facile at using a keyboard and touch-screen. Not everyone in my group is so blessed, and we’ve had some difficulties using the voice-transcription software. Nevertheless, my gut tells me that in a month or two more, we’ll be getting along with our new system swimmingly. It’s the sort of thing I have wanted for a while, …
EMRs can slow medical charting by requiring too much information
I must admit I’m a little weary of the entire debate on health-care reform. But something still haunts me. And that something is accountability. Of course, over the almost twenty years that I have borne the title ‘MD,’ I’ve learned a few things about accountability.
I understand that, almost without fail, the buck stops with me. The nursing home director knows the elderly lady wasn’t seriously hurt in that fall, but …
Nobody will be held accountable if healthcare reform fails
Most of us went into medicine because, in addition to being good students, we wanted to help people. How many oceans of ink and forests of paper have been used explaining that point to admissions committees we’ll never know. Suffice it to say, it felt very good when our professors wrote us glowing letters of recommendation. Of course, we were also saying, “I want to feel good about helping people. …
Good doctors sometimes may make patients unhappy
I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some …
The joys of practicing rural emergency medicine
I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and …
How teamwork is essential in the emergency department
Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are blind to what we have.
I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern …
When compassion meets progress in American health care
One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why.
Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency …
Will more primary care doctors keep patients out of the ER?
It happens over and over. I call a surgeon about a patient with abdominal pain.
‘Well, what’s the white count?’
‘Normal.’
‘Did you get a CT Scan?’
‘Yes, and it was normal. But they just look uncomfortable.’
‘Sounds like nothing for me to do. Call the hospitalist.’
It happens in other specialties. Cardiologists who aren’t interested in a patient with a normal stress test, pediatricians unimpressed with negative chest x-rays and normal labs. ENT’s unconcerned if …
Is medical technology making doctors less relevant?
An emergency physician, like me, may be the worst possible person to discuss relationships with patients. I mean, one of the reasons I chose this specialty was that I didn’t want long-term relationships with my patients. I see, now, that God has a great sense of humor.
See, the county I landed in after residency is small enough that I do know many of my patients, and I do see them …
Are relationships being lost in medicine, and are hospitalists partly responsible?
My kids love to play Monopoly. They delight in acquiring properties, making money and crushing their siblings. They play with passion and savagery. That is, until recently. A couple of weeks ago I walked past the Monopoly board, spread on the floor between my children and their dear friend Tyler.
“˜How’s it going guys?’
“˜Great game, but we all ran out of money. So, we just put some more money on the …
Edwin Leap: Who pays when politicians commit malpractice?
While I was driving my rental car a few days ago in another city, a man passed me on his chopper. He was covered in tattoos and his long hair was blowing wildly in the wind. He looked the very image of freedom, of unrestricted energy. Snug in my safe (boring) Chevy Cavalier, on the way to a meeting, with Mozart on the radio, I didn’t give him another thought. …
Edwin Leap: The strength of our sameness
I often joke that I’m not only an emergency medicine specialist; I’m an’alcoholologist.’ It took quite a while for me to develop that expertise. See, I grew up in a home where no one used alcohol and none of our friends used alcohol. Consequently, other than some college and medical school exposure to the stuff, I was pretty naïve about alcohol.
Now, 15 years into my practice, 18 years after medical …
Edwin Leap: For God so loved the drunks
I have read many articles about professionals who left their career fields after many years and decided to teach. Many of them go into the public school system to share their knowledge and experience with the next generation. In fact, it sounds like a grand idea. Qualified teachers are a commodity of inestimable value.
But I have been stricken by a comment made by many of those who changed careers Almost …
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