I suppose it is obvious that I am a fan of stories. I like to hear them, read them, watch them, collect them and tell them. I believe I am participating in stories every day of my life. The story of my family is a beautiful epic. The stories I hear at work can break my heart. One of my favorite …
In medicine, we have murdered the story
Thanks to the measles outbreak, the news is full of stories on vaccines and anti-vaxxers. The blogosphere and Twitterverse and all the other social media dimensions are buzzing with invective against ignorant unvaccinated savages and their backward science denial. For the record, I’m a pro-vaccine physician. My children have been and are vaccinated, despite being unsocialized homeschoolers.
I’ve had my own share of needles; Physicians are mandated to have hepatitis B, …
The sense of superiority by those who are pro-vaccine
Just a short observation. Medicine is immersed in the customer service mentality. We’re always reminded to be appropriate and understanding, especially when patients are frustrated or upset. I get that.
Right now, I’m sitting in the airport in Detroit. We’re about 3 hours late leaving because we don’t have a flight attendant. That’s right; it’s not the weather (as it was on one of my earlier flights this week). And it’s …
Medicine is immersed in the customer service mentality
I have a unique perspective as a physician. Having traveled to many hospitals in the past two years, working as a locums emergency physician, I can comment on a variety of issues with a reasonable amount of experience.
One of those issues is EMR, or electronic medical records. I have spent plenty of time writing about this in the past, and I …
Pay doctors and nurses for the time they spend charting
The non-medical reader may wonder what I am complaining about. Of course, many of you have to be credentialed in your fields as well, whether law or accounting, law enforcement or public service, education, nursing or a trade. But those of you in medicine know how difficult it can be to become credentialed as a physician, either by a state for purposes of a license, or by a hospital in order …
Medical credentialing: Explaining yourself when you’re off the grid
When I was in residency, sexual assault exams were part of our training. We spent a lot of time learning how to ask the right questions, how to be gentle and empathetic, how to gather evidence appropriately and thoroughly.
While many hospitals now have SANE programs (Sexual Assault Nurse Examiner), I have never enjoyed the privilege of working with one of them. I have, for two decades, performed sexual assault exams on …
The relevance of drugs and alcohol in sexual assault
Walking around the ER in Tiny Community Hospital, I had a few realizations. In medicine, we hold onto some things very tightly. We love tradition; we love the known. We don’t always know why, but we choose “the devil we know,” almost every time, no matter how pointy his horns.
For instance: “No cell phones.” First of all, has anyone ever seen a cell phone interrupt anything we do? No? Neither have …
Stop clinging to tradition in medicine
I went into an all night pharmacy recently, after getting off of work at 10 p.m. I had to pick up a prescription for my endless, insomnia-inducing cough. Walking up to the counter, I was bathed in the smell of cigarette smoke, carried on the coats of patrons. Eight of us stood by the counter, outnumbering the staff by 100 percent. …
From a physician: God bless the night shift
Dear health IT staff,
I know that, on many levels, physicians must be the absolute banes of your existence. We are grumpy and resistant to change. And some of us are still confused by graphing calculators, much less complex modern computer systems. We call you because we forgot our passwords, then because we forgot the new passwords. We call because the system …
Dear health IT: Please understand our frustrations
I have issues with the customer satisfaction paradigm, but it’s not generally hard to make patients happy. Sometimes, though, it can be nearly impossible. It all depends on our own inner life as physicians and human beings. The key to medicine, to being a beloved physician, is to love our patients.
This can be a tall order. Human beings are remarkably difficult …
The key to medicine is to love our patients
I tried to order an echocardiogram yesterday at work. But it turns out, they only do them on Monday, Wednesday and Friday. Fair enough. It’s not an unknown phenomenon. Some places, surgeons are only available on Tuesdays and Thursdays, cardiologists on the second Wednesday of months with an R.
After hours, most hospitals now struggle to have ultrasound at all, unless, of …
What would restricted physician’s hours look like?
Tonight I will sleep in bed, all night, with my wife. The hours will pass in pleasant dreams, wrapped in a blanket, warm beside my darling. We are on vacation, and our teenage children will be sleeping in their beds as well; after they have watched enough bizarre videos on YouTube and eaten all the chips in the house.
But as I …
Enduring the night of a never-ending ER shift
I appreciate the need for physicians and others to sleep. I’ve spent a great deal of my career awake in the wee hours. In some very real ways, emergency medicine as a specialty exists as a shield between patients and their sleeping (or otherwise engaged) physicians. But I fear we’re all wearing a little thin. Because the emergency room has become …
The American hospital as we know it is in peril
People ran to the church for refuge in Medieval times. It was considered a place of safety, a sanctuary from civil punishment. In the church, one could claim a right to justice, food, water and shelter. That role was recognized by church and government authorities alike; doubtless sometimes grudgingly as the wanted escaped harsh punishments.
These days, America’s emergency rooms have filled …
Holidays in the ER: What you’ll see is a lot of humanity
How often do we have this interaction: “My wife was here yesterday for belly pain. That doctor didn’t do nothing! Told me she just needed to get over it. I am not happy and something needs to be done about this!”
(Frequently spoken by spouse.)
Records are reviewed. Treatment: Included numerous doses of morphine and phenergan, as well as fluids and Zofran. Frequent warm blankets were …
They didn’t do anything! The inverted homeopathy of the ER.
When I was in college and decided I wanted to go to medical school, I kept a picture of a medical transport helicopter on my desk. It represented the excitement I wanted to experience one day. When I was in medical school, I loved nothing better than watching in the chaos of the trauma bay, helping as the blood spurted to …
Everyone cries when they bury their dead
Emergency medicine, like every specialty, is its own religion. And on many levels, it tracks right along with the progression of religions from their ancient origins to their modern incarnations.
Our unique profession grew out of a pressing need for physicians who could provide immediate and life-saving care to the sick and injured, at all hours of the day or night. The …
The religion of emergency medicine: It’s time for a reformation
Medicine is not about money, except when it is.
When I was in my residency training, pharmaceutical reps still roamed the land. Vast herds of gorgeous young women in tight skirts and stilettos traveled through doctor’s offices, clinics, hospitals and residencies all over creation. Their appearance was always a thing of joy, especially for sleepy, hungry physicians-in-training. Someone would run to the …
Money has always been and will always be a big part of medicine
Whatever our individual belief systems, here is a cause that can unite us. Whatever our party affiliations, this can cause us to “reach across the aisle.” Whether or not we are religious, or believe in this life only or the next, this is a cause we can agree on, here and now. Conservative or liberal, right or left, theist or atheist, libertarian or green, male, female, gay, straight, we must …
Ebola: A cause that can unite us
Preface: I love to write about many things. People, pets, children, family, nature. But over and over I come back to a theme: my colleagues in our specialty and the forces arrayed against us. I’m not trying to be the toxic voice, the endless complainer. But if people like me don’t beat the drum, then nothing will ever change for the …
The striking parallels between warfare and emergency departments
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