Patients often think doctors do nothing, but they’re wrong

Physician
September 10, 2011

Very often I ask patients about their recent visits to other doctors.  While I am taking a history, it’s important for me to know if you’ve recently been seen by another provider for the same or similar complaints and what they did, what they diagnosed you with, what they prescribed, etc.  I often get a kind of irritated response such as “Oh, he didn’t do anything” or “he said it …

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Patients often think doctors do nothing, but they’re wrong

What to say if you suspect child abuse in the ER

Physician
June 19, 2011

I don’t know anyone that works in health care that does not dread suspected child abuse.

On all levels it is horrible.  Horrible that someone would do such a thing to a child, horrible for the logistical nightmares it can cause in treating the patient, horrible going though the whole mandated reporting process.  It just sucks.  Now, if it is obvious and you are totally sure it’s going on, you …

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What to say if you suspect child abuse in the ER

The futility of prolonging life and the benefit to patients

Physician
April 2, 2011

In case you have not heard about it, there is a very gut wrenching court case St Louis Park, MN.   A doctor in the hospital system is going to court to replace a patient’s wife, Lana Barnes, with a substitute decision maker, claiming that she is making futile and reckless decisions to prolong her near-vegetative husband’s  life.

He has …

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The futility of prolonging life and the benefit to patients

Government is already involved with the majority of health care

Policy
January 26, 2011

US District Judge George Steeh of Michigan ruled last year that the constitution permits the federal government to require individuals to obtain health insurance coverage.

This lawsuit was filed by a Christian legal organization called the Thomas More Law Center, as well as others.   Other lawsuits are in the works in numerous other states.   These suits are filed primarily by Libertarian-types who don’t want to be forced to buy health insurance …

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Government is already involved with the majority of health care

When a chief complaint doesn’t match the ultimate diagnosis

Conditions
October 9, 2010

Most times a patient that is triaged with a specific chief complaint ultimately have a diagnosis that appears to relate to that complaint. Such as “chest pain” often results in a diagnosis of “unstable angina” or “pulmonary embolus.”

Occasionally, something will be a little different like “back pain” turns out to be “biliary colic” or “myocardial infarction.”  Still, those are not surprising.

However, once and a while you have a chief complaint …

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When a chief complaint doesn’t match the ultimate diagnosis

The TPA time limit for acute stroke causes mass chaos in the ER

Conditions
September 1, 2010

I hate acute strokes. There are several reasons for it. Most of them are logistical. First, everyone gets into a tizzy because of the 3 (or 4.5) hour time limit after the onset of symptoms that which TPA can be given and hopefully improve the patient’s outcome. Unfortunately, this time limit (and the data for TPA’s efficacy is only OK at best) causes mass chaos and annoyance.

First, one has to …

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The TPA time limit for acute stroke causes mass chaos in the ER