One of the topics I went to China to discuss was our medical school’s approach to teaching medical ethics.
At Wuhan University they have a first-year course, but I was told by both the school administrators and some of the students that the material is dry and not seen of immediate importance, so students often skip the class.
Here’s how …
Every once in awhile amidst the weekly deluge of medical articles comes a show-stopper that has the potential to change the way we practice.
Rarer yet is the article that not only changes how we practice, but calls into question why we do what we do.
This recent article from the New England Journal of Medicine is just such an article. Before you bolt, let me simplify it for you.
For five years I worked at GlassHospital’s Student Care Center.
I don’t get no respect, neither.
One of the great things about GlassHospital is that it sits on the campus of a well-known and fairly well-respected former Big Ten university.
Like all colleges and universities, our place acts in loco parentis to the students that grace its campus. This means responsibility for our students’ health and well-being.
I loved working at the Student Care …
NPR has a great blog on their website called Shots about current events in health care. Recently, Scott Hensley, the main blogger there, posted a recent article on treatment of prostate cancer from the Archives of Internal Medicine.
If you look at the article, you may notice a very small subheading above the article’s title. It reads “Less is More.”
Very telling.
The thrust of the article and the …
Recently, I had the opportunity to decamp from the the friendly confines of GlassHospital and trek a few miles to the north.
GlassHospital has brokered a teaching and patient-sharing agreement with a nearby religiously-affiliated community hospital I’ll call Our Lady of Blessed Proximity.
Our Lady has a residency training program, just like ours, with the major difference being that nearly all of the doctors come from foreign lands.
Something you should know about medicine in …
Most people enter the healing arts with a genuine desire to serve others.
The long educational journey and the realities of both the workaday world and the various business models of health care often strain our abilities to act in an empathic manner.
We have to pay the bills, after all.
“No money, no mission,” is a refrain I’ve often heard in the non-profit corners of the health care world, justifying business decisions …
What do Enterprise Rent-a-Car, KeyBank, and the Cleveland Clinic have in common?
They all make customer (patient) satisfaction a top priority.
They accomplish this in industry-specific ways, but together their emphasis on service as a passion shares common themes:
1. Buy-in for a service culture comes straight from the top, and permeates the entire organization.
2. Copious resources are delegated to building a service culture, starting with hiring.
3. Employees are “hired for fit.” If …
Time to turn our attention to an unpleasant topic: Lawsuits.
Who files them?
Why? And what actually happens?
There have been oceans of ink spilled about medical malpractice. An oversimplification of the various positions on malpractice and malpractice reform goes something like this:
I’ve just finished a month “on-service” as a teaching attending for a general medicine team here at GlassHospital. This means I served as the physician of record for every patient admitted to the team.
You might find it interesting to know that patients admitted to the hospital’s general medicine service get assigned to their teams by random assortment. Since there are five teams, one team takes call every fifth day. …
Working in the hospital this month, my team has been caring for Mr. M. He was here when we started on service at the beginning of the month, and unless his planned transfer to another facility goes through, he’ll be here when we sign off to the next team at the end of the month.
Mr. M is in his fifties. He speaks Spanish. He is an undocumented immigrant from Central …
Beginning in the 1970s, the house call began a slow death. As the medical-industrial complex (MIC) burgeoned, with bigger hospitals and a surfeit of technology, it became incumbent on patients to come see us rather than us going to see you.
Yet there are pockets of house calls still left in the U.S.
For the geriatric age group, there has been growth in the care-at-home sector, especially for homebound elders. They can …
In America, too many people die in the hospital.
I don’t mean that they die due to medical error or incompetence, though that’s always a hot topic of discussion amongst doctors, researchers, administrators, and regulators.
What I mean is that if you ask most people, they say they’d rather die at home, surrounded by their loved ones, drifting off to sleep painlessly after having had last rites administered (feel free to plug …
One of the joys of practicing at an academic center is that I get to do many different things in my job.
The foundation of my work is seeing my own patients in a large group (more than thirty doctors!) primary care practice.
Two months a year, I take my turn rotating on the hospital inpatient services, supervising teams of residents and students who are the primary caregivers for patients with illnesses …
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I made a New Year’s resolution to become a vegetarian. Or a mostly vegetarian.
I’ve been thinking about it for a long time, but with young children who love meat and don’t have the broadest palates, I think it’s important to feed them protein any way I can get it in them.
Having passed 40, I’ve finally realized that I can no longer eat what I want with impunity. Further, as a …
The ER is the portal of entry to our hospitals now, for better and for worse.
On the plus side, this means that most patients being admitted to general medical and surgical services have a workup at least started and are triaged appropriately to their destination.
A good ER evaluation should answer the following questions:
1. What’s the nature of the illness?
Are we dealing with the heart, the brain, or an abdominal organ? …
Like most people, I’ve found the news and images coming from Haiti in the aftermath of the January’s earthquake appalling and upsetting.
The sheer amount of devastation and orders of magnitude loss of life make the story compelling by itself. Coupled on top of Haiti’s ignominious history, the situation touches us for its Job-like quality: ”How much misery can one people withstand?”
I’ve been pleased at the outpouring of support for Haiti. …
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