Jordan Grumet, MD

The intimacy gap between doctors and patients

March 31, 2015Mar 31, 20154

I used to think that there was a communication gulf between doctors and patients. Somewhere in the hubbub of the harried office visit some secret sauce was missing. A divide that was so fundamental that both parties often left the room feeling disjointed and uneasy. Patients wondered if doctors truly heard them. Physicians wondered if anyone was listening to what they were saying. The tension ebbed and flowed but never …

This is who is behind every doctor

March 27, 2015Mar 27, 20154

Behind every doctor is a little boy or girl who once watched helplessly. Maybe it was her father or grandfather who suffered under the weight of a disease that was deemed all but incurable. Perhaps her own skin was battered and bruised by the repeated trauma of an unrelenting tourniquet. She swore that when (if) she got older she would protect the innocent from such things. Her vow was the …

This is who is behind every doctor

Our health system is changing, and it’s a damn shame

March 22, 2015Mar 22, 201545

I understand that there is a difference between perception and reality. I also get that the kind of people one meets on a tropical vacation in the middle of March are of a certain economic and sociopolitical status. Nonetheless, I…

Nonetheless, I am amazed at how history seems to repeat itself. Year after year, while sitting in the shade and relaxing by the pool, …

I lost a patient, but gained a friend

March 2, 2015Mar 2, 2015

Loss is something all humans face in their everyday lives. As a physician, the effects are often magnified. People die, they move away, they graduate from your services, or occasionally they pursue care elsewhere. Parting can sometimes bring relief, and others a deep sense of failure. But with Clara, I’m not sure we actually parted. Mostly, I was left with confusion.

Clara came to me by way of the nursing home. …

I lost a patient, but gained a friend

A patient, mortally wounded by those purported to love him

February 17, 2015Feb 17, 20154

Neither of the two most important people in Aaron's life could stand to be in the same room with each other. There was a long colorful history between his ex-wife and his brother, and as his disease began to accelerate,…

Neither of the two most important people in Aaron’s life could stand to be in the same room with each other. There was a long colorful history between his ex-wife and his brother, and as his disease began to accelerate, the feuding became quite intense. They argued over Aaron’s advance directives. They both tried to coerce and manipulate themselves into commanding positions. The shouting became louder, the fury more fierce. …

Medical education

The fight against MOC: The spark that unites physicians

February 8, 2015Feb 8, 201525

Physicians are docile. We are programmed to put the greater good above our own. We train mercilessly, work tirelessly, and bend faithfully at the alter of those we have vowed to heal. This is our birthright. This is the covenant…

Pay for a doctor and get a plumber instead

February 3, 2015Feb 3, 201512

It seems everywhere you look in health care today; some consultant is telling you that "less" is actually "more." Less care leads to more quality. Less expense brings better outcomes. Nurse practitioners with less training are more cost effective. Fewer…

It seems everywhere you look in health care today; some consultant is telling you that “less” is actually “more.” Less care leads to more quality. Less expense brings better outcomes. Nurse practitioners with less training are more cost effective. Fewer work hours for residents builds a safer hospital environment.

Never in our entire history have we gotten so much for so little.

Arshya …

Doctors who attack other physicians

January 29, 2015Jan 29, 20159

Her heart was failing; her ejection fraction was unmeasurable. Her hip was broken, and she developed a pulmonary embolism post-operatively. She was painfully close to death. Yet at some point, the hospital finished and spit her out at the nursing…

She was confused.

I tried to take the best history that I could. Her answers where usually no more than a single word. Her physical exam revealed a desperately weak woman, …

Doctors who attack other physicians

The final gift of the dying

January 22, 2015Jan 22, 2015

I assumed many things that morning. For instance, I thought it was likely that Ronald's fatigue was from lung cancer that had metastasized to the liver. Or that he decided to stay in his room in the nursing facility because…

I assumed many things that morning. For instance, I thought it was likely that Ronald’s fatigue was from lung cancer that had metastasized to the liver. Or that he decided to stay in his room in the nursing facility because the decision to elect hospice had finally taken its toll. I was sure that he was both physically and emotionally spent. I reasoned that I wouldn’t want to get out …

The final gift of the dying

Remembering the humble profession of taking care of each other

January 15, 2015Jan 15, 2015

It was a rather unlikely place to begin my clinical career. Shortly after starting medical school, I signed up to volunteer in the hospice unit of my academic medical center. The first few visits I relegated myself to fairly banal…

It was a rather unlikely place to begin my clinical career.

Shortly after starting medical school, I signed up to volunteer in the hospice unit of my academic medical center. The first few visits I relegated myself to fairly banal activities. I shredded old medical records, or I might do a load of laundry for a family member who had been waiting tentatively by their loved one’s side and was …

Retail clinics sound good. But if you need follow-up care, good luck.

January 9, 2015Jan 9, 201532

The truth is, I know it's easy to go to the Minute Clinic. I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the…

The truth is, I know it’s easy to go to the Minute Clinic. I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the end of your appointment. Who doesn’t like convenience and a friendly smile to add? Who doesn’t like the customer service offered …

Stemming the flood of memories that threatened to drown her

January 6, 2015Jan 6, 2015

Julie was lost in thought. Her right pointer finger slowly traced the edges of the metallic trinket. It was tucked far enough into her pant pocket that only the longest digit could reach. Back and forth, her hand moved caressingly,…

Julie was lost in thought.

Her right pointer finger slowly traced the edges of the metallic trinket. It was tucked far enough into her pant pocket that only the longest digit could reach. Back and forth, her hand moved caressingly, pausing from time to time to inspect any irregularity, any imperfection. In such a manner Julie built a mental image of the old forgotten piece of jewelry. Her hands visually occupied …

How the kind, humble physician met his demise

December 30, 2014Dec 30, 201415

There once was a kind, humble physician who worked for years in an office building across the street from the hospital, toiling day to day to take exceptional care of his patients. He was open and deliberate, calm and thoughtful. He himself hired every secretary and medical assistant, every nurse, and biller. His staff formed a protective family who fiercely advocated …

Escaping the curse of experience, for just one moment

December 21, 2014Dec 21, 2014

It's a strange thing to be driving about in your car in the middle of the day. For one who has spent the majority of his professional life sheltered in dark offices and aseptic hospitals, the summer sun and fresh…

It’s a strange thing to be driving about in your car in the middle of the day. For one who has spent the majority of his professional life sheltered in dark offices and aseptic hospitals, the summer sun and fresh breeze is quite lovely. One almost begins to approach humanness. Normal. This must have been what it felt like before immersion into the tribe of medicine.

Sometimes I have trouble remembering …

Our health care system makes no sense. But what if it did?

December 7, 2014Dec 7, 2014

The conversation was almost comical, until I thought more deeply about it later. Apparently I was on "the list." Insurers make such lists for customers who are searching for a doctor who accepts their coverage. Every so often my name…

The conversation was almost comical, until I thought more deeply about it later. Apparently I was on “the list.” Insurers make such lists for customers who are searching for a doctor who accepts their coverage. Every so often my name comes up on these lists, and I get a smattering of phone calls from perspective patients. Maybe a few times a …

Health policy

Why does the government fail to bend the cost curve?

December 3, 2014Dec 3, 20146

A few months ago I assessed a patient with dementia. I dutifully ordered the appropriate blood testing and MRI. As I delved further into the history, I was concerned that there may be a component of depression. Pseudodementia (memory disturbance and dementia like symptoms caused by depression) can often mimic classic Alzheimer’s disease, but resolves with proper treatment. The best way to differentiate these two syndromes is neuropsychological testing. I decided to send my patient to a colleague …

Health care monopoly: How it affects the nursing home

November 26, 2014Nov 26, 20145

Check. The administrator's voice wavered as I picked up the phone. He was calling about the nursing home patient that I admitted the day before. While normally forthright, I could feel the discomfort in his tone as he danced around…

Check.

The administrator’s voice wavered as I picked up the phone. He was calling about the nursing home patient that I admitted the day before. While normally forthright, I could feel the discomfort in his tone as he danced around the issue. The patient’s insurer had called. Apparently they made an “arrangement” with the mega-ACO owned by the latest consolidation of Goliath health systems. They wanted my patient transferred to another …

You always remember your first patient

November 18, 2014Nov 18, 201413

I didn't think much of it at the time. Most physicians can trace back and recall their first patient. For some, it is a clinical encounter the third or fourth year of medical school. The more creative may point to…

I didn’t think much of it at the time.

Most physicians can trace back and recall their first patient. For some, it is a clinical encounter the third or fourth year of medical school. The more creative may point to their cadaver during first year anatomy and nod knowingly. My first patient was a mouse. Or shall I say a group of them?

My freshman year of college, I volunteered in …

You always remember your first patient

When a doctor cries

November 12, 2014Nov 12, 20143

The calls came simultaneously. One from the hospital and the other from a nursing home. Two deaths separated by fractions of a second. My heart swelled. For a moment. The pile of papers on the desk softly whispered. My mobile howled jealously vying for my fragile attention. I could feel the emotion drain as I turned back to the task …

When a doctor cries

Years after a stroke, and wondering if the right decision was made