There’s a great scene in the classic West Side Story in which members of the Jets gang go through all the different things people say is wrong with them.
“The problem is he’s crazy, the problem is he drinks, the problem is his mother, the problem is he stinks.”
“I’m depraved on account ‘a I’m deprived!”
It’s satire, and it’s funny, and it’s a catchy song, but it illustrates the complexity of social and …
Where do I start with this: The $2.7 Trillion Medical Bill.
I’m going to let Ms. Rosenthal tell you about how many unnecessary colonoscopies we do. I’ll let her tell you how much more it costs here than anywhere else. I will address the anesthesia bit.
Let me tell you a little story. When I was a baby anesthesiologist my hospital sent anesthesiologists downstairs to do anesthesia for GI procedures …
At a recent faculty meeting, we learned that the first year residents in anesthesia will now have to take and pass a written exam at the end of their first year. They will have a certain number of tries and if a resident can’t pass it by the third try they’re either out of the program or held back in some way.
Now, it used to be when I was a baby …
One of the things that used to make physicians different from other providers is the ability to prescribe drugs. This is not true anymore, but the majority of prescriptions are still written by doctors. Prescribing practices of physicians vary widely across different populations and specialties. If a doctor takes Medicare patients, his prescribing patterns are part of the mountains of data Medicare collects about it’s patients. In 2003 the government …
I read the New York Times. I read the health section as much as I can to keep track of what the paper is saying about health-related issues. I read Jane Brody. I like Jane Brody. I’m not sure what Ms. Brody is, but I don’t think she’s a clinician.
In her article “Avoiding Emergency Rooms,” she makes some suggestions on how people should get care if they need …
A woman’s mother dies at age 56. A blood test is done. The woman finds out she has a genetic pre-disposition to cancer. She takes what action she thinks she needs to take. A familiar story repeated over and over again every day. I’ve met many women who have made this choice. While not “normal”, it is a familiar situation. These women’s difficult choices go unheralded. But not Angelina. She …
I recently blogged about the question of what the difference is between a doctor and a nurse, now that advanced practice nurses can do so many of the same things physicians do. As both a nurse and a doctor I thought maybe I could wade into that quagmire. In that post I suggested that the real difference is one of ultimate responsibility. A reader pointed out that this …
I am affiliated with the institution where Dzhokhar Tsarnaev is currently hospitalized. I am friends with people who have treated him. I’m trying to stay away from those people; I would be unable to help asking them about him. They might be unable to help talking about him.
There has been a flurry of emails and red-letter warnings cautioning people here not to talk about Mr. Tsarnaev or look him up …
Academic Medicine, a journal of the American Association of Medical Colleges, has sent out a recent call for articles addressing the 2013 question of the year: “What is a doctor? What is a nurse?” Thirty years ago this would have been an absurd question. Not only would it have been absurd for doctors and nurses, but for patients too. Roles were …
I was watching Jon Stewart recently, and he had Michelle Rhee on. For anyone who doesn’t know her, she’s the superintendent of schools in Washington D.C. who made a bunch of reforms that caused some controversy and resulted in her being one of the main spokespersons for education reform in this country. Her conversation with Jon made me realize the similarities between …
Today I’m doing anesthesia for colonoscopies and upper GI scopes. Nowadays we have three board-certified anesthesiologists doing anesthesia for GI procedures every single day at my institution. I’ll probably do 8 cases today. I will sign into a computer or electronically sign something 32 times. I have to type my user name and password into 3 different systems 24 times.
I’m doing essentially …
A resident is a person who has an MD, meaning they have completed 4 years of school, but they are not yet qualified to actually do anything. An MD is just a piece of paper saying you did your time in the lecture hall/lab. Residency is where you learn how to be a doctor. The term “resident” originates from the old days in which newly-minted doctors were actually living at …
Let’s talk a little about health accountability. Two news items have provoked the following rant: why is it always someone else’s responsibility?
The first item was on NPR. The FDA, reacting to the epidemic of prescription drug abuse in this country, is offering incentives to the pharmaceutical company that can come up with a less addictive painkiller. Such a drug would be a gold-mine for that pharma company because it could …
For most people, anesthesia is one of the more mysterious branches of medicine. What we do for patients is done, generally, when they are asleep. You the patient don’t exactly know what we are going to do, or how it’s done, but you put yourselves in our hands willingly. It’s sort of a weird relationship we have with other humans. We have done our job right if our patients don’t …
A recent editorial in the New York Times about non-physician health care providers or NPPs, has drawn more than 260 comments. Who are these NPPs and why do so many people care about them?
Historically, nurses have a long history of stepping in when there are gaps. For example, in the early 1900s anesthesia was given by med students and interns, and …
A few months ago, when I thought I should throw it all away and go to law school, an acquaintance who is a lawyer said something unexpected. He said “law school is learning how to think like a lawyer and deal with the uncertainty within the law.” Uncertainty? A law is a law right? Don’t speed. Don’t drink and drive. Write thank-you notes. Turns out the law often requires interpretation, …
Doctor: What medicines do you take at home?
Patient: Something for the diabetes.
Doctor: Do you know the name of it?
Patient: “Starts with an M. Or a P. Honey, what’s the name of that pill?
Wife: Well dear, I don’t know but it’s a little blue one. You know doc, the little blue one?
Nothing will drive your health care provider more crazy than conversations …
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