Have you ever said, “I’m going to be perfectly honest with you” or something to that effect? Have you ever had someone tell you that they were going to be perfectly honest with you? Have you ever thought about what statements similar to these really mean? You should.
Trust is an earned commodity and hard to get back once lost. “Doc, I’m going to be perfectly honest with you” means that, …
When it comes to medical care, honesty is essential
Impersonal and self-absorbed as Manhattan may be, it’s still embarrassing to cry on West 32nd Street. I looked for a store, any store, and ducked inside. The pace of my steps and angle of my head as I buried myself into a back corner, thumbing through pants twice my size, gave me away. A store clerk walked over and asked if I was okay. I knew I’d have to meet …
When doctors are called providers
A few months ago, I came out with a post on why I love my own doctor. Today I want to celebrate my patients, both past and present. For me, without the experience I have had over the past 14 years, I would not have enjoyed medicine quite as much as I do.
What I like the most about medicine is the ability to interact with people. That’s what clinical medicine is all …
8 reasons why I love my patients
Today and for the next few years the weather of this industry will be dominated by pervasive, discontinuous change. Structures, revenue streams, relationships of every level: All are shifting in fundamental ways. Specifically, the weather will be driven by:
i) invention and propagation of new business models;
ii) shifting risk onto both the provider and the patient, accompanied by building of new risk-based relationships, contracts and alliances;
iii) smart primary care coming to …
10 strategic questions to ask yourself about the future of health care
There are an awful lot of reasons that led up to my eventual resignation from a career in primary care medicine. I don’t know that any one of them is more important than the other (it really just depends on which day you ask me). One that stands out for me though as a universal problem shared by millions is Managed Health Care, and the imposition it has posed on …
Why this pediatrician quit medicine
A tug-of-war is going on in medicine right now between the past and the future. The present is confused and very unsure of itself.
Though I could be writing about health care in the U.S and the looming Supreme Court battle over the new health care law, I’m actually raising a much more intimate issue: Whether your doctor touches (examines) you or not.
Many pundits have weighed in on whether the …
Is it necessary for a doctor to examine you on each visit?
Four brutally honest declarations:
1. I can perfectly decide what is best for myself, my family, my patients, and my practice. I don’t need outside guidance telling me how to lead.
2. I decide what works best on my terms to practice the best medicine.
3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goals.
4. My goal is to make …
Doctors need to stop being so complacent
I don’t like selecting colleagues through the Match. The process was established to allow students to get the best opportunity available and I feel that our program (and our patients who rely on our trainees to provide care) is in jeopardy every year. It always turns out better than I anticipate, so I shouldn’t complain. However, we have to interview 60 prospective residents to fill our six slots so …
Advice to prospective family medicine residents
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. Diagnosing an illness is an art. A diagnostician needs to be one part scholar, one part detective, and four parts artist. He has to be a good listener, open minded, and capable of assimilating a large amount of sometimes confusing data into an accurate picture of a disease …
Diagnosing an illness is an art
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever before. In fact, the rate almost doubled in the 10-year period between 1999 and 2009.
This drives up the cost of care, as specialist consults tend to be more expensive than primary care visits. Furthermore, specialists tend to …
Why more primary care doctors are referring patients to specialists
Are doctors really going broke?
According to this piece from CNN Money, some are: “Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors’ lack of business acumen is also to blame.”
That’s all entirely true.
Pressure on reimbursement, combined with a lack of …
Doctors: Don’t be ashamed about going bankrupt
About six weeks ago, while in clinic, I developed pain in my stomach — specifically, in my right upper quadrant, just below the ribs. I had experienced this a few times before, but this time it seemed more persistent than usual. Following the rule that physicians make the worst patients, I kept working through it until my nurse told me I looked poorly, and made me see my own primary …
Our healthcare system is unfair and unbalanced
Imagine this scenario. You are a male health care provider and you complete an evaluation of a woman close to your age. You establish good rapport as you always do, she laughs at some of the same jokes you make with all patients, and she expresses delight that you are listening to her problems (unlike those other providers she says she has seen), feels you are helping her, and is …
Should healthcare providers hug their patients?
Political correctness and sensitivity training are interfering with medicine and healthcare. In a recent article published in the journal, Pediatrics, a group of researchers published their findings regarding parental perceptions of the terminology that doctors use to describe childhood obesity (ages 2 to 18). The researchers found that it was undesirable to use the term “fat,” “obese,” or “morbidly obese” because they were stigmatizing, blaming, and the least motivating to …
How political correctness interferes with healthcare
In my new role as one of the directors of an internal medicine training program, I help select new interns out of medical school for the three year training stint of residency.
At the end of residency, many graduates go on to subspecialty fellowships, another two to four year period of intensive training in fields like cardiology, nephrology, critical care etc.
For those that don’t choose a subspecialty, one choice remains: traditional …
Young doctors don’t see value in primary care careers
Doctors inevitably come into spotlight, being at the front end of health care delivery. Sometimes seen as guardian angels restoring health and life, other times, greedy minds sucking resources while they carelessly harm and kill patients to fill their wallets. After experiencing, observing, and hearing from others like me, I wonder if doctors are given more responsibility than they can handle, often attributed more aura than they deserve and frequently …
Are doctors given more responsibility than they can handle?
Historically, American physicians and surgeons were fiercely independent practitioners, who owned their own practices, worked long days and maybe longer nights, made a good income, but saw little of their families. They trained in a male-dominated world in “residency,” so named originally because their extended 120 hour/week work schedule demanded them living in dormitory type residence adjacent to the hospital.
They developed long-standing professional commitment to their patients that superceded time …
Impersonal care from the new generation of physicians
Today, I want to review another article I wrote in last year. That article started with a confession: “I confessed that I ate lunch with a representative of a pharmaceutical company.”
I must now confess that I often eat lunch with representatives of pharmaceutical companies and I’m proud of it. At this stage of my career, I can well afford my own lunch. I could sit quietly and relax over a cup …
I eat lunch with drug company representatives and I’m proud of it
Let me start by saying that I love my father dearly. We have an excellent relationship, and talk regularly. So there’s no bitterness in this post, nor any desire to engage in armchair psychology.
My father, now retired, was a general and thoracic surgeon, who was triple-boarded in critical care, and ran a trauma unit in inner-city Philadelphia. He was in private …
I will never be the physician that my father was
A recent study confirmed that the doctor’s office may be one of the worst places to determine if your blood pressure is under control. The automatic rise in tension many people experience when they are being scrutinized contributes to artificially high blood pressure readings. Although many times the only way improve one’s blood pressure is through treatment (such as medication, a low salt diet, and weight loss), other times …
Simple tips to improve your blood pressure checks
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