For just a moment, let’s take a scientific viewpoint about gun control here and try to leave emotions (and the Constitutional argument) out.
The best type of study to determine whether gun control and/or regulation would be a randomized trial: randomizing a state or country to regulation or not.
Since that’s not going to happen, the next best type of evidence we have to go by is observational, either case-control or cohort …
It has always been my assumption that my new practice will be as “digital” as possible. No, I am not going into urology, I am talking about computers.
[Waiting for the chuckles to subside]
For at least ten years, I’ve used a digital EKG and spirometer that integrated with our medical record system, taking the data and storing it as meaningful numbers, not just pictures of squiggly lines (which is how EKG’s …
No one knew just how long Freddy had been homeless nor what circumstances had brought him to the doorstep of the Baltimore Rescue Mission shelter. As far as Dr. Dalton – our physician supervisor – and his students knew, Freddy had been there forever. Residents of the shelter were required to help out, sweeping floors or cooking for the other residents. Freddy always volunteered for clinic duty and was charged …
When I was in medical school in the 1990s, students were given a bleak picture of the life of a subspecialist. We were told that there would be few job opportunities and that the only way to ensure a job was to pursue a career in primary care. Many of my classmates did go into primary care but the majority of us accepted residency positions in surgery, neurosurgery and other …
Should marijuana be legal, for either medical or recreational use? I think the best initial answer to this is: It’s a crummy question! We are good at those.
It’s a crummy question, because it calls for answers based on unsubstantiated opinion. Answering it does not invoke or even encourage any relevant evidence, or precedent. So what would a better question be? How about: On what basis should any particular substance be …
“Discrimination against heavy people, by the general public and medical professionals, might be a greater health and social problem than any extra pounds they may be carrying” argues UCLA Professor Abigal Saguy, PhD, in a provocative essay in the Washington Post.
“Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their …
Cleveland and northeast Ohio are not hospitable to private practice medicine. I should know. I’m one of them. Private practice is fading as health care reform suffocates it by design. When this occurs, the public will have lost physicians who, in my view, have practiced patient advocacy and service at a higher level than our employed counterparts.
Keep in mind that the first half of my professional career was spent as …
As with any disease, prevalence of this narcotics abuse is region-specific; an hour north of the office where I practice, Rio Arriba County in New Mexico is home to one of the highest opioid overdose rates in America – up to five times higher than the national average. Our patients routinely lose family to addictions; our clinic has been home to a …
Would it be silly to ask, “Is the history and physical examination worth performing anymore?” especially in this era of high-technology medicine? Does it matter if the diagnosis is made by the bedside in contrast to CT or echocardiography? Someone did ask, and the answer is intriguing and was debated. Let’s look at the data.
Four hundred and forty-two consecutive patients were admitted from the emergency department to an …
When it comes to attracting new patients using the Internet is crucial. Many people begin their searches for new products and services online. You may have heard before that word of mouth is the best type of advertising. While that is true, it is important to realize that a lot of that communication between people is happening online, rather than in person.
It is important for physicians to use social media …
Do you read the comic strip “Dilbert” by Scott Adams? I read it most every day. It tells the story of an engineer named Dilbert and the people with whom he works, including notables such as Wally, Alice and the pointy-haired boss. Mr. Adams daily relates amusing situations of the dysfunctional relations at Dilbert’s work site. While the situations are hilarious at times, they reflect the actual work processes at …
There’s certainly a lot of buzz surrounding the word “holistic” in the field of medicine lately. For the purposes of what I am talking about in this article, I assume that all, or at least most, doctors take a holistic approach to medicine. Meaning that they can think across many of the body’s systems, understanding how one condition or component affects the others, and considering each aspect of a patient’s …
As a physician, do you care enough about your patients? It is my belief – and my experience – that physicians care deeply in ways that we demonstrate through our hard work, our commitment, and our willingness to go beyond the ordinary almost every day of our professional lives. What often gets “lost in the soup” of busyness is the communication of that caring in a mindful, purposeful and comfortable …
Once upon a time a doctor first attended 3 or 4 years of college, then finished 3 or 4 years of medical school, trudged through 1 to 8 years of residency training to hang out “a shingle,” and finally begin to practice medicine, usually in solo practice. Those days are long gone. Time has expanded—schooling and training are longer.
Breaks are taken between and during this once but no longer traditional …
Even doctors must become patients eventually, and often challenging patients at that. We know enough to be dangerous but not enough to be in charge. We want to question everything but try not to. We can tend to be catastrophic thinkers because that is how we are trained to be, but fear being alarmists. We want our care providers to actually like us, when we know they inwardly cringe knowing …
On January 7, 2013, a federal appeals court rejected six Georgia primary care physicians’ (PCPs) challenge to the Centers for Medicare and Medicaid Services’ (CMS) 20-year, sole-source relationship with the secretive, specialist-dominated federal advisory committee that determines the relative value of medical services. The American Medical Association’s (AMA) Relative Value Scale Update Committee (RUC) is, in the court’s view, not subject to …
The numbness overwhelmed my immediate sense of dread throughout my body. I was trembling inside, full of anguish and at the same time, unable to contain my seething anger over an uncontrollable destiny. Just a few minutes ago, I turned off her life support system. The series of beeps had slowed down, pace by pace, like the ritardando in a finale movement of a concerto. …
Have you ever gone to the doctor and felt like he wasn’t listening to you? Have you tried to tell your story, only to have him interrupt with a checklist of questions: do you have chest pain, shortness of breath, fevers, cough, and so forth? Have you ever felt ignored, and left thinking that your doctor never understood why came to him in the first place?
Medicine is big business. If you don’t believe me, the next time that you travel by plane, pick up the airline magazine in the seat pocket and read the ads. If the advertising is a reflection of the air traveling …
I have the privilege to work in the medical profession where astonishment and revelation awaits me behind each exam room door.
In a typical clinic day, I open that door 36 times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient. I must peel through the layers of a person quickly to find the core of truth about who they are and why …
