Touch is a sensitive thing. No pun is intended here, but whether and how we touch our patients deserves our careful thought and deliberation.
So much interpersonal contact these days is virtual, with emojis, abbreviations and whole words thrown around as substitutes for human contact. Think XOXO and, “hugs and kisses.” And when people do touch in our health care environment, it is often with gloves, even for simple fingerstick blood …
I just did my first telemedicine video visit.
The concept seems so strange, the idea of carrying out an “office visit” without the patient actually being in the office.
Right now we have it structured so that when a patient calls up requesting to see me on a day when I am already fully booked (or, as is usually the case, overbooked), …
I made my 10:20 a.m. patient wait while I told my support staff about my day off.
“I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there were no serious injuries and all I did was to distract the passenger so she wouldn’t panic while we waited for EMS. Her husband hit a tree with their van, and …
According to a recent Harvard report, physician burnout is “a public health crisis that urgently demands action.”
Half of all doctors report troubling symptoms: depression, exhaustion, dissatisfaction, and a sense of failure. These physicians are twice as likely to commit a serious medical error, research finds. Experts predict that if left unaddressed, burnout will further erode the mental health of doctors and radically undermine …
Every year, there’s this rite of passage, the passing of the baton, as our graduating senior residents move on to fellowships, or into spots as hospitalists, or to practice jobs here in New York City or other cities, and a fresh new group of newly-minted physicians arrives ready to take up the gauntlet of training as Internal Medicine doctors under our …
So, who doesn’t want a better health care system?
We are barraged with stories in the medical literature and in the public press about the terrible state of our health care system, what poor outcomes we have, the inefficiencies in care, complaints about the electronic medical record, inflated costs, lives ruined by medical bankruptcy, and massive social inequities in terms of access …
It wasn’t even nine o’clock when the screen on my laptop suddenly froze. From that moment until my last patient left the building, my clinic had no internet.
For my part, the day went pretty smoothly, mostly because of some of my own work habits. It also helped that it was a warm, sunny day, and my schedule was on the light side. Others have frowned at my old-fashioned work habits, …
I’m a doctor. And, like most medical professionals, I’m a bad patient.
Two years after my last appointment, I got a CTJ, “Come to Jesus” from my doctor.
I called his office for a form. I needed proof that I don’t have tertiary syphilis. For my Thai visa.
Why tertiary syphilis, as opposed to HIV, cholera, lepers or bubonic plague? I don’t know. That’s the power of bureaucracies. They don’t have to make sense. …
Falling through the cracks, when it comes to health care, is a bad thing, but the way things are going, it’s getting harder and harder to avoid.
Providers in every setting are bombarded on all sides with data, results, messages, and things crying out — screaming — for our attention. Take, for instance, the conundrum that appears when a patient is …
As Wei Wei Lee sat with her doctor to discuss starting a family, she felt a “distance” between them. The physician was busy on the computer and focused on the screen.
“It just didn’t feel very personal,” Lee said. “I didn’t feel heard.”
It seemed as though keeping a record of the conversation was more important to the doctor than making a connection with Lee.
It wasn’t the experience she wanted, but she …
Yesterday, I got just about the strangest version of “MD aware” I have ever had.
We all know what this is, the person who is relaying some critical clinical information (positive blood cultures, Mr. Smith in Room 402 is having chest pain, etc.), and then they ask for your name so they can write it down somewhere in the chart.
In this case, …
Our job as health care professionals is not just to diagnose our patients by applying our scientific knowledge and clinical skills, but also to be the “communicator-in-chief,” “listener-in-chief,” and “reassurer-in-chief.”
Any doctor who doesn’t fully grasp this, is not doing the best job they can or being the best doctor they can be. I truly believe that over 90 percent of our everyday job as a physician involves being a good …
One evening in the clinic’s bullpen provider office, a colleague of mine wondered aloud how to respond to a difficult question a patient asked via patient portal message. A physician within earshot responded, “Just because someone asks you a question doesn’t mean you have to answer that question.”
I tried to empathize with where the physician was coming from. Surely after decades of practicing medicine, one might become weary of spending …
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A guest column by the American College of Physicians, exclusive to KevinMD.com.
In the late 1800s, William Osler stated, “… if you want a profession in which everything is certain, you had better give up medicine.” He made this observation at a time when the science underlying health care was nascent, and little was understood …
I am a small-town family physician, and I am blessed enough to be living my dream.
You see, I have always wanted to be a doctor. I cannot think of one other occupation choice that has ever entered my brain. I have wanted this since I was four-years-old, and I can remember in vivid detail telling the world this was what I was destined to be.
So what happens when your dream …
I, like many physicians, am the only doctor in my extended family. To say that they are proud is probably an understatement. I’ve been a practicing physician for seven years now and yet my grandmother each time I see her greets me with, “There’s my doctor grandson.” I have worked quite hard to get to where I am, and I enjoy what I do. I, too, am proud to be the …
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Some drugs are used for indications beyond their original FDA approved ones that make complete sense. I mean, if old seizure medications help nerve pain, it might be reasonable to try new ones for the same purpose if everything else fails.
Sometimes the broader use of a medication leads to additional FDA approved indications. One good example is bupropion, Wellbutrin, for smoking cessation. It even got a new name for that indication, Zyban, …
Doctors who disparage, or even ridicule, what parents tell them are, fortunately, rare. Nevertheless, sometimes parents may infer from what the doctor says or how he acts that he does not value what they are telling him, even though he did not mean to imply such a thing. All physicians have had the experience of overly touchy parents inappropriately assuming from our questions that we do not respect their ability …
Jill Ladkin was already having a terrible autumn. It began with a seizure that put her in the hospital with what seemed like scores of unfamiliar physicians attending to her state of health. The brain scan revealed a mass in the lining of her brain, a location usually signifying a benign tumor; but, given her seizure, the tumor was hardly what you would call a harmless growth. The surgeon had a theory of what …
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From the sublime to the ridiculous.
That’s sort of how my day went yesterday.
It started out with an early morning meeting with a colleague who has been implementing a telehealth program at one of our institution’s practices, learning about how they have been using this technology, some of the bumps in the road they’d hit, and how they’d been able to …
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