Recruitment season is my favorite time of year. The CVs pile into the database, and we sift through the resumes, searching for candidates that would make a great fit for our organization. Next, I get on the phone and assess their level of interest and try to sell them on everything we have to offer. We fly them out for a live interview, and the negotiations begin.
Last year was a …
I spent a couple of hours today discussing a topic that has become increasingly important in the world in which we live, and which would have completely mystified an earlier generation of physicians. The subject was attribution. Simply put, how should one decide which patients “belong” to which doctors? On a more technical level, what algorithms should be employed to connect patients, or episodes of care for those patients, or …
When a wife suddenly comes in for her husband’s appointment, I usually worry a little; when a husband shows up for his wife’s visit, I sometimes worry a lot.
I have come to expect that when I enter an exam room, and a male patient has his wife with him in the room, she is there to make sure I hear some part of his symptom history that he has never …
Christine Sinsky, MD, from the American Medical Association interviews Pamela Wible, MD, after her TEDMED talk. Watch periscope video here. Fully transcribed below:
Dr. Sinsky: This afternoon we’re here in Palm Springs, and I’m delighted to be here with Dr. Pamela Wible, who gave a terrific TED talk last night. I’m Dr. Christine Sinsky, the vice president of professional satisfaction at the …
Amid ongoing health care transformation, clinicians will increasingly face the tension that the late physician and health services researcher John M. Eisenberg, MD, MACP, described over 30 years ago: providing high-value care with simultaneous commitments to patients and society.
Physicians have always been charged as patient agents to advocate for patients’ best interests. Simultaneously, however, they are tasked with considering the societal good by using resources wisely. While these commitments often …
From ancient times, doctors have appreciated that, for all their similarities, no two patients are exactly alike. This understanding is what made physicians act like, and earn society’s respect as, professionals.
The commercialization of health care has brought in managers from other industries and other branches of academia, and their rise to power has been predicated on their ability to treat patients and doctors not as individuals, but as small cogs …
Combine a hot start-up valued at 9 billion dollars, an articulate Stanford drop-out CEO with celebrity-like press coverage, and a recent Wall Street Journal report that calls into question the reliability of the company’s “revolutionary” testing, and you have the perfect storm to set the internet abuzz about Theranos.
Amidst the melee of accusations, “change-the-world” start-up jargon, and anecdotes of incongruent lab results, something has been missing: an organized, …
We’re not imagining it: We really are losing our connections to each other. It’s a huge problem. In fact, it’s life-threatening.
A recent Wall Street Journal article discussed the Brigham Young University study that found that social isolation increases our risk of death by 32 percent.
Duke University and the University of Arizona have been watching our connections go down the …
I lost a very dear friend about a week ago. She was my nurse, office manager, and friend. She was Ginny. Ginny came into my life about eight years ago as I assumed the responsibility of medical director for a multi-location clinic. I spent about as much time with her as I did my family, she was my “work wife.”
About nine months ago I became concerned with her rapid loss in …
In the ten years since I graduated from residency, I have noticed an interesting correlation between burnout and finances among my physician colleagues: The more secure we are financially, the more we enjoy our work. However, physicians working long clinic hours and moonlighting 15 times a month as a hospitalist in order to make alimony payments, boat payments, mortgage payments, or all …
I peeked. Several months ago, I met a 60-year-old woman with shortness of breath. Her hospital stay was a whirlwind. She had lost weight, and a test detected her stool had blood in it. This was an ominous sign. Within a few hours, she underwent a colonoscopy that revealed she had colon cancer. The colorectal surgery team whisked her away from my general medicine team. I soon left that hospital for …
It’s a change in nomenclature that’s come a bit out of the blue over the last few years. The forces appear to be aligning to gradually push the word “doctor” out of the center and towards the periphery of health care. Whether we are talking about administrative communication or health care information technology order entry — it seems that we are no physicians or even clinicians, but we have all …
I have previously written about a patient on this site: “How elderly patients can be stubborn to their own detriment.” In that post, I discussed how the patient repeatedly turned down appropriate therapy for her hypertension, saying she didn’t need the help. Now I’m writing an update.
Due to the patient’s refusal to accept treatment for her hypertension, despite counseling on the part of her cardiologist and primary care …
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Theresa arrived in a cloud of noise and commotion.
She had called after four o’clock the day before, but I hadn’t noticed the new message in my electronic inbox before I left the clinic.
Her almost brand new alprazolam bottle and her pain pills were missing, and Theresa was reeling. As she walked down the hall to the exam room, I heard her explain to Autumn how she had been to Walmart …
“I’d like an MRI for my leg pain. I haven’t had an MRI for many years, and I’m worried.”
These were some of the first words I heard from a patient I was seeing for a new patient visit. Based on this patient’s story and physical exam, her pain was most consistent with a muscle strain. My preferred approach to manage this complaint was to ask the patient to rest her …
Studies show over and over again that empathy is the key to physician-patient communication and is directly related to patient satisfaction, adherence to medical treatment, lawsuits, and clinical outcomes. Yet despite its importance, many doctors still struggle with showing empathy.
The reality is that while most medical students start school with high levels of empathy, it doesn’t take long before that empathy is beaten out of us. Studies show …
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I’ve been thinking about this over the last ten and a half years since my soul mate had a cardiac arrest and died. He was 38 and as fit as a fiddle. I am a rural general practitioner in South Australia (family practitioner in American parlance). He left behind four kids (from his previous relationship), and me with a broken heart. We had been together a little over two years.
Western …
While studying for a certification exam, I came across a question that stayed with me well after taking the practice test. The case discussed a patient who was prescribed antibiotics by his physician for a presumed bacterial illness and then returned the following week with an antibiotic-associated diarrheal infection. The test question then asked what could be concluded from this case. The answer: informed consent (i.e., patient permission for a …
Ask physicians across the country what problems they want solved, and they won’t hesitate to tell you. They worry about the growing health risks they observe in patients based on lifestyle choices, obesity and a variety of social factors that they feel powerless to change. Ask what they would modify if they had a magic wand, and they’ll point to the illogical, problematic and increasingly complex reimbursement schemes still favored …
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Sixty years ago, before he became a controversial figure in the field of psychiatry, Dr. Thomas S. Szasz co-authored an article for the Archives of Internal Medicine (now JAMA Internal Medicine) on “The Basic Models of the Doctor-Patient Relationship,” which is well worth reading today, particularly for those who believe that patient empowerment/engagement is a novel and disruptive innovation of our digital times.
The paper is describing …
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