1. When your doctor looks into your eyes with a flashlight, shut your eyes tightly so he can’t see your pupils. Later, when your doctors asks you to shut your eyes tightly to test your eyelid strength, look at him like he’s speaking in tongues and keep your eyes open. If he whips out his flashlight to look at your pupils …
I am a fourth year medical student that attends an institution that does not have a department of family medicine.
Currently there are only 10 such allopathic institutions in the country. When I tell colleagues and friends that I intend to enter family medicine they say, “oh primary care?” While yes, it is true that family physicians obviously practice primary care, I am disheartened that my colleagues do not know or …
With immigration reform under hot debate, it’s important to remember that all of us except the Native Americans are foreigners. It’s what has made our culture so diverse. People from foreign countries ideally bring the best of their cultures to the US and enrich us all with the diversity of life. This advantage lessens considerably when those visitors want to enter fields in which understanding of endemic American culture is …
I’ve been traveling around the United States working as a locum tenens (in Latin, “place holder” – a more elegant name than “temp”) physician. We’ve all heard of traveling nurses, but more and more physicians are also “living la vida locums,” as it were. There are actually over 100 agencies who find/provide temporary physician coverage for hospitals who need to fill gaps in their full timers’ schedules. You can find out more about …
High fructose corn syrup, that sweet over-produced commodity of agribusinesses everywhere, has been linked in two miserable ways to bees and honey. The first discovery was made almost two years ago, and the second only 2 months ago. First, most of the “honey” available for purchase in supermarkets is not really honey, but instead an ultra-filtered impostor often produced in China, and …
In my over three decades of family practice, I have come to the conclusion that we, as doctors, should provide non-medical people with as much medical information as we can. Not as much as we think they should have, or information just related to the problem at hand, but as much as we can provide. Period.
I started practicing when many still debated whether we should tell a patient if he …
Monday afternoons are always the same. I pick up the kids from their grandparents. We drive home with their backpacks and a carton of home made food. We park in the garage, and carry all the contents of the car into the house. As the kids unload, I push the recycle container to the front for street pickup the next day.
Occasionally, I stop and socialize. Yesterday, I waited at the edge …
It occurs to me there are several keys to being an excellent physician. One must love science, enjoy hard work, have the courage to make tough decisions, carry a modicum of intelligence and suffer angst at receiving 94% on an organic chemistry test. In addition, the very best physicians, those we admire and to whom we flock, have a secret weapon. They do not care.
I do not mean that they …
In recent months, AAFP President Reid Blackwelder has been editorializing and debating what they see as the encroachment of nurse practitioners (NPs) and other “mid-level providers” (physicians are, presumably, “upper-level”) on the practice territory of family physicians (FPs). Dr. Blackwelder has repeatedly said that NP and physician roles are “not interchangeable.” The AAFP’s position on this issue seems to be resistance to the increasingly common decisions by state legislatures to …
I guess what is so utterly frustrating is that the guys up there don’t see what is going on down here. The march of health care reform continues with little realization of what it feels like to be one of the tiny peon foot soldiers on the ground. We are not deaf. We hear the politicians and policy wonks. We read as non-clinician “doctors,” ivory towered administrators, and the business …
I remember how my son’s autism diagnosis was delivered. He was three years old. It wasn’t a surprise really, merely a confirmation of something that I expected and feared. He was already enrolled in speech and occupational therapy making very little progress. He saw a developmental specialist at age two and two and half who initially believed that he was not autistic but merely delayed with sensory issues. After we …
As I shopped for a new car last year, I realized that my priorities were considered odd by most car salesmen. The three most important characteristics I desired in a new car were good gas mileage, good crash safety, and relatively low concentrations of “new car smells.” The often celebrated (but particularly noxious) new car smell is actually a synthetic blend of respiratory irritants and potential carcinogens off-gassing from the …
As a healthcare consultant, it is not unusual to be asked about HIPAA regulations on a weekly basis. Three questions come up regularly and seem to cause the most confusion when discussing HIPAA. I call them the Three Big HIPAA Myths – you can’t place medical charts on exam room doors, you can’t use sign-in sheets, and you can’t leave messages on patients’ voice mail or answering machines.
Here, then are …
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Tests like cholesterol levels are considered screening tests because they are cost effective, have high sensitivities (a low rate of false negatives), and have been proven to be beneficial in the identification of conditions that may require treatment before symptoms occur. The vast majority of medical tests are not considered to be “screening” because they violate one or more of these principles, …
Jeff Goldsmith recently opined on why practice redesign isn’t going to solve the primary care shortage. In the post, Goldsmith explains why a proposed model of high-volume primary care practice — having docs see even more patients per day, and grouping them in pods — is unlikely to be accepted by either tomorrow’s doctors or tomorrow’s boomer patients. He points out that we are replacing a generation of workaholic boomer …
Do you want to know if your doctor has been eating pizza for lunch that was purchased by Pfizer as she listened to a drug rep describe a new medication? Do you want to know if your endocrinologist has been paid $1,500 to give a brief talk about a new injectable diabetes medication to his colleagues as they gobble down filet mignon? If the answer is “yes,” then you are …
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My time as a medical student has quickly come to an end. This past winter, with nearly four years of arduous study, countless examinations and numerous clinical rotations under my belt, I couldn’t help but think, Yes, I’m ready to be a doctor.
And then I became a patient.
I’d always thought I knew what it’s like to be the patient. For much of my childhood, my father suffered from chronic fatigue syndrome, …
As Americans we spend more money on healthcare per capita than any other nation in the world. We have the latest medical innovations and for decades have been able to provide cutting edge therapy without regard to cost. However, as a profession, doctors are not doing nearly enough when it comes to prevention of disease. Certainly, costs will be reduced if we are able to prevent chronic illness and associated …
Medscape published an article titled, 4 Top Complaints of Employed Doctors, and it was a very interesting read. Turns out the things employed physicians complain about are basically that they are employees.
Let me lay out these employed physicians gripes for you with a little detail so you will see what I mean. I will finish this article with a solid way to address all of them. These …
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Nothing exemplifies more the complete lack of understanding of the issues surrounding our healthcare system than an article that appeared in the New York Times recently.
Author Jane Brody’s piece attempts to address issues with the astronomical costs and misuses of emergency department (ED) visits in the US today. While I agree that ED visits for routine issues are a waste of resources and money, her suggestion that physicians should …
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