My late father often repeated the adage, “Any man who serves as his own lawyer has a fool for a client.” We physicians may not represent ourselves in court, but we often try to treat ourselves or neglect our own medical care — and end up with a fool for a patient.
My uncle was a family physician who practiced in the Kenai Peninsula of Alaska. He was my childhood hero …
Physician heal thyself. At your own risk.
In 2006, the Mayo Clinic asked 192 patients an important question: What makes an ideal physician? From their responses, several characteristics emerged. Among the top criteria, they wanted doctors to be “personal,” “empathetic” and “humane.” This shouldn’t come as much of a surprise.
Of course, we want doctors who relate to their patients as people instead of just another “case.” We want doctors to have sympathy for patients …
What’s happened to clinician empathy?
Practicing medicine at the frontlines is hard. It’s damn hard. Every minute you need to be alert, ready to respond to a potential life or death situation, and be called to another important problem. The current medical practice environment — with excessive bureaucracy, suboptimal information technology, and extreme time pressure with patients — adds exponentially to the mix, and can make for a very stressful job. Make no mistake, even …
3 health tips to help busy physicians
Very few things in the universe are 100 percent good or 100 percent bad. Cannabis is perfectly ordinary in having a mixture of good qualities (medical benefits) and bad qualities (medical risks). The people who want to make money – lots of money, by the way – from selling marijuana do a perfectly fine job of pointing out the good. But they don’t educate the public about the possible risks. They know it will …
America has seen medical marijuana before: This is what we learned (and forgot)
This article is sponsored by Careers by KevinMD.com.
“Sometimes you want to go where everybody knows your name.” So go the famous lyrics from the theme song for “Cheers,” the iconic sitcom of the 1980s. The name thing can get really personal in medicine — and everyone has an opinion — as evidenced by a plaintive blog posting …
“Doctor” or first name: Which do you prefer?
I often wonder what it was like before patient-centered care became a mainstream catchphrase. Was there a poor relationship between the patient and physician in the outpatient setting? Were hospitalized patients’ feelings, desires, goals, and therapy options ignored? It amazes me that we were able to care for patients more than ten years ago without using a “patient-centered” approach.
According to NEJM Catalyst, “Patient-and family-centered care encourages the …
The fallacy of patient-centered care
As medical professionals, one of the most challenging things to do is to motivate a patient to make changes in their lives. We passionately want the best for our patients, and it is sometimes so difficult for us to be able to connect with and inspire them to take the next step on a path to disease prevention and longevity. The solution? Enter Lebron James and Tom Brady.
It is no …
How Tom Brady and Lebron James can change your patients’ health
I didn’t become a primary care doctor to treat opioid addiction.
I wasn’t trained for it. To be honest, it scared me.
But when you work, like I do, at a clinic that serves a lot of people who have little money or who struggle with mental health and substance use issues, there comes a point when you have to step up.
When I started seeing patients in 2009, I knew that opioid …
Physicians can choose not to be powerless against opioid addiction
Apocryphal story from residency:
On morning rounds in the critical care unit, the post-call resident starts to present a complicated patient admitted overnight with chest pain, and after the first bits of the history have been presented, the wise old cardiology attending turns to the gathered medical students who are just starting their first clinical rotation and asks them what they …
What if EMRs can never capture the clinical experience?
I see several patients daily with cancer. Some days can be tough, but nothing compares to what they are going through. I know that. The physical anguish and toll that chemotherapy, radiation, and surgery can take on the body. The burden that the disease can take on the mind and the soul. It’s devastating and almost always life-changing. What makes things harder though is when a patient did not go …
An oncologist explains how to get your loved ones tested for cancer
First, the cancer diagnosis. Then, the barrage of trite encouragements: You can beat this! Don’t give up. Keep fighting! It’s not only friends and family members who utter these clichés — usually at a loss of what else to say. Health care providers also attempt to bolster patients’ morale with well-intentioned but well-worn phrases too. Unfortunately, these sentiments frequently fail to have the intended effect. Instead of conveying comfort and …
Have bad news for your patients? Mind your metaphors.
My elderly patients miss the days when, in an emergency, they could call their family doctor at home, and they’d be cared for. Retired doctors reminisce about the “good old days” when they were in charge of their own schedules and could prescribe whatever drug or test they felt necessary based on years of experience. While there was a strong doctor-patient relationship in those bygone days, it was not necessarily …
The commodification of health care is destroying the doctor-patient relationship
When a patient goes to the doctor, they usually have a specific health problem in mind. Sometimes, the treatment is straightforward; a urinary tract infection warrants antibiotics. A laceration can be sutured. Other issues, however, are more complex. For example, communicating a terminal diagnosis to a patient. Consoling his grieving widow two months later. In circumstances like these, even if there is no cure, there is still space for healing.
Central …
Become more than a clinician. Be a healer.
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I have been practicing telemedicine successfully for four years. In 2015, I had to beg doctors to work in telemedicine. Because so many doctors were wary of it, I started to get licensed in multiple states, and now, I have 15 state licenses. Well, what a difference a few years makes. Now, in 2019, I get six to seven Linkedin, Facebook, and Instagram messages a week from physicians asking …
How telemedicine can help patients and solve physician burnout
To treat any condition, the doctor needs to know what it is. You would not expect to have your sore ankle treated with penicillin or to have an appendectomy recommended for your sore throat. While this may be self-evident, I know of at least one patient who had a normal appendix removed because the surgeon did not notice the few telltale blisters that were warning the careful observer that the …
How to help your doctor with diagnosis
Being a primary care physician, I was afraid to start my own practice. There was discouragement from fellow physicians, hospital leaders, business colleagues, and even patients. Many said that the small practice model was not viable. With insurance mandates, mounting bureaucratic pressures from Medicare and Medicaid, increasing regulations by DEA, higher volumes of paperwork, and the health IT requirements, the task of setting up a private practice with primary care …
Physician Strong: a private practice journey
In my clinical practice, I have encountered patient aggression typically with narcotic medications, in particular with the refusal of a refill due to evidence of concerning behavior, like a positive drug screen for drugs not prescribed. Aggressive behavior can include yelling, threatening physical violence or intimidation. I have had less trouble with narcotic-related aggression nowadays especially with media coverage of the dangers of narcotic abuse and especially since a lot …
Inappropriate antibiotics are the new drugs of abuse
“How do you say cultural competence in Korean?”
“I am always treated with respect in America. So why don’t they care about me here?”
My first patient at my community clinic rotation struggled to speak English. But she came prepared, her words memorized, printed from Google Translate.
“All I want is help.”
She had immigrated from Korea not too long ago and found this community health center for her first dental care in over …
My first patient taught me a humbling lesson
No one wants to be sick, especially when no one can tell them what is wrong. In the U.S., we live in a culture where we want instant results; we want easy answers for complex problems. However, in medicine, there are often no easy fixes. Adverse medical events happen, despite our best efforts. For example, a young child was recently diagnosed with Type 1 diabetes mellitus. While he and his …
How can doctors address patients’ expectations?
Just because something is legal, doesn’t make it right. Just because we enjoy a right of free speech, doesn’t mean we should be verbally insulting people. Just because the Food and Drug Administration (FDA) approves a treatment or a test, doesn’t mean we should pursue it.
The FDA has given approval to 23andMe, a private company, to provide genetic testing directly to individuals. The results provide genetic risks of contracting several …
Will the public be able to resist the pitch from 23andMe?
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