I recently left medical practice in order to pursue a career in mobile health technologies, for which I have had a passion for many years. I had wanted to become a physician since I was very young. The intellectual challenge and curiosities of the natural science and the human body stirred my intellect like nothing else.
What I will surely miss most are the priceless personal interactions I experienced on a …
Why I miss practicing medicine
Studies in the past have shown that when someone complains about not being able to sleep to a doctor, more often than not, a sleeping pill is prescribed. The reason is that young doctors are taught in training that pharmaceuticals like Zolpidem (Ambien) stimulates GABA receptors in the brain, promoting sleep. There’s essentially no mention that cognitive behavioral therapy for insomnia works just as well for insomnia in the short …
Physicians need to wake up to the importance of a good night’s sleep
Are doctors really going broke?
According to this piece from CNN Money, some are: “Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors’ lack of business acumen is also to blame.”
That’s all entirely true.
Pressure on reimbursement, combined with a lack of …
Doctors: Don’t be ashamed about going bankrupt
Most of you are quite familiar with the rather astounding facts regarding medical errors. There are many reasons why medical errors occur in healthcare. There are errors in omission, there are errors because of poor communication, there is the ever present risk of human error and perhaps the ever increasing stress on physicians to see more and more patients in less and less time. …
How patients can avoid medical errors
An excerpt from What Is It and How Did I Get It? Early Stage Chronic Kidney Disease.
The symptoms of kidney disease don’t show up until you’ve lost most of your kidney function. That’s when you’ll experience the fatigue that’s not always a result of anemia, the muscle cramps that usually – but not always – present themselves in your calves, nausea, vomiting, appetite loss, easy bruising, itching and the shortness of …
Chronic kidney disease from a patient perspective
Throughout my career in oncology, I thought I was communicating difficult concepts to patients and families relatively well. Recently, my wife and I visited our daughter in Salt Lake City over Thanksgiving. Catherine is an extremely accomplished blogger and video broadcaster. So when she commented on my blogs, I paid attention. Her (constructive) criticism was my use of some medical terminology which she didn’t understand. More surprising to me was …
Understanding the process of cancer metastasis
One will find many examples of precaution and their corresponding examples of risk in how medical care is provided by physicians and accepted by patients. In fact, not only do these two elements correspond but at times the price, itself, of precaution becomes the risk.
Risk is everywhere in medical practice. Risk is present when a patient is selecting a physician. The risk is becoming the patient of a doctor whose …
Balancing precaution and the apparent risk in medicine
Incredible innovative and entrepreneurial skills have led to many new techniques and technologies in medicine. Some are both disruptive of the old way of doing things. Others are transformational. Over the next few weeks I will review some of those that I believe are among the most disruptive and transformational. Medical simulation is such an advance. It is dramatically transforming the way medicine, especially medical procedures, are taught and it …
Simulation is a disruptive and transformational technology in medicine
The principle of autonomy is one of the four guiding principles of medical ethics, the others being beneficence, nonmaleficence, and justice. It means that patients have the right to decide what is done to their own bodies. For children under eighteen, the age of majority, this means their parents decide for them. What happens when parents refuse a treatment that their child’s doctors recommend? (The right of a minor child …
Is ethical for parents to refuse surgical treatment for their child?
Here’s a devil’s advocate position.
Historically doctors have held power over patients as compensation for the responsibility of that position, and the epatient and other patient advocacy movements seek to address that imbalance with good reason, arguing that the doctor-patient relationship should be equal. I don’t mind that. But let’s be truly equal partners then.
The patient’s right to choose a doctor and be informed of the best ones via doctor rating …
Isn’t it time for a patient rating system for doctors?
I sit here today, in this small, windowless call room with its low twin bed that is covered in untouched hospital blankets and sheets. Tonight is one of my last nights on a 30-hour call shift in the medical intensive care unit. Yet another mile-marker on this long journey of residency. My day began at the break of dawn, when I and another resident passed each other in the parking …
Reduce sedation in critically ill patients
“Medical training rarely deals with helping the dying patient find peace and comfort. In fact, most physicians are uncomfortable with the entire subject. I believe it is one of the most neglected aspects of medical care. I have spent my career as a pulmonary and critical care physician, and I have cared for thousands of dying patients. In many cases, both the patients and I knew that they were dying. …
Advance planning should be a public health issue
What causes a doctor to commit suicide?
A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected in his field, having published many research papers and traveled the world helping to set up brachytherapy clinics in several countries. He also had been an acting alderman in his …
Did hospital politics lead to physician suicide?
ADVERTISEMENT
With health care industry reaching unsustainable lows, media attention is on physician’s relationship with the pharmaceutical industry. A Google search will give results that paints doctors as culprits, leading to a prejudiced opinion where doctors are thought of as co-conspirators with drug companies. This article teases this tainted relationship, from a typical doctor’s perspective.
Pharmaceutical companies have strategies not only to survive, but also to grow with general public investing in …
Taking the knife to doctor-drug company relationships
“I’m sorry, Doctor, but we can’t have you give that talk; you have a conflict of interest since you’ve been paid to do research on that medicine.”
“Well, Senator, it’s a conflict of interest for a doctor to sell those crutches in his office.”
“It is the opinion of this newspaper that physicians should declare to each patient any ownership interest they might have in a surgery center so that the …
Stop trivializing conflict of interest
I have not always been excited to hear patient complaints. As a younger manager I absolutely dreaded when a patient wanted to speak to me. I felt that I had little to offer a patient who expressed anger or frustration with something that had happened and I was very impatient to get past the complaint and get back to my “job.”
Now, I can’t wait to hear patients’ complaints. Complaints …
Why patient complaints are an opportunity
Cancer is a dreadful disease. Just dreadful. Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the end of their lives. I believe a large part of their difficulty stems from the ridiculously …
Saying no to your oncologist is sometimes the right thing to do
The instruments were indicating to the two co-pilots at the controls of the Airbus that they needed to pull back on the stick.
They held back on the stick for 54 seconds.
This is the position they were in when the Air France jet plunged into the cold water of the Atlantic killing everyone on board.
The fix?
Recognizing that a protocol or guideline might be giving them wrong instructions, seeing that there …
They don’t make protocols for patients like me
How is a doctor allowed to mess around with body parts he doesn’t understand?
If doctors were required to understand everything we touched we wouldn’t be able to touch you at all!
The human body is still a deep mystery. Doctors understand more than most people, but what we know is still a vague approximation. Just because our educated guesses often work out well doesn’t mean we have any idea what’s actually …
The myth of physician omniscience
Evidence-based medicine and health insurers generally focus on what’s medically necessary, not what’s epidemiologically relevant, not what soothes the mind of the bereaved or of the physician grieved and mystified by the loss of a patient.
Once, the autopsy was a venerated tool for medical advancement and humility. An invaluable means of learning one’s own limitations and the extraordinary diversity in nature and human physiology, it has now become an unreimbursed …
A eulogy for the autopsy, and a call for its return
Get free updates delivered free to your inbox.
