Physician

Why physicians should welcome patient complaints

10 comments Carla J. Rotering, MD | April 18, 2013

Physician communication is the number one factor most highly correlated with the likelihood that patients will return to a hospital or medical practice. This conclusion is one that I have personally experienced and highlighted as a speaker at healthcare conferences and seminars and when consulting with fellow physicians on improving communication and building and maintaining a successful practice. Physician communication is so important because understandably patients are anxious about their health ...

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Reduce the chance that you will be harmed by an incidentaloma

0 comments Kenneth Lin, MD | April 18, 2013

Mrs. Smith (not her real name) fidgeted in her chair in my examination room as I scanned the radiology report she had given me. She had visited the emergency room the previous evening with severe abdominal pain that had eventually been diagnosed as gastritis, or swelling of the stomach lining due to a virus. During her evaluation, the ER physician had ordered a CT scan of her abdomen and pelvis. ...

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Should physicians discuss spirituality with their patients?

26 comments Peter Ubel, MD | April 18, 2013

"I can fix this." The neurosurgeon was nothing if not confident. "The cyst is pushing on your spinal cord. If it continues to expand, it will damage your nerves and you may lose the ability to walk. But I can remove the cyst, and cure you." The patient was a business school professor, a man comfortable with risk-benefit ratios and complex decisions. He probed for more information. The surgeon was happy to provide ...

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Anesthesiologists are victims of their own success

21 comments Karen S. Sibert, MD | April 18, 2013

New research just out in the journal Psychology and Aging says pessimists live longer and healthier lives. If this is true, then contemplating the future of anesthesiology ought to make us immortal, because our professional prospects don’t look bright. As we teach residents to do what we’ve always done, shouldn’t we ask ourselves honestly if we’re training them for a future that doesn’t exist? Especially here in California, it seems ...

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Who are the physicians that make the decision to deny care?

20 comments Wes Fisher, MD | April 17, 2013

A phone conference had been arranged. They wanted to talk to me about a denial for payment on a portion of a patient's pre-authorized procedure after the fact. Its participants: the regional medical director of a large insurance company, his female assistant administrator, and me. He cordially introduced himself as a pediatrician by trade from a large well-known (and highly respected) academic institution with impeccable credentials responsible for our region of the United States. ...

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Medicine does not compel us to like everyone we treat

84 comments Don S. Dizon, MD | April 17, 2013

“Great,” I thought, as I stood at my desk, looking at my patient list early in the morning. She was coming in today. “She” was a patient of mine in her forties, with newly diagnosed triple-negative breast cancer, without nodal involvement. Our first meeting had been several months ago, and it had not been a good one. I had asked about her ...

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Because I said so: Why that doesn’t work with patients

3 comments Jennifer Middleton, MD | April 17, 2013

Let's explore one of the most well-studied health behavior theories - the health belief model (HBM). The HBM states that our health choices are a direct consequence of our perceived susceptibility to a disease, our perceived severity of a disease, and the perceived barriers that keep us from adopting better habits. Perceived susceptibility, perceived severity, and perceived barriers are three of the main constructs from the HBM. The word "perceived" is very ...

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I am a surgeon: Therefore I think

11 comments Richard Patterson, MD | April 17, 2013

"If you can’t do this drunk, you shouldn’t be doing it at all." The eminent professor was speaking to a friend of mine about heart surgery. He was not supporting operating under the influence, or am I. The point is that the technical component of surgery -- the cutting, the sewing, the rearranging -- is very easy. It is true that in the OR, as on the golf course, some are more ...

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Seeing patients the day after the Boston Marathon bombings

1 comment Suzanne Koven, MD | April 17, 2013

A psychiatric colleague once told me that the incidence of anxiety disorders went down drastically during the blitz, when London was under constant siege by German bombs in 1940-1941. I don't know whether this is true, or even how you could measure such a thing under those conditions--but it makes sense to me. The patients I saw at Massachusetts General Hospital the day after the terrorist attacks just two miles ...

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How to know when to call the doctor

2 comments Claire McCarthy, MD | April 16, 2013

Sometimes, when a parent tells me about something that happened with their child, I think (and say, as nicely as I can): Why didn't they call right away? And sometimes, when I'm talking to a parent or seeing their child in the office, I think (but don't say): Why did they call about this? It can be really hard to know when to call the doctor. It's hard because sometimes you plain old ...

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