In today’s China, both eastern and western medical philosophies and practices exist relatively harmoniously.  Patients with minor, usually self limited problems are treated initially with a seven day course of seven liquid herbal preparations taken each day.  If symptoms subside, usually treatment is discontinued.  If improved but not resolved, formula may be modified.  If worse, regimen can be changed and/or referral to specialists arranged.  There are hospitals that practice purely ...

Read more...

I'm always surprised at the number of physicians I work with who worry about, discount, or do not see their relevance outside of clinical practice. I do, of course, recognize their relevance - the trick is to get the docs to. For many physicians, venturing into positions of leadership, becoming a Department Chair, VP Medical Affairs or even Chief Medical Officer) is a logical step for those looking to expand their skills ...

Read more...

The last patient of the day rushed to the office before closing time. When I entered the room, the dad was texting as the nurse finished recording the child’s temperature.  He shook his head in disbelief and confessed that he just sent his wife this message, “I feel stupid.  No fever here.” Parents apologize to me everyday because they feel like they wasted my time and/or their co-pay.  Coordinating a doctor’s ...

Read more...

Recently I learned that my friend Hester had been suddenly diagnosed with Stage 4 cancer.  She had been focused on daily living, her long road stretching out to the horizon, attending to friends, creativity, work, and related pleasures and struggles.  Within days, her life abruptly made a hairpin turn into a new path, narrow and poorly lit, and short.  One week after I spoke to her, she died. It is at ...

Read more...

As a doctor, I appreciate that I am at an advantage when I seek medical care. Knowing terminology and basic medical principles helps a lot. In addition, when you’ve been practicing medicine for a while you get a feeling from how a doctor discusses options if the care seems valid or if a second opinion is in order. Other things I look for are board certification and a doctor ...

Read more...

Let's set aside for the moment the question of whether it's appropriate to talk about gun control in the wake of the shootings in Aurora, Colorado (though I can't think of a more appropriate time to talk about it). And let's not consider whether it makes sense that it's legal to buy thousands of rounds of ammunition on-line in the U.S, without any background check (though could it, really?) And ...

Read more...

If you pay attention at all to news about medicine, you must have heard about the tragic death of a 12-year old boy who was seen and discharged from the emergency department of the prestigious New York University Medical Center. He had developed sepsis from what appears to have been a small cut and the diagnosis was missed. When he eventually returned to the ED and was admitted, it ...

Read more...

I am a physician and guns are a disease I feel guilty about the killings in Colorado.  As a doctor, those horrid events are a personal failure.  I have spent a career fighting illness, often investing hundreds of hours in a single cancer case, yet in minutes, a dozen people vanish and 58 are grievously wounded.  Another 32,000 will die this year from gunshots, over 76,000 will be crippled and ...

Read more...

Too often I see both generalist physicians and subspecialists failing to fall back on the basic principles of a careful history and physical and then understand what specific tests to order. One can blame academe somewhat.  Too many subspecialty consults in academic centers end with a laundry list of tests, excluding almost anything that could ever be part of the differential diagnosis. One can blame the payment system.  The generalist physician, rather ...

Read more...

30 day hospital re-admission rates. It's a statistic that keeps hospital administrators up at night. Whether you agree or disagree with the use of this statistic as a quality and reimbursement metric, if it creates change, reduces hospital re-admissions and improves patient care, then in theory I support it. I'm reminded of Mrs G. She is emblematic of today's chronic disease patient. She was admitted to our hospital for a congestive heart ...

Read more...

Most Popular