Shouldn't everyone get an individualized assessment of likely benefits, burdens, and risks before making a big medical decision? I was asked this question recently, during an interview for an Internet radio show on aging. Per my host's request, I'd been explaining the practice of geriatrics, and talking about the geriatric approach to addressing the medical needs of older adults. Since I'd mentioned that aging often brings on greater risk of side-effects or ...

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shutterstock_10173301 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 ...

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Having gotten all of the members of our team on board, how do we get them to actually get together? We've all got busy days, all have lots of jobs to do, pulled in multiple different directions. The time needed to be thoughtful and really invest in the patient's care is missing from our day. We need to make room for it, to get together, to really apply ourselves to ...

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We live in a profoundly different time today when it comes to caregiving, parenting, and gaining health care/advice than we did even 5 or 10 years ago. The Internet has changed things dramatically. During an interview recently a reporter asked, “You were raised on digital media, yes?”  Well, no. I didn’t started using email until late 1995 just prior to leaving college, didn’t get a cell phone until I was teaching, didn’t ...

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Fear is more pain than is the pain it fears. - Sir Philip Sidney In our specialist age it has, in fact, become a major function of the general physician to examine thoroughly, to explain simply, to reassure as far as may be, and to protect his patients from unnecessary medical or surgical interventions. - John A Ryle, MD, 1948 in the Journal of Mental Science, published by The Royal Medico-Psychological Association Re-reading my ...

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What should doctors disclose to patients in the aftermath of adverse events?  Does it matter if the adverse event was related to an error?  Does it matter if it was preventable or not, anticipated or unexpected? Recently, I was at the Carolina Refresher Course facilitating a session on adverse events in anesthesiology.   We touched on a variety of issues, but spent the most time discussing the importance of disclosure conversations, as ...

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I had a nice conversation with a dermatologist at a party recently.  He started complaining about the notes he receives from other physicians.  He used terms like piles and piles of junk. Talk to any experienced physician and they will tell you that once upon a time our teachers taught us to write notes appropriate to the situation, not appropriate to the billing system. Several years ago I ranted about the necessity ...

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shutterstock_90578188 Dear patients, It has been a hard week. I wanted to take a moment to personally apologize for all that you have endured. As one who has witnessed your pains and struggles, I can only wince with each new passing hurdle you are forced to leap over. This business of disease and illness is not for the weak of heart (metaphorically, that ...

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In my practice, as in most medical practices, we accommodate patients' particular needs in all kinds of ways: wheelchair accessible rooms and hallways, interpreters of virtually all languages including American Sign Language, gowns and instruments in a wide range of sizes, information sheets and videos suitable for patients with a variety of educational backgrounds. No one questions the appropriateness of these accommodations. But what about when the doctor or nurse requires an ...

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Online dating is a bad idea for teens -- especially young teens. That’s why it wasn’t particularly responsible of Seventeen Magazine to publish a blog in which “dating blogger” Isabelle Furth floated the idea of using sites like Match.com to find dates. To be fair, she had concerns about the idea, and she’s in college, so theoretically old enough to make these decisions. But college kids don’t read Seventeen. Middle school ...

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