Why I decided to opt out of Medicare as a provider There’s a lake in Northern Arizona where I jog. I call it “my” lake. It used to be filled to the brim, a playground for ducks, geese, Monarch butterflies, rabbits and squirrels. Over the years when I’d jog in the cold mornings, my lake dried away from drought, measured by bathtub rings on the boulders which surrounded it. Today, rust-colored grass ...

Read more...

When a medical student sees you, consider it your lucky day Medical students rotate through the clinic I work at. I love it. It brings me back to those days. Sure, it reminds me how old I am, but also reminds me of the incredible impact patients have in directing the course of our career paths. We all have those memories. Our first delivery. Our first code. The first time we had to ...

Read more...

It is nearly impossible to ignore the need for clear thinking, confident and “in control” leaders. And whether in Congress or in a physician’s office, medical school department or hospital administrative suite, women leaders are notably absent. And while recent research tells us that women aspire to be leaders, the barriers to achieving this nebulous goal are enormous. So whose fault is it anyway?   I say both the women and the ...

Read more...

An excerpt from Pet Goats and Pap Smears. Both my parents are physicians. They are never home much because they work all the time. With no reliable child care, Dad takes me to work. The morgue is my favorite spot. It’s like our secret clubhouse. Nobody ever bothers us there. Entering the morgue, Dad opens the stainless-steel doors to the cooler and says, “Good morning! Is anyone home?” Then ...

Read more...

I visited Safdarjung Hospital in New Delhi recently – an institution with  1,531 beds and 145% occupancy rate.  Yes, 145%.  You do the math.  A lot of bed sharing and asking families to bring in cots.  It’s right across the street from the All India Institute of Medical Sciences (AIIMS), the premier public healthcare institution in India.  While both AIIMS and Safdarjung are run by the federal government, ...

Read more...

I expect most of us agree that an incarcerated felon experiencing a heart attack should receive medical treatment, even if that treatment comes at taxpayers’ expense.  The same probably goes for more preventive measures—blood pressure pills, cancer screening tests and the like.  While serving out the sentence for their crimes, prisoners should not be forced to suffer from treatable and preventable illnesses without receiving appropriate medical care.  They can pay ...

Read more...

Physician a burnout has great current interest.  Many authors are worrying about burnout and therefore writing about this problem. What are the common root causes of burnout?  Primarily burnout comes from loss of control and overwhelming undesirable activities. Burnout occurs when the job becomes overwhelming. Burnout likely is increasing because many physicians feel that they do not control their lives.  Too often the current finances of medicine "force" physicians to spend inadequate time ...

Read more...

I recently treated two young men, both injured in the same football game.  On the way out, one passed the other in the hall, injuries treated and dressed. "See you next game!" they said.  They laughed and looked forward to the struggle. My wife and I have tried to raise our kids that way.  To enjoy life, to move through difficulty and injury. They suffer from having a physician father, so ...

Read more...

In June of 2006 Mary Ann Ambrogio went to see her gastroenterologist Dr. Frank Troncale in Connecticut for a follow up of her history of liver cirrhosis and associated hepatic encephalopathy. Reportedly following this visit Mrs. Ambrogio was driving home when she passed out and hit a pedestrian John Jarmie causing “severe and permanent” injuries. The injured pedestrian sued Dr. Troncale claiming malpractice under Connecticut law in that the ...

Read more...

During an internal medicine residency, newly hatched doctors are responsible for some of the sickest patients in their teaching hospitals. This is because those patients often don't have private doctors to attend them and are poor and sometimes self abusive, with the complex problems that go with smoking, drug and alcohol abuse and lack of regular medical care. These patients often present with their diseases late in game, when much ...

Read more...

Most Popular