How do you choose a doctor?  Perhaps you start with a recommendation from a friend or a trusted physician, then you look at factors such as training, experience, board certification, access, online reviews and of course that vital issue, how well you like the doctor when you meet him or her.  Tough thing, picking a person you barely know to whom you trust health and life.  To this list, I ...

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Medicine, like politics, sports, and everything else, has gotten sucked into a 24/7 sound bite culture in which the most complex issues are spun into a few provocative words on news sites, TV, and radio shows. Enraged readers and listeners then weigh in. As the old expression goes, much heat, but little light ensues. But three recent stories involving medicine are worth a closer look, and cooler heads. First, consider the
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Several days ago, I had the opportunity to listen to a lecture by a visiting physician who practices narrative medicine, a medical humanist.  She is well-known for bringing a voice to the interactions between doctor and patient, the healing relationship, the unparalleled bond formed between these two individuals.  In her talk, she spoke of the "turmoil" that ensues when caring for a patient, caused by the interaction of deep concern ...

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All of us come to the study and practice of medicine through different pathways: some because of family members who were doctors or patients, some out of our own illness or woundedness, some out of intense drive to achieve and serve. I came to medicine because of my grade school classmate Michael. My grade school represented a grand social experiment of the early 1960’s.  It was one of the first schools to ...

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Some things are just so damned hard to write about. People often ask me, "Why do you have so many animals?" The current count is 4 dogs, two horses and a cat. I used to say, "Because it’s good for my children to learn responsibility. Having a dog, whose life is so much shorter than our own, teaches them about love, and about death. They get to practice parenthood, before ...

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Questions such as this from proactive, increasingly knowledgeable patients place a physician on the horns of an ethical dilemma.  Although fellows are closely supervised and trained under a gradually increasing responsibility principle (based upon subjective evaluation), a time will come when there is no one available to back you up in the catheterization lab. Fact: Someone has to be a physician’s first case of any given type. However, no one really ...

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I remember a short lecture I received in my medical officer's course when I joined the Air National Guard around 1988. The room was full of young medical students, physicians, nurses, and other health care folks who were beginning their service. The topic was appropriate documentation in the medical record. Among the notable examples of what not to do was this gem, written by a medical officer about another officer's wife: ...

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Doctors are already busy, but do they need to do more in a day? If you think a physician’s job is to take the best possible care of patients, then the answer is a resounding yes. But additional responsibilities do not necessarily mean more work—they just require different training. It doesn’t take unique insight to understand that doctors, in many ways, act as social workers. They help patients schedule follow-up appointments, ...

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In my office, every new patient encounter starts the same way.  I walk in and say, "Hello."  Then I put down my computer (which I take from room to room), wash my hands (which I purposely point out that I do before I touch anyone or anything else), and then I turn to the family and greet the child first.  Depending on the age, I might be squatting and gently ...

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Some of you may know that I started out in an internal medicine residency and quit for physical medicine and rehabilitation (PM&R). Switching residencies? Not recommended. But entirely doable. I spent most of my first half of internship being really, really miserable. I remember sitting in the call room during my ICU month, talking to my mother about how badly I wanted to quit and what my options would be if ...

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