A recent little essay entitled “Do patients bond best with doctors who misinform them with optimism” got me thinking about balancing honesty and optimism in practicing any medical specialty in which patients not infrequently die. Tragic things can happen in the pediatric intensive care unit. Anyone who works there — doctors, nurses, respiratory therapists, and many others — see these ...

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One of the gripes that patients have about the medical profession is that we physicians don’t communicate sufficiently about our patients. In my view, this criticism is spot on. Patients we see in the office often have several physicians participating in their care. The level of communication among us is variable. While electronic medical records (EMR) has the potential to facilitate communication between physicians’ offices and hospitals, the promise has not ...

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Internal medicine is the branch of medicine that deals with diseases of the internal organs in adults. It also involves dermatology, minor surgical procedures, general psychiatry and preventive care of well people. It is an excellent field, full of opportunities to think and feel and connect with people, mysteries to be solved and an endless variety of stuff to be learned. ...

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Defined as someone “having the faculties impaired by alcohol, those of us who work in an acute healthcare facility are witness to many illustrious examples of drunk patients coming through our doors. Underaged kids passed out at a house party? Yup. Raging alcoholics who are brought into the ER at least once a week? Sure. Elderly women who secretly binges on wine ...

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A new message pops up on my phone. I signal to the attending and step out of the OR.  I’m on anesthesia rotation at Santa Clara Valley Medical Center, as a pediatrics resident at Lucile Packard Children’s Hospital at Stanford. But because I’m also a mom to a first grader in Cupertino, both my pager and my cell phone are frequently “on call”. “I want to take this opportunity to update ...

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In the past, the radiology profession was seen as a very financially successful specialty, but as every businessperson knows, success often has peaks and valleys.  Radiology residencies are some of the most competitive to obtain, which is due to the combination of expected financial compensation and the assumed quality of life. In the early 1990’s, when financial pressures first appeared on the ...

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I had a conversation with a family practice physician today, a man who is far closer to the end of his career than the beginning. He is part of a private practice group that recently was sold to one of the larger hospital groups in the area, which put him on a salary, but also allowed him to work only three days per week. He stated that the decrease in ...

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The Affordable Care Act comes with the promise of a dramatic overhaul in what many see as a broken health care system. It promotes the potential for “better all around” – better care, easier access to hospitals, and affordable treatment. It also comes with a price. For one reason or another, the turbulence within the American health care system is causing doctors to shut down, downsizing or sell their practices ...

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shutterstock_38772856 Recently there was a news story about Dr. Russell Dohner, of Illinois. He charges all patients a flat fee of $5 per visit. He doesn't take insurance. This led to several online threads featuring comments such as "Finally! A doctor who cares!" Apparently, this means that doctors like me, who charge more than practically nothing, are evil and don't care. I respect ...

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I first met her when I consulted on her hospitalized son, who'd been in and out several times with transient abdominal pain. He'd already been through various tests and consultations, each time improving before a diagnosis was established. When I was asked to see him he was once again on the mend, but I concluded that he likely had the uncommon ...

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