There are so many changes in medicine these days, but it takes a bit of time away from the keyboard to appreciate them. So glued have I become to looking at computer screens, it's been hard to pull my head from them any more.  Doctors lives are spent staring at these damn screens now.  I wonder how many of my youngest colleagues know how to start an IV, a foley, place a central ...

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Cancer survivors are truly remarkable peopleDavid Sampson, who is a colleague of mine here at the American Cancer Society, recently sent me a blog written by a woman well known in the breast cancer community who days previously had been diagnosed with recurrence of her breast cancer. The blog has captivated me, perhaps more so now that I have been facing some of my own ...

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Medicine, like law, the military, and many other professions, has its own language--a kind of verbal secret handshake by which its members recognize one another and close ranks against outsiders. Sometimes, the use of technical terms, abbreviations, and other forms of jargon can impair patients' understanding of their medical care. This article discusses the extent to which clinicians overestimate patients' "health literacy"--with potentially dangerous results. But sometimes, medical lingo has ...

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People often ask how old my son is when we are out and about. When he proudly says, “Two!”, the most common response is a smile to him ... and a knowing glance to me. This is often accompanied by, “Oooh, the terrible twos!” I’m here today to stand in the defense of two-year-olds. Sure, they have their share of tantrums and the transition from infant to preschooler is sometimes a ...

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We live in an age of patient empowerment.  Medical students are now routinely taught that the “right choice” often depends on patient preferences—on how an individual patient weighs the pros and cons of her treatment alternatives.  That means medical decisions depend, more than ever, on good communication. Physicians need to help patients understand their choices so that they can partner with their patients in discovering the best alternatives, ones personalized ...

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In a recent post, you met Catherine, a young woman who came down with a stomach bug but was ushered through numerous blood tests and a CT scan, only to be even more confused than ever. You saw how shared decision-making needs to begin with the process of establishing a partnership for shared diagnosis, because diagnosis is the first and most critical step to your medical care. Here are ...

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Mom, what is the one thing you can’t live without?” My six-year-old son asked me out of nowhere one day. Air? Water? It was a more interesting riddle than usual. “Love.” He said proudly, not waiting for me to answer. Wow. He’s right. Love. But if it is the one thing you can’t live without, why are we so afraid of it in medicine – a field that sustains life? Doctors seldom use the word ...

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My change from a traditional practice to direct-care has caused me to challenge some of the basic assumptions of the care I’ve given up to this point.  Certainly, the nature of my documentation will radically change with my freedom from the tyranny of E/M coding requirements. Perhaps the biggest change in my care comes courtesy of the way I get paid.  The traditional way to be paid is for service rendered (either at ...

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There was some good news recently about teens and driving: according to the Centers for Disease Control (CDC), the number of teens who report drinking and driving has come down by half in the past decade from two in ten to one in ten. While that really is good--great--news, it doesn't change the fact that motor vehicle crashes are the leading cause of death for US teens. In 2010,  every day ...

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Metastatic (stage IV) colon cancer and lung cancer are fatal incurable illnesses. That doesn’t just mean they are life-threatening. A fatal incurable illness is one which has zero survivors. You don’t know anyone who had metastatic colon or lung cancer who survived and is no longer ill. Chemotherapy is still occasionally used in such cases and sometimes can prolong life by a few months. Chemotherapy might also help temporarily alleviate some ...

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