The pressure on physicians to provide better care at lower costs is coming from all directions – top down from policymakers who want more accountability in how healthcare resources are being used and bottom up from patients who want more transparency in how their money is being spent.  Obstetrician and gynecologists have not been spared any scrutiny. As primary care providers for many women we are in thick ...

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shutterstock_95618707 A new crop of medical students will begin a residency in plastic surgery this summer. They have worked long and hard to secure these coveted spots.  As a service to them and the profession, I wanted to take this opportunity to help make their path a little easier by offering a bit of advice. When asked what you do, simply say that ...

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shutterstock_69074263 It is hard to see a child in pain. I have seen quite a few children in the emergency departments of South Carolina in the past three years, more than I could have imagined just a while ago. Now, in the interest of full disclosure, I am not a child psychiatrist by trade. Like any general psychiatrist, my training provided me with didactic ...

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I’m lucky, I work for one of the best hospitals in the country and I have access to the best medical care that our society has to offer. With one glitch, that is -- when I access that care, my medical records are put into a system that can be viewed by thousands of people, some of whom include my bosses, co-workers, supervisees, neighbors, and even some of my patients. I ...

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What is a natural death, anyway? I get it - death is part of the cycle of life. Seasons change.  The moon waxes and wanes.  We are born. We die.  Death is natural. But what is a "natural" death?  Seriously, what comes to mind when you think of natural death?  Here is a video of a natural death, taken from the Planet Earth series: Death in nature is often violent, brutal, ...

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Surgical instruments-big Next in a continuing series. There's a reason for the cliche -- surgeon barks out the name of an instrument, scrub nurse whacks it into the hand. The reason is this: when you are focused on a particular area -- especially if it's one in which danger lies -- you don't want to look away. If you need to change ...

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Let me start by saying that I am by no means an expert in medical oncology and I have great respect for what my colleagues in this field are able to do for their patients and their families. From my earliest days of internal medicine training at the University of Virginia, I can remember the oncologists as being some of the most caring and compassionate physicians around.  However, recently I came ...

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Physicians are bothered by their patient’s fear.  One of the worst parts of actually caring is that when other people suffer and especially when they are frightened, you suffer with them.  It is bad when the trepidation is about something real, such as a new disease, but it is particularly disturbing when the source of the fear is confusion or bad information. There are several common sources of inaccurate terrifying data.  ...

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As physicians, we are all privileged to share with our patients the experience of illness, helping to inform and guide. When we as physicians become ill ourselves, we face unique challenges and gain unique insights. This column will explore those dimensions of experience, when doctors become patients. We recently spoke with Robert S. Brown, MD, FACP, associate professor of medicine at Harvard Medical School and attending nephrologist at Beth Israel Deaconess ...

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Below find excerpts of an email sent by a faithful reader.  I have included the whole text, but broken it down to respond to each point accordingly.

I have really enjoyed your blog postings and the sensitivity you showed toward patients. But, your new venture is a real turn off, and makes it hard for me to want to read your posts anymore.
I have been waiting for this.  Expecting it.  I knew ...

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