An excerpt from A Quiet Death. Even as I lay perfectly still in the near-complete silence of my car, I could hear Dr. Tierney’s adenoidal voice in my mind. He always seized every opportunity to assure us that his diagnostic or therapeutic approach to patients was firmly supported by the ...

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Just a short observation.  Medicine is immersed in the customer service mentality.  We’re always reminded to be appropriate and understanding, especially when patients are frustrated or upset.  I get that. Right now, I’m sitting in the airport in Detroit.  We’re about 3 hours late leaving because we don’t have a flight attendant.  That’s right; it’s not the weather (as it was on one of my earlier flights this week).  And it’s ...

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Dear doctor no longer seeing vaccine-hesitant families, I know that creating your “no tolerance” office-wide vaccine policy was not easy or came without soul-searching. I can only imagine the heated boardroom meetings and passionate arguments throughout the weeks the policy was being drafted. I trust it is because of your support and love for the families you currently care for that you felt the need to create the policy, and it ...

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shutterstock_176790740 I bolted through the conference room door on the first day of residency orientation.  The room full of interns shifted in their seats.  All one dozen of the faces looking up at me were male.  I got some crooked, goofy grins.  So began my introduction to the world of surgery. So, what would I tell my daughter about how to survive and ...

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shutterstock_126097835 When my older children were in elementary school, I sent in cupcakes for their birthdays or for class parties. My youngest is in elementary school now, and for his birthday, I sent in pencils and temporary tattoos for classmates -- because the school doesn't allow us to send in sweets anymore. When the change was first made, my reaction was: For real? Banning ...

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In a recent article posted in JAMA, authors presented a viewpoint about the phenomenon of the flipped patient when describing the increasing reliance that millennial trainees place on getting to know the electronic health record (EHR) of patients rather than the patients themselves. As I read through the text, I found myself agreeing with the points made by the contributing writers that EHRs are increasingly used as the first line of ...

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One of the obligations of a medical or surgical specialist is to communicate with the referring primary care provider.  This can take many forms: a phone call, texting via smartphone, email, messages sent via EMR, and dictated letters.  The format is pretty standard no matter what medium is chosen.  You thank the referring doc for the consult request, you give some brief background info about the patient in question, and ...

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"I've been getting winded lately." He's a middle-aged man with diabetes.  This kind of thing is a "red flag" on certain patients.  He's one of those patients. "When does it happen?" I ask. "Just when I do things.  If I rest for a few minutes, I feel better." Now the red flag is waving vigorously.  It sounds like it could be exertional angina.  In a diabetic, the symptoms of ischemia (the heart not getting ...

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shutterstock_233214331 In the busy world of hospital medicine, where doctors and nurses find themselves rushed off their feet for most of the day, time to sit down and actually listen to patients is at a premium. Every doctor knows that our primary focus has to be on the most important aspects of the history and clinical examination in order to get to ...

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shutterstock_134837474 I’m an old school general surgeon. I graduated from med school in 1974 and after a five-year surgical residency in San Antonio, Texas, I started out on my own, ready to cure the world. Boy, was I raw. Like many of my peers, I got married during medical school, and like every surgeon back in those days I told my wife, ...

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