Doctors still work while on vacation Last week, I took a 6-day vacation.  Two days before and two days after, I put in a total of 32 unpaid hours of work which was cut short by a call from my daughter asking me why I am working during my time off.  While away with my family, I ran into people of different walks of life and noted ...

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Sandeep Jauhar has this wonderful sentence in his New York Times op-ed, "Busy Doctors, Wasteful Spending": "There is no more wasteful entity in medicine than a rushed doctor." And yet physicians are rushed. Dr. Jauhar writes about the payment system driving shorter visits. That problem represents an important component of undesirably short visits, but it is not the only problem. The electronic health record adds documentation time, as do the billing ...

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The secret lives of doctors Recently, when my parents came for a visit, our conversations led me to realize something important: I have been a doctor for more than 20 years, and yet my parents have no idea what my daily life is like. It then occurred to me that if they have no idea, then surely my patients have no idea either. So, if you're a ...

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Dear patient: Your 5 minute appointment is awaiting you. Dear patient: I am writing to inform you of some recent changes to my practice. These changes have been implemented to improve the quality of your care. I will no longer be able to see you for a 20-minute or 40-minute appointment. These will instead be shortened to a 10-minute or 20 minute-appointment based on your stated needs. For example, if you just ...

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A 32-year-old woman recently came to see me for an opinion on stomach pain.  Why would I refuse to see her again?  Abdominal pain is an everyday occurrence for a gastroenterologist.  She was accompanied by her mother.  I had never met this woman previously. She had suffered abdominal pains for as long as she could remember.  She recalled frequent visits with the school nurse when she was a young girl. She has abdominal distress ...

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3 ways to master the art of teaming in medicine A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. As a physician anesthesiologist in a community hospital setting for more than 25 years, the quest for mastery keeps my practice from getting stale or boring. I relish the technological innovations in the past decade: the video laryngoscopes and ultrasound-guided nerve blocks that allow my ...

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Moving annual visits into the 21st centuryA guest column by the American College of Physicians, exclusive to KevinMD.com. The recent uproar over the American College of Physicians’ recommendation against routine pelvic examinations made me think about the status of the annual visit (a.k.a. yearly physical, annual exam) on average risk, asymptomatic adults that most internal medicine specialists perform. Some would say that ...

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As a doctor, I’m trained to do many things: I listen. I ask. I examine, order, and test. And then I assess. I certainly try to treat. All too often, this includes prescribing. What frequently gets obscured in this paradigm is that, on many occasions, the listening part is enough. Take Gene, for instance. He’s a retired biochemist. When I met him for the first time as a patient, I took a ...

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If you (or a loved one) have been admitted to a hospital recently, you were probably surprised by the number of times you were asked the same questions. At first you might assume that the staff are being diligent in double-checking your information, but after the fifth healthcare provider asks you to explain why you’re there, you start to feel as if interacting with “the system” is like talking to ...

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It’s easy to get frustrated in the ER. First, you’re at work. Second, most of your patients don’t want to be there. Third, many (if not most) of your patients don’t need to be there. Finally, by the time you see them, most of your patients are tired of being there. It’s easy to become jaded when you trudge through this never-ending mire of patient after patient, and indeed ER docs ...

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