Every day physicians and other healthcare professionals are engaged in an invisible battle at work. In one corner is our desire to help other people, make a difference and practice the skills we worked so hard to perfect. In the opposite corner is burnout and it's entire gang. Most of us don't recognize burnout has a whole team on its side. We are outnumbered at least ten to one. I call this ...

Read more...

In advance of their annual User Conference, the social media team at athenahealth was able to talk about modern medicine with the event’s keynote speaker, Dr. Abraham Verghese. A physician and Stanford professor, Verghese has also authored several books, including the New York Times bestseller, “Cutting for Stone.” Here he talks about the importance of being present during the exam, in an era with so many distractions threatening to ...

Read more...

A heretic essay in JAMA by Vinay Prasad (Northwestern of Chicago), Adam Cifu (U. of Chicago) and John Ioannidis (Stanford) should be required reading for every medical student, resident, and to pass any board certification exam in any specialty ... in my humble opinion. John Ioannidis became one of my personal heroes with the publication of his great paper in PLoS Medicine, "Why Most Published Research Findings Are False," and ...

Read more...

The manner in which a physician communicates information to a patient is as important as the information being communicated. Patients who understand their doctors are more likely to acknowledge health problems, understand their treatment options, modify their behavior accordingly, and follow their medication schedules. In fact, research has shown that effective patient-physician communication can improve a patient’s health as quantifiably as many drugs—perhaps providing a partial explanation for the powerful placebo ...

Read more...

They say a good doctor needs to be able to stand in his patient’s shoes, but Stuart only had one; a size 12, left foot Nike Air Max. Back in May 1991, after his car ran off an Australian country road, wrapping itself around a gum tree, Stuart ended up losing a leg. In a photo taken at the scene of the accident the following day, you can see a ...

Read more...

It isn't that it was a bad day, because it wasn't really. There was too much work, yes, and I ended up staying late, but it was mostly made of good interactions and I felt generally competent. So, no, it wasn't just a bad day. Still, this evening I feel like the best possible future would be one in which there was no technological medical care, where we just worked ...

Read more...

Parenthood.  It has changed everything. Snot on my sweater goes unnoticed.  Hobbies gather dust in the closet.  Kissing away the boo-boos and wiping away tears become daily ritual.  Screams, laughter, tantrums, and toys crashing to the floor become the household white noise.  All my Facebook status updates are about my kids. Some people manage to continue their lives with style. Me?  I’m just tired.  And I need a haircut.  Smartypants would say I need a ...

Read more...

Last week was tough.  I had to refer several patients to hospice, and a few more received bad news regarding their disease.  This has always been the toughest part of my job, but it’s also the part patients need me to handle best.  I have to remind myself that no matter how hard it is for me to give bad news, the patient and their families are the ones receiving ...

Read more...

Dr. Lake used to be a businessman. His books were clean and orderly. His staff was efficient and kind. He steered his ship agilely through troubled waters and still managed to provide the highest quality care. His was not only physician but small business owner. He was proud. As the political climate changed, Dr. Lake became more distressed concerning his situation. His overhead was increasing and the regulatory culture was expanding. ...

Read more...

If you live in southern California, you can’t miss the billboards advertising laparoscopic gastric banding at “1-800-GET-THIN” outpatient surgery centers.  They feature happy people who’ve lost 100 pounds or more, and urge you to “let your new life begin” by having a “lap band” inserted.  Fees at these centers are much lower than they are at university medical centers or other major hospitals. Recently, however, those surgery centers and their owners ...

Read more...