asco-logoEvery once in a while, something unexpected occurs that shakes me to my core -- where I question the point of life, ask why we even bother; when in the end, it all just ends. This time, it happened on a Sunday morning. I woke up in a good enough mood -- the sun was shining through my windows, and my cat, ...

Read more...

At the International Conference on Communication in Healthcare, which I just returned from, there was a discussion continuously coursing beneath the surface and bubbling up every once in a while. If we, acolytes of shared decision making, whether patients or providers, want to encourage decision making that has the person involved at the center, recognizing their preferences and values, does the kind of decision in question have anything to do ...

Read more...

To what end? Those three words have become something of a mantra, a mission, a philosophy of care.

  • To what end do I prescribe a medication?
  • To what end do I make a diagnosis?
  • To what end do I order tests?
  • To what end am I documenting?
  • To what end is there a patient record?
  • To what end do I send a person to a specialist?
  • To what end do patients need to come to see me in ...

    Read more...

Here’s a familiar story in America’s hospitals. An “old fashioned” surgeon decides that the protocols and procedures put in place by the medical executive committee or other governing body don’t apply to him. “I’ve done it this way for 30 years, and it works fine. I’m the busiest surgeon here, and no one is going to tell me how to do my job.” People in the risk management field will advise ...

Read more...

asco-logoOrdering CT, MRI, or PET scans for my patients when they feel well always makes me nervous. As a radiation oncologist, I’ve chosen to frequently make observations that potentially find active, progressive cancer. And this creates an existential crisis that scares me -- but not as much as it scares my patients. With each test, I set in to motion a real-life application ...

Read more...

As someone who has recruited a very large number of physicians over the years, I am quite sold on the benefit of a “letter of intent” or “LOI” as a tool for physician recruitment. While physicians are highly familiar with medical/surgical concepts and while many are in no way intimidated by dissection within the human body, many to most are not qualified or really desirous of dissecting a complex legal document ...

Read more...

I grew up in a solidly middle class family.  Our home was safe, loving, and we never wanted for anything.  My parents believed in hard work and instilled in me the importance of a college education.  I was the first kid on the block to have a computer.  That Radio Shack TRS-80 was a marvel of modern technology and made me the envy of my friends.  Today, a TRS-80 is ...

Read more...

shutterstock_229239346 When I started my surgical internship, my chief resident told me some magic words: Whenever something bad happens, stay calm and say, "I assume full responsibility. It won't happen again." As a young surgeon at the bottom of the totem pole, those words were my mantra for the times when someone's head was going to roll. In those nascent days of my ...

Read more...

surf Sometimes I’m surprised I wasn’t born with gills. It’s like I was meant to spend more time in water than on land. I didn’t discover this until I was thirteen or so, when I started high school and had to join a sports team because of a school requirement. I arbitrarily chose water polo, because it was a fall sport. I sucked at ...

Read more...

Sometimes it’s difficult to practice what I preach. But I try. A couple of weeks ago, I spent the evening in the emergency room with our youngest son (don’t worry – he’s fine). I hate going to the ER, but every once in a while circumstances necessitate it. I called doctor friends in the relevant specialty, as well as our son’s pediatrician, to confirm the need for the trip. They said to ...

Read more...

Most Popular