A pediatrician decides a struggling teen with mental illness needs hospitalization to neutralize psychologic demons impacting their personal and social life. A workers’ compensation doctor requests a neck MRI in a powerline worker with growing right arm numbness and weakness to search for potential paralyzing nerve impingement. An orthopedist orders special testing to determine if an elder patient with right hip pain which limits walking and driving might need surgery to improve ...

Read more...

When I read a case report in a journal or whenever a patient comes in to see me about a new symptom, all my senses are tuned in, and I know there is a diagnosis to be made. But on regular clinic days with “routine” follow ups, I find myself not being as tuned in as I would like to be. I know my patients well; we are all growing older ...

Read more...

In 1949, my maternal grandparents left everything and everyone they knew -- a happy family, a comfortable home, a thriving medical practice -- to travel further across the Earth than any of their family ever had before, to come through Ellis Island, and to trek to the Mayo Clinic so my grandfather could become a pioneering anesthesiologist. Twenty-one of my aunts, uncles, and cousins have since followed in their footsteps and ...

Read more...

I burned out, big and bad.  I can see that now.  My practice environment had become gradually untenable and every attempt I made to change it was blocked.  My call schedule was inflexible and a lot more frequent than when I started my job.  The hospitalists and ED kept sending me cases I didn’t feel qualified to manage, but as it was usually the middle of the night and I ...

Read more...

The benefits of coaching have long been shown in research, yet is widely underused in the physician community.  For decades, executive coaching has been used to in the corporate world for executives, and their teams to increase efficiency and performance. Business and marketing coaching frequently used by small business professionals helps grow and expand their business. Wellness and life coaching is frequently used by individuals to improve balance and well-being. ...

Read more...

Reducing the essence of a human being to a single sentence is impossible, but in taking care of patients, we doctors do it all the time The one-liner attempts to summarize an individual and an illness into a single, typically run-on, sentence to expedite communication.  It is a thesis statement for your diagnosis. Word choice and omission are critical.  By the end of this thesis statement, your audience, in spite of ...

Read more...

Danny rarely came to the clinic. He paid a sliding scale fee for the visit but this, in addition to the money he paid for his medicines, was already too much for him to afford. Now, in early November 2013, he had become concerned. Danny had previously owned a jewelry boutique with his wife, Jacky. She made her own pieces and sold them in the store. Over time, the economy had ...

Read more...

"So, that's it? Huh. Well, there's not much to say.  I didn't think I wanted it ..." "It" was a heart lung transplant.  He, my patient, was 30 years old. We had just learned that he was 100% sensitized with antibodies to any donor.  He would not be offered a transplant as he was certain to reject the precious gift of these organs.  As he would have said, his body had ...

Read more...

The other day, the last two appointments on my schedule were "unable to get pregnant, consult" and "pregnant, desires a termination." Even my medical assistant commented about the timing of those last two patients. Although these are not unusual issues for patients to see me about, the fact I was seeing them back to back, haunted me all day. Why? Why did life deal them these cards? Did fate make ...

Read more...

I love teaching my children about history, and in the process, I often see a clearer perspective of events I learned about at a young age when I had less life experience under my belt. As I have been revisiting the evolution of our country, the formation and restructuring of our society, and the emergence of periods of oppression, rebellion, and social change, I have been struck by the concept that ...

Read more...

Most Popular