We’re born into our bodies, and we take that for granted. Our first job is to take a breath, something we’ll hopefully do many millions of times and never think about.  That first breath changes everything: Our blood starts to flow through our heart and lungs in a different way and for the first time we taste a new world. Before we’re born, all our needs are met via an artery and ...

Read more...

Faxes! Who still uses faxes? The medical industry does. Here is a picture from just today: 27 faxes received and about 20 sent, and that is only counting after noon. Some days are worse, with up to 40 faxes to handle in our small medical practice. Who still uses faxes? The medical industry does. On the left are the 27 faxes received: We use e-faxing, so they arrive as pdfs. On ...

Read more...

Pretty much on a weekly basis I come across an article about how awful life is as a practicing physician. Articles focus on how unhappy physicians are with their jobs, with their hours, with their pay or with health care reform. After almost a decade of practice, the fact is that I like my job. Is it perfect? Absolutely not: quite far from it, in fact. There are certainly many times when ...

Read more...

The New York Times has reported on a woman who wanted to deliver vaginally and claims she was forced to have a repeat C-section (her third C-section) against her will. I can’t comment on the veracity of her claims, however a forced C-section is never, ever acceptable. It doesn’t mater if the fetus has an agonal rhythm (is visibly dying on the monitor), as an OB your role is to ...

Read more...

As a family doctor, I had the privilege of sitting down at the hospital recently with Mr. M, a longstanding patient of mine, and his family. Mr. M is a college-educated engineer, struggling near the end of his life with end-stage kidney disease, dialysis, severe congestive heart failure and crippling COPD. And he was pretty down about it. In the hospital, a critical care physician, a pulmonologist, a nephrologist, and a cardiologist ...

Read more...

The dark underbelly of health care is becoming all too visible now. Fresh faces in neatly pressed white coats are in the halls.  Eager.  Enthusiastic.  Clearly very bright.  All hoping for a moment, an experience, an encounter that makes all their hard work worth it.  Surely they'll have one, but not before the thousands of keyboard clicks, the mandatory lectures, rounds and lots of lengthy, lonely call nights. He was a doctor ...

Read more...

The Institute of Medicine of the National Academies has released their long anticipated 500-page report, titled ,"Dying in America – Improving Quality and Honoring Individual Preferences near the End of Life." This is a critical addition to the ongoing conversation about health care in the United States and makes observations and conclusions, which we need to consider and understand.   They conclude, as has been said before, that we waste ...

Read more...

Britain’s most prolific serial killer was a general practitioner (GP), Dr. Harold Shipman. He wasn’t England’s most famous murderer. That accolade goes to Jack the Ripper. The Ripper killed five women in the streets of Whitechapel. Shipman might have been responsible for over 200 deaths. Shipman’s legacy to the medical profession was not just a permanent simmering of mistrust. He triggered the introduction of revalidation, Britain’s version of maintenance of certification ...

Read more...

My life changed dramatically when I started my new practice.  The biggest change personally was a dramatic drop in my income as I built a new business using a model that is fairly new.  That's a tough thing to do with four kids, three of whom were in college last fall.  OK, that's a stupid thing to do, but my stupidity has already been well-established. Yet even if the income stayed ...

Read more...

It had been crazy busy all night in the emergency department and I had been running from room to room patching holes and trying to get patients seen. I felt behind all night.  Finally, I had a moment to collect my thoughts and turned my attention to a patient who had been waiting for quite a while. This patient had multiple large and deep lacerations to his forearm, self-inflicted wounds caused during ...

Read more...

Most Popular