My nurse practitioner was pleased to see me at my annual physical this year. “So how does it feel to be 20 pounds lighter?” “It feels terrible,” I replied. Allow me to explain. Weight has been an issue my entire life. Raised on a standard Midwest diet of complex carbohydrates and the best processed delicacies that government assistance could buy, I spent most of my childhood socially segregated by my peer group due ...

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Medical school applications can raise big hairy questions about the long-term potential and trajectory of your relationship as well as the question of whether you get a say in where the applicant applies and attends medical school. For some, the timing of these questions arises in synchrony with the relationship’s natural progression that is at a time when you and your partner are beginning to discuss your long-term prospects. Other ...

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When I was in television, I was friends with the late Gene Siskel (the film critic’s syndicated show would shoot in our Chicago CBS studio). Siskel would drop by my office to talk and get free medical advice. Siskel was, you might say, frugal. I remember when I was in contract negotiations with CBS, my bosses couldn’t praise me enough — but the money wasn’t there. When I told Siskel about ...

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The young woman in my clinic, whom I’ll call Nicole, was 8 months pregnant with her third child. It should have been a joyous time -- but she was in a county jail. Nicole was awaiting trial for a misdemeanor, and while a judge had set bail, she couldn’t afford to pay it. I’m a public health researcher and physician in the Los Angeles County Jails, the largest jail system in ...

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Of course, it matters a lot -- hospitals vary enormously on quality of care, and choosing the right hospital can mean the difference between life and death. The problem is that it’s hard for most people to know how to choose. Useful data on patient outcomes remain hard to find, and even though Medicare provides data on patient mortality for select conditions on their Hospital Compare ...

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A transcript of the Loyola Stritch School of Medicine 2017 commencement speech, Saturday, May 20, 2017. Angela Jiang: Good morning! As the class vice president, it is my pleasure to welcome Dr. Pamela Wible to our graduation. Dr. Wible is a family physician and a pioneer in the ideal medical care movement. After completing a family medicine residency and working in different family practices for over ten years, Dr. Wible ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated for a 2-year history of cough and a 1-year history of increasing dyspnea. He describes the cough as nonproductive, and his shortness of breath is worse with exertion. He does not have chest pain, orthopnea, paroxysmal nocturnal dyspnea, or any other symptoms. ...

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A few thousand years ago, a talking snake convinced a child to pick a piece of fruit, squeeze it really hard, and drink whatever came out. The kid liked it, obviously, because what’s not to like about juice? So the next day at preschool, he told all his friends to ask their parents for juice, too. Some of them said the magic word; others just whined until their parents gave ...

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Sixty is the number of patients left on our schedules at the end of the day on Monday this week, people who never showed up, what we call no-show appointments. This number does not include those patients who did reach our practice to reschedule (these are counted separately), but simply those who never made it in for their scheduled appointments. While we are a very busy practice, and this is not ...

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It started with nightmares. I would wake up frightened, covered in sweat and searching my empty room for an intruder. It progressed. I started setting traps on my doors to see if anyone was coming into my apartment when I wasn’t there. I didn’t open my blinds often. And when I did, I ensured no one would be able to see inside. I meticulously planned movements outside my apartment — ...

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It’s common knowledge in medicine: Doctors routinely order tests on hospital patients that are unnecessary and wasteful. Sutter Health, a giant hospital chain in Northern California, thought it had found a simple solution. The Sacramento-based health system deleted the button physicians used to order daily blood tests. “We took it out and couldn’t wait to see the data,” said Ann Marie Giusto, a Sutter Health executive. Alas, the number of orders hardly ...

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"Do no harm." This is a key phrase in the Hippocratic Oath; one that I announced with conviction at my medical school graduation. I swear to do no harm. What would Hippocrates, the Father of Modern Medicine, think about the concept of harm reduction? Canada has a drug problem. We are one of the world’s largest per-capita opioid consumers. The country is facing what has become known in the media as the ...

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Burned out cardiac surgeon seeks opportunities or empathy,” one message reads. “I feel stuck,” another confides. A third says simply, “I don’t want to be a doctor anymore!” The posts come in from across the globe, each generating its own thread of commiseration and advice. “I just wanted to reach out and let you know I feel your pain,” a doctor-turned-MBA replies to one surgeon. “Your story is so similar to ...

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I’ve spent a lot of time writing about the suboptimal nature of electronic medical records and what we need to be doing better. At their best, health care information technology systems can make finding patient medical data unbelievably quick and easy. However, at their worst, they take up an unacceptable amount of physicians’ time and also dumb down medicine, reducing our patients’ stories to rows of meaningless tick ...

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I sometimes joke that hospitalists are the medicine version of the mullet haircut; you know, all business in “the front” (i.e., the patient care area) and all party in “the back” (i.e., the work room). In “the back,” the usual scenario is to complain and moan about our frequent flyers, our drug seekers, our many unsaveable patients, the incredible situations (“He put a nail where?"), with good-natured but somewhat bitter ...

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At a time when physicians are feeling besieged on all sides, it hardly seems fair to write about the lack of civility demonstrated by some members of the profession on social media in Canada. But it’s still an important issue that needs to be addressed — with the caveat that no profession or segment of society is blameless and the focus is due to the focus of this particular blog. The post ...

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Monday morning and no place to go. After 35 years of practicing medicine and GI, including a year of eager anticipation, the day had arrived when there were no patients in my schedule. Nor would there be tomorrow. Nor the next day. I was happily accustomed to a scheduled life. For me it had been decades of awakening early, working out, assembling a breakfast to inhale in the car, kissing the ...

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I carried it around with me the entire shift. I showed it to my E.R. colleagues, the internists, and even a couple of surgeons. I’d tell them the story. “Never,” one of them said. “Not in twenty-eight years. Never seen that before.” One of them held the small urine jar up to a light and began unscrewing the lid. “Don’t!” I said. “Why not?” “It stinks. You wouldn’t believe how much it stinks. We ...

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Jimmy spent 10 years on the street chasing oxys and heroin. He lost his family and friends after lying and stealing. He lost his truck when the bank repossessed it. He lost his four-year-old son to the Department of Child Protective services. His life was like a country song. Now a member of our suboxone group, Jimmy has two years of sobriety under his belt, he is enrolled at the local ...

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To my fellow physicians: I apologize for asking you to do one more job. But I must. It is for the sake of humanity. We are already overburdened with the administrative nightmare that hospitals and insurance companies heap upon us. The struggle to find pride and purpose in our daily life has become a full-time job. We have become oppressed by our increasing allegiance to the demands of administrators as opposed to ...

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