Think about it; athletes aren’t the ones who document their performance. It’s other people that keep the score. That’s a whole science in itself. People talk for hours after the game or tournament is over about how each athlete did this or that in whatever way they did it, and the numbers are in many cases captured by extremely sophisticated electronic equipment. Physicians work hard to diagnose and treat their patients, ...

Read more...

“I am not on call,” Dr. Brian Stoltz said over a lot of background noise through what must have been the speakerphone in his car. “I know,” I said. “Cityside ER said there is nobody on call for ophthalmology this weekend. I have a 54-year-old woman with intense tearing, discomfort and only 20/70 vision in her right eye.” “And she’s not a patient of our office?” “No, she has only had to see ...

Read more...

The SOAP note isn’t what it used to be. And what it has become needs to be scrapped, because it has made the office practice of medicine cumbersome and unsafe. In simpler times, when medical records were written by and for doctors, the SOAP note represented a significant leap forward in expanding and organizing office notes and also notes from emergency rooms and walk-in clinics. Before that notes sometimes only documented ...

Read more...

My colleague, Dr. L.T. Kim, was off this week and I covered for him. On Friday afternoon, I dealt with two of his patients and learned — or relearned — two important lessons. I saw a man with thoracolumbar back pain. He had fallen off a ladder a few years earlier and suffered from recurring bouts of back pain — sometimes with tingling in both legs. He had been to the emergency ...

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...

As a physician with a strong sense of calling, I always see myself working for each patient, regardless of who pays the bill. Following in the footsteps of role models like Hippocrates and Osler, how could I do anything else? Ted has been my patient for decades. He can’t seem to lose weight. John has admitted he doesn’t know how long he can keep doing the kind of work that has supported ...

Read more...

The problem with health care and drug prices in America isn’t that we spend too much money. The real problem is that we believe we are spending “other people’s money.” Yes, I was raised in Sweden, but no, I’m not a Socialist. The irony is that “free” health care there is more clearly understood to be directly financed by local(!) taxes that can go up if people in that region consume ...

Read more...

On an ordinary day last month, I saw patients for eight and a half hours. I addressed a dozen computer messages, took four or five calls from outside providers and held innumerable curbside conversations with medical assistants, case managers and colleagues. I didn’t get to any of the 100+ lab results or 50+ documents in my electronic inboxes. Consequently, the care for several dozens of my patients didn’t move forward. Many of ...

Read more...

We are like a restaurant that charges handsomely for sit-down dinners but gives away food for free at the takeout window. And we only pay our providers for serving the dining room guests. If traffic gets backed up at the drive-through, we hold our providers responsible, even though we never planned for our ever increasing demand for takeout. In simpler times, patients went to the doctor when they felt unwell, and ...

Read more...

Theresa Miller is one of the hardest working women I know. She doesn’t come into the office very often. She no longer needs my prescription for her heartburn medication, as it costs less for her to buy it over the counter these days. Today I saw her for a preoperative clearance. She finally decided to get an operation for her chronically sore shoulder. She had injured it many years ago>. In ...

Read more...

12 Pages

Most Popular