Injury to the brain continues to be a unique thing in medicine. These injuries are scary and unfamiliar to many health care providers. There is a finality to them. Their consequences are hidden a little bit; the asystole is easy to figure in the emergency room but the suppression and brain death isn’t something so easily recognized. They’re what you might imagine, along with polytrauma, as poster child conditions for tertiarization ...

Read more...

Infectious disease is the most hyperbolic of all medical fields, at least when the media gets ahold of such. Right now we are to fear a new avian influenza virus. Previously there was another avian influenza strain whose outbreak threatened the world and of course SARS and, more distantly, the ebola virus and the threat of bioterrorism. And on the periphery, as these acute threats come ...

Read more...

I’ve written about trying to communicate acuity to families. Maybe that needs to be expanded to encompass the same to other physicians. To be fair I’m sure some of this, perhaps much of it, rests solely on my shoulders. Recognizing that I’m still going to make an accusation that talking life and death with families and patients is a skill not fostered in many providers. More accurately ...

Read more...

A recent survey by Deloitte of physicians opinions on health care reform has drawn some very differing conclusions from partisan commentators. The 501 physicians answered a number of questions, the most notable of which included a dichotomous question on whether the Affordable Care Act was "A good start" or "A step in the wrong direction." The question was split 44% to 44%. All respect for Mr. Pollack and Dr. Murthy writing ...

Read more...

In an op-ed appearing in the New York Times on May 29th, Drs. Bach and Kocher lay out a plan for making primary care more attractive to medical students. They propose the following: "Under our plan, medical school tuition, which averages $38,000 per year, would be waived. Doctors choosing training in primary care, whether they plan to go on later to specialize or not, would continue to receive the ...

Read more...

Debates over resident autonomy are nothing new. Informed patients are sometimes reasonably concerned about just how much responsibility for their care will be delegated to their doctor's trainees. Care within academic medicine, especially acute inpatient care in a public system, can and does sometimes mean going a whole admission without meeting the attending physician presumably responsible for your care as a patient. At least in my limited experience. This as ...

Read more...

Healthcare is a limited commodity. It’s limitations are defined by the numbers of professionals supplying it and their physical limitations on the number of patients they’re able to treat, on availability of biomedical equipment and technology, on availability of physical space to safely provide medical care and, underlying all of these, on the funding for such. And so, not ...

Read more...

The intersection of social media and privacy has made an older generation, and even some of my own generation, incredibly uncomfortable. There is talk of present and future consequences. Lost jobs, lost income, civil judgments, loss of respect/embarrassment, even criminal penalties for all that you put online. There is an idea that the blurring of intimate boundaries will come back and bite a whole generation. Being online has responsibilities and consequences, ...

Read more...

I’ve made some fairly outrageous claims about the workload of a neurosurgical resident recently. Seems like a reasonable time to lay out exactly what a day on call can be like for me and my fellow residents. To be fair an average experience may be hard to articulate. Different rotations and different days yield different … adventures. Right now I’m on a service that could hardly be called grueling, but I ...

Read more...

I don’t think there is anything nobler than being a physician. In it’s most prime form it is service to life’s most basic needs. Certainly there are professions and lives with similar dedication. But lawyers and journalist I can’t reasonably place amongst them. This from someone who favors liberty and transparency in society above most else; certainly things that lawyers and journalists can help foster. And yet, for all the respect thrown ...

Read more...

2 Pages

Most Popular