While working at small rural hospital I was once again faced with the emergency physician’s dilemma.  Admitting  a patient and being told to write holding orders.  In the midst of a very busy department, I sat with a nurse who guided me through the ridiculously complex and counterintuitive electronic orders system.  All this so that the admitting doctor wouldn’t have to log onto the computer, from home mind you, and trouble ...

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shutterstock_117726904 I suppose it is obvious that I am a fan of stories. I like to hear them, read them, watch them, collect them and tell them. I believe I am participating in stories every day of my life. The story of my family is a beautiful epic. The stories I hear at work can break my heart. One of my favorite ...

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Thanks to the measles outbreak, the news is full of stories on vaccines and anti-vaxxers. The blogosphere and Twitterverse and all the other social media dimensions are buzzing with invective against ignorant unvaccinated savages and their backward science denial. For the record, I’m a pro-vaccine physician. My children have been and are vaccinated, despite being unsocialized homeschoolers. I’ve had my own share of needles; Physicians are mandated to have hepatitis B, ...

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Just a short observation.  Medicine is immersed in the customer service mentality.  We’re always reminded to be appropriate and understanding, especially when patients are frustrated or upset.  I get that. Right now, I’m sitting in the airport in Detroit.  We’re about 3 hours late leaving because we don’t have a flight attendant.  That’s right; it’s not the weather (as it was on one of my earlier flights this week).  And it’s ...

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shutterstock_224345509 I have a unique perspective as a physician. Having traveled to many hospitals in the past two years, working as a locums emergency physician, I can comment on a variety of issues with a reasonable amount of experience. One of those issues is EMR, or electronic medical records. I have spent plenty of time writing about this in the past, and I ...

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The non-medical reader may wonder what I am complaining about.  Of course, many of you have to be credentialed in your fields as well, whether law or accounting, law enforcement or public service, education, nursing or a trade.  But those of you in medicine know how difficult it can be to become credentialed as a physician, either by a state for purposes of a license, or by a hospital in order ...

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When I was in residency, sexual assault exams were part of our training.  We spent a lot of time learning how to ask the right questions, how to be gentle and empathetic, how to gather evidence appropriately and thoroughly. While many hospitals now have SANE programs (Sexual Assault Nurse Examiner), I have never enjoyed the privilege of working with one of them.  I have, for two decades, performed sexual assault exams on ...

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Walking around the ER in Tiny Community Hospital, I had a few realizations.  In medicine, we hold onto some things very tightly.  We love tradition; we love the known.  We don’t always know why, but we choose "the devil we know," almost every time, no matter how pointy his horns. For instance:  "No cell phones."  First of all, has anyone ever seen a cell phone interrupt anything we do?  No?  Neither have ...

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shutterstock_27236638 I went into an all night pharmacy recently, after getting off of work at 10 p.m. I had to pick up a prescription for my endless, insomnia-inducing cough. Walking up to the counter, I was bathed in the smell of cigarette smoke, carried on the coats of patrons. Eight of us stood by the counter, outnumbering the staff by 100 percent. ...

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shutterstock_140188489 Dear health IT staff, I know that, on many levels, physicians must be the absolute banes of your existence.  We are grumpy and resistant to change. And some of us are still confused by graphing calculators, much less complex modern computer systems.  We call you because we forgot our passwords, then because we forgot the new passwords.  We call because the system ...

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