There has been so much change in medicine, physicians are leaving primary care, and new ideas are being bantered about such as patient centered medical homes (PCMH) and accountable care organizations (ACO), in an attempt to try to address the problem. To add to this strain, is the knowledge that medicine is going to have to be ready to absorb thousands of additional patients in the near future ...
Sharon Bahrych, PA-C, MPH
The culture of medicine needs to change
I’ve been involved in clinical medicine for more than 20 years and during this time I’ve come across numerous situations that created stress, or emotional upheaval within myself, and even times of burnout. At one point, I came close to permanently leaving my chosen profession. The culture of medicine is not geared towards allowing health care providers to de-stress, acquire emotional support, or discuss in an encouraging environment various conflictive ...
Let’s stop degree creep in health care
How long ago was it that we were all content with having the physician have a MD or DO title after their name, the clinic or hospital floor nurse having a RN after her name, the pharmacist having RPh after their name?Now unless the pharmacist has PharmD after their name they can’t be a pharmacist. And for the nurse, unless they have RN, BSN or RN, MSN after their name ...
What happened to the art of medicine?
During our medical training we are taught to use evidence based medicine. This means using the most up to date scientific research data that has been analyzed and accepted as fact. But does this mean every patient we see fits into the evidence based medicine algorithm that we have been taught to use?I hope not. For this would mean we would only be following half of medicine. The art of ...
Patients have a part to play in their own medical care
Medicine has changed so much over the past years, I look back even to when I finished my program and in the mere 20 years since I finished, medicine has changed dramatically. I can remember when I was a student, seeing a patient with rheumatoid arthritis and advising her that the best treatment we could give her was a DMARD. Now we have multiple monoclonal antibodies that not only ...
Kids and their fascination with foreign objects
Kids will swallow or poke up their noses, or into their ears the strangest things. I remember during my student days, I was doing a rotation in pediatrics when a 6 year old came into see us. I went in to take the history and her mom told me that her daughter had a very pungent odor to her, which she couldn’t get rid of.I examined the patient and ...
How elderly patients can be stubborn to their own detriment
The elderly population can be fun to take care of (they have more stories than you have time to hear), or they can be a handful in regards to all of their chronic complaints and numerous medications. But then, there are those senior citizens that come into clinic and tell us, "I don’t need to take medications, I haven’t taken medications my whole life, and look at where it’s ...
Intuition saved this patient from a potentially fatal diagnosis
I was working in a rural health clinic when I went into to see a new patient. Amy was 18 years old, with her 6 day old newborn son by her side.I introduced myself and then asked, "what brings you into the clinic?"Amy responded, "Shortly after giving birth, I started having problems with shortness of breath, ankle swelling, and high blood pressure. I told the OB residents and they brushed ...
Take the effort to reach across cultural and language barriers
I was working in an urgent care clinic when I walked into the exam room to see my next patient. He was a six-year old who primarily spoke Spanish, with some broken English. Jose’s mom was with him, she only spoke Spanish.I sat down and picked up the phone receiver to contact our translator service. With the Spanish interpreter on the line I was able to proceed. I then asked ...
Without wives, men’s health suffers
I was working as a PA in an internal medicine office seeing patients. One afternoon, I was in the clinic hallway when I saw an elderly looking wife in her 60s actually pushing her husband into the next exam room. He had his heels dug into the floor, but she was winning, due to his obvious shortness of breath and audible wheezing.I walked in behind the medical assistant who ...
Taking the time to answer patient questions
I was working in the bone marrow transplant clinic of an internationally known cancer center. When I looked into the patient’s faces, I saw hope as they were being worked up for a possible transplant.I went into see a new patient. She had leukemia and had relapsed after her remission. Her sister would be the donor.Gretchen, age 19 came in with her mom for the appointment. She was tall, youthful ...
