In another entry for the communication category, here’s a little play I wrote: Scene: Pre-op area.  Patient arrives for surgery exactly at the scheduled start time, that is, 90-minutes late. Anesthesiologist (me): Good morning Mrs. Jones.  I’m Dr. so-and-so.  How are you this morning? Patient: Oh, doctor, I have the most terrible headache.  They told me my surgery was at 11 so here I am at 11, and now they tell me I’m late. Me: ...

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Imagine this:  You are sick.  You are the sickest you’ve ever been.  You want to die.  You almost did die.  You want to bury your head in your cozy bed for the next two years. But you’re not in your bed.  This bed has plastic for covers and sandpaper for sheets.  You need to throw up every thirty minutes but you have to share a bathroom with someone you don’t know, ...

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We all want the advantage.  We put our kids in special preschools so they have the advantage.  We work 100 hours a week so our kids can do 8 activities and get the advantage. Tall people have an advantage, we’re told.  Poor people are “disadvantaged.” Well folks, there are a whole bunch of senior citizens in Massachusetts who are about to get disadvantaged starting September 1. UnitedHealthcare (UHC) will be
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After I graduated from medical school, my very first real ward rotation as an internal medicine intern was at the VA.  Therefore, I can say with absolute certainty that all the stuff being said about the VA health system is true.  The place is a mess. Let’s start with the computer system.  The VA medical record system has been held up as an example of an effective EMR system, in which ...

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Apparently all doctors must practice medicine until the day the die.  Or so says Gordon Marino in a New York Times piece called “A Life Beyond Do What You Love.”  This article caught my eye, since I am currently trying to do “what I love,” having already lived a couple of lives doing “what I think I should love.”  I didn’t agree with everything the piece said about doing what ...

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This is why doctors practice cover your ass medicine A small case with big implications almost escaped my notice recently  The Boston Globe reported a case in which a family sued after a 23-year-old man died after being diagnosed with a lung infection. According to the Globe, the young man went to one of the Boston emergency rooms complaining of cough, fever, and chest pains.  OK, stop right there ...

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A few months ago while I was working in the interventional gastrointestinal unit I noticed something because it was driving me nuts.  One of the monitors in the holding area that slaved to one of the procedure rooms was beeping.  Just a low, constant blip blip blip blip.  The screen read, "no data." So I asked one of the nurses "can we turn that monitor off?  No one is using procedure ...

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Let’s talk for a moment about medical education.  I went to a work-related party recently and rode in the elevator with a dear friend who is my contemporary, and a more senior and highly regarded faculty member known for her work in medical education.  Both were afraid for the future of medical education in different ways. My contemporary was concerned that the emphasis on the use of advanced technologies like ultrasound ...

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I have written a good amount about automation, the good, the bad and the ugly.  I have written about doctors and ancillary providers and physician extenders, also good, bad and ugly.  A recent comment on Karen Sibert’s excellent blog A Penned Point caught my eye as an amalgamation of these subjects. This person wrote, and I hope he doesn’t mind my quoting him:

American anesthesiologists should focus much more on ...

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I hate being told what to do.  I will scratch and claw when ordered around.  It takes a conscious act of will to smile and say, “sure, I’ll get going on that right now.” This is a problem since, as an anesthesiologist, I get told what to do all the time.  My kids order me around all the time.  When I was a nurse I used to bristle at the term ...

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