Next in a series. What are some of the characteristics of healers? They listen and do so nonjudgmentally. They respond on the patient’s terms. They are humble. They are truthful. The healer communicates on the patient’s (and family’s) own terms. The healer always explains his or her reasoning. The healer tries to diminish the information gap. Despite all of medicine’s sophisticated technology and providers’ skills, the patient still needs the doctor ...

Read more...

Next in a series. Years ago while in oncology training, I was on night duty when a patient of one of my colleagues was having severe penile pain. He had received a new investigational chemotherapy and it turned out to have an unexpected property of damaging the lining of the bladder and urethra. It gave him a strong uncontrollable urge to urinate yet each time the burning was excruciating. Oral ...

Read more...

Next in a series. The art of healing is very important in medicine. There is a difference between being a modern day physician and being a healer. All societies have healers -- wise men and women, shamans, medicine men and people of other names. The “old time practitioner” was almost always a healer but many physicians today are not. It is an issue of interest, training, time and prioritization. Most ...

Read more...

Next in a series. As a patient, you have probably had the experience of meeting a physician for the first time and very quickly becoming comfortable that he or she has your very best interests utmost in mind. The sense comes quickly; you become comfortable, less anxious. Unfortunately you may have had the opposite experience of encountering a well-educated, well-trained physician who, although technically an expert, left you cold. As a ...

Read more...

Next in a series. How many patients can a primary care physician (PCP) reasonably care for? I have been interviewing PCPs: Here are some of their thoughts when asked this question.   Responses were widely divergent  ranging from about 300 to 3,000 or even more. Yet many are clearly conflicted. Some say they can manage about 2,000 with little difficulty -- but then observe elsewhere in the conversation that they have no ...

Read more...

Next in a series. Good question. You call for an appointment and are told it will be about 20 days. You arrive on time only to sit in the apt named waiting room for 40 minutes. Finally you get to see your primary care doctor (PCP). You begin to explain why you came in but are interrupted within about 23 seconds even though it would have only taken you about ...

Read more...

Next in a series. There has been a lot of interest in the Daily Beast article written by Dr. Daniela Drake, about very frustrated primary care physicians (PCPs). She quoted both Dr. Kevin Pho and myself from posts here at KevinMD.com. Dr. Drake noted that nine of 10 doctors would not recommend medicine to their children as a career and that 300 physicians commit suicide each year: “Simply put, being a doctor ...

Read more...

Next in a series. Beginning with a deep understanding of medical science and years of training and experience, the primary care physician (PCP) needs to delve deeply into the patient’s personal, family and social setting in order to fully understand the context and causes of the patient’s illness. The PCP also needs to know when it is important or even critical to call upon others with specific knowledge, techniques or ...

Read more...

Next in a series. Primary care physicians (PCPs) have multiple frustrations today. The greatest frustration is “time, time, time.” From in-depth interviews with over 20 PCPs, everyone said that time or more correctly lack of time was the greatest frustration of their practice (or was previously if they now were in a practice that limited the patient number to a manageable level). Each knew that they could not give the ...

Read more...

Next in a series. As a general rule, PCPs like people. This was true of them long before they started medical school and it will have only blossomed further during training. Ask PCPs, as I have with in depth interviews, and they will tell you that certain types of individuals are drawn to primary care careers. They like to converse with people. They enjoy getting to know about a person -- ...

Read more...