It is unethical not to be compassionate when you are a physician.  Treating people or their families poorly isn't helpful to anyone in a stressful situation.  But a big problem exists there - ethics is not taught in medical school.  Then again, neither is compassion.  So where do you learn them?  Can you learn compassion, or is it something you just have? Or don't have? She could have been anyone's grandmother.  White ...

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Overwhelmingly, doctors’ reimbursement has been the target of government programs and insurance companies.  The idea underlying this movement has been, pay doctors less and curtail their incentive to see patients and the cost of medical care will decrease.  As a result of this faulty reasoning, we have ushered in the era of unhappy doctors, those retiring early, and those asking for extra payments to justify the hours needed to give ...

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Her wary eyes, magnified from her thick-lensed spectacles, watched my every move as I pulled room 21's curtain to the side and entered her room. In her early eighties, it was apparent to me that my entrance into her life was more important than the abdominal pain that brought her to our emergency department. In the corner sat a slight man with wispy gray hair poking out from the border ...

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He was a 24-year-old African American man with no history of medical or eye problems.   On an ordinary Thursday evening at 8 p.m., he arrived into the emergency department complaining of a sudden loss of vision in both eyes. “He couldn’t see a thing on our chart.  Vitals are fine, pupils are equal and reactive, and the rest of the neuro exam is unremarkable,” the emergency room attending briefly explained.  “Can ...

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I would like to explain why Michael Kirsch's article, "Why the ER admits too many patients," is wrong, in all the myriad ways, in his contention that emergency physicians (EPs) admit too many patients because of improper motivations. Note that I am not going to argue that EPs don't admit too many patients -- that's a legitimate discussion to have and there may be some merit to the ...

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Emergency physician Brian Goldman, host of CBC's White Coat, Black Art, wants to lift the cloud of shame when medical mistakes are made, so they can be openly discussed and not be repeated by other physicians.  In this masterful TEDx Toronto talk, Dr. Goldman shares compelling stories of his own errors and reveals the 3 words that every emergency physician fears. When it comes to mistakes in medicine, the ...

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Every player in the medical arena has found itself challenged by conflicts where one’s self-interest competes can skew what should be pure advice.   This issue is not restricted to the medical universe.  Every one of us has to navigate through similar circumstances throughout the journey of life.  If an attorney, for example, is paid by the hour, then there is an incentive for the legal task to take longer than ...

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There’s a war being waged on one of America’s most revered institutions, the emergency room. The ER, or emergency department (ED for the sake of this post) has been the subject of at least a dozen prime-time TV shows. What’s not to love about a place where both Doogie Houser and George Clooney worked? Every new parent in the world knows three different ways to get to the closest ED. It’s the ...

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From MedPage Today:

  1. Google Glass in Medicine: Not Quite Ready Yet. A long list of potential medical applications for Google Glass was counterbalanced by an equally long list of obstacles to widespread implementation.
  2. Safety Net Hospitals Already Benefit from ACA. At Seattle's largest safety net hospital, the proportion of uninsured patients fell from 12% last year to an unprecedented low of 2% this spring ...

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I wish I could share the photo of my 4mm boomerang shaped kidney stone.  I labored for 2 months, back in early 2009 to pass it, the second stone in 5 years. During my ordeal with these stones, I had the following health care encounters, tests, medicines, lab and imaging tests.

  1. at least 5 sets of blood work, with CBC and chemical profiles, parathyroid studies
  2. several urine tests, including urinalysis and urine culture, ...

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