As an Air Force family physician and faculty at a family medicine residency, it was my job periodically to lead an inpatient team of young family medicine residents and medical students.  That particular morning seemed like any other -- half a dozen new admissions, total census of a dozen or so, and a few new consults.  And it was my habit to see the new patients and new consults before ...

Read more...

shutterstock_143533171 I take a deep breath as I get ready to go see Mrs. H. I can predict after sign-out from the ER doc where this is likely to go. Mrs. H. is an 87-year-old woman who comes to the emergency room with weakness. She stumbled and fell to the floor but could not get up to reach the phone to call ...

Read more...

shutterstock_233804005 The outcry over antipsychotics has ranged far and wide.  Everyone from governmental agencies to senior advocacy organizations have pointed to the abysmal data.  Antipsychotics have a negative impact on morbidity and mortality.  They say we are chemically restraining those who are too fragile to stick up for themselves.  They say we are sedating instead of treating. And I disagree wholeheartedly. I manage a ...

Read more...

We have all seen the statistics; America is an aging country. The baby boomer generation is retiring, and families are having fewer and fewer children. In health care, we often hear about this issue in the context of an inadequate health care workforce. An aging population in conjunction with the ACA has created a quickly growing pool of patients that outpaces the slow growth in the supply of health care providers. But ...

Read more...

I’m walking very slowly with my dad down the produce aisle at the local supermarket, past the colorful waxed apples, Mexican mangoes and Rainier cherries, and imagining my life's blood trickling onto the floor from an invisible wound. As I pass by the misting system spraying the bins of green, red, yellow and orange peppers, past the lady reaching for carrots, past the stock guy balancing the heirloom tomatoes into a ...

Read more...

I was a first-year medical student, starting my first afternoon at an outpatient clinic as part of an introductory course in clinical medicine. My white coat was freshly washed; I had a rainbow of pens in one coat pocket, and my shiny name tag dangled from the other. I only hoped that I was as prepared as I looked. I entered Mrs. Carr’s room. A fifty-five-year-old woman, she sat gingerly at ...

Read more...

Loss is something all humans face in their everyday lives.  As a physician, the effects are often magnified.  People die, they move away, they graduate from your services, or occasionally they pursue care elsewhere.  Parting can sometimes bring relief, and others a deep sense of failure.  But with Clara, I'm not sure we actually parted.  Mostly, I was left with confusion. Clara came to me by way of the nursing home.  ...

Read more...

medpagetodayFrom MedPage Today:

  1. U.S. Seniors Losing Grip on Muscle Strength. The first national survey on grip strength in older adults found that 5% of those over 60 had weak muscle strength, and 13% had intermediate strength.
  2. Low MI Risk in Patients With Non-MI Chest Pain. Patients treated in emergency departments (EDs) for ...

    Read more...

Flossie Marks used to complain now and then about shortness of breath on exertion. She never had chest pain and, after all, she carried firewood from the basement to feed the wood stoves and fireplaces in her large Victorian house. At 81, who wouldn’t be a little short of breath doing that? Last summer, she finally sold the house where she and Eli had raised four children and hosted nine grandchildren ...

Read more...

It was a rather unlikely place to begin my clinical career. Shortly after starting medical school, I signed up to volunteer in the hospice unit of my academic medical center.   The first few visits I relegated myself to fairly banal activities.  I shredded old medical records, or I might do a load of laundry for a family member who had been waiting tentatively by their loved one's side and was ...

Read more...

11 Pages

Most Popular