Referencing a recent New York Times article “What Kids Wish Their Teachers Knew” got me thinking about both sides of the coin.  Physicians are human beings and sometimes this fact gets lost when a patient is angry or frustrated seeking help from the medical system.  Here is a primer on what I wish my patients knew. (This is a companion piece to "I wish my doctor ...

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In general, I would predict that the audience reading this blog knows about medicine’s suicide epidemic: Roughly 400 physicians and 150 medical students kill themselves each year in the United States. This means that every year, about a million Americans lose their doctors to suicide. This crisis is a public health issue. The puzzling question is: Why isn’t it publicly known? If one million Americans were affected each year by ...

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Pretend you're a 30-year-old woman who's 34 weeks pregnant. You develop a cough while cleaning a dusty room. You put up with it for several days. After a week you realize the cough has kept you from sleeping and is creating pain in your rib cage. Time, you think, for medical attention. That should be an easy thing to do. After all, you have health insurance, and you're articulate and assertive. ...

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an-ingrown-toenail-is-not-a-lung-transplant Illustration by Jorge Muniz, PA-C. Here’s a quick review of health care delivery basics: Primary care. Stuff you can get handled with your primary care doctor in your neighborhood. Example: ingrown toenail. Secondary care. Stuff your primary care doctor refers to a secondary specialist down the road. Example: colonoscopy. Tertiary care. Complex stuff you need to deal with at a big-city hospital. Example: lung transplant. Simple. Right? Here’s the problem: ...

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The Haitian doctors’ strike ended recently, and it is unclear if there are any winners. The conditions in which the striking doctors -- medical residents in Haiti’s public hospitals, to be precise -- work are appalling, and the low pay was galling, but without the doctors, hospitals shut their doors and the poor were left to take care of their own illnesses and injuries for nearly five months. At issue were ...

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Physician wellness begins in realizing our identity in medicine and society. Shamans, priest, and healers have existed in ancient times and in small and large indigenous tribes since man began to gather together in social packs. The unique role of tribal and community leaders who guarded health and wellness was understood as important for the whole of society. All doctors have degrees of empathy. We as an order select for this ...

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In 1996, Jerry Maguire was fired for advocating a reduction in his sports management firm’s client base thereby risking the firm’s profits.  While writing his infamous memo (or as he would tell you, his mission statement), he recalled his mentor’s advice: “The key to this business is personal relationships.” Tom Cruise’s voiceover continues: “Suddenly, it was all pretty clear. The answer was fewer clients. Less money. More attention. Caring for them, ...

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figure-1-for-kevin-pho Do doctors make too much money? I don’t think so. I read with great interest the blog by Dr. Michael Kirsch defending physicians’ salaries: "If you think doctors make too much money, think about this." Unfortunately, the public’s perception of physicians’ incomes has been that physicians make too much money. Whenever I hear this remark from patients or even non-physicians, I show ...

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I'm new to the job of coroner. Though I'm sure it won't surprise anyone to hear that it's nothing like C.S.I.; you measure the wait for test results in months, not minutes. It's not like Quincy, M.E. either, where the same person responsible for the autopsy hops about cracking a case that somehow befuddles police. Most deaths are natural, with a good number of accidents and suicides, despite the media's ...

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“Any alcohol use? Any tobacco use? Any other drugs?” These are the three main questions that most health care providers ask their patients when documenting a social history on a note. "What stressors do you have in your life? What social support do you have? What is your home life like? What do you do for fun? Do you wear a helmet when you ride a bike? Do you wear a seatbelt?" I ...

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