Today I had a very special experience, one which many of my patients have faced: I was treated like a nobody while at the hospital. Yay me. I went to visit a patient who was admitted over the weekend to see what was going on.  She was a bit upset about the confusion of the hospitalist service and how orders apparently didn't get written for her care by the admitting physician. ...

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As Americans, we love to associate with groups. More than that -- we love to plant ourselves in a group, stand firmly in our decision, and then adamantly refuse to budge or to see the other party’s perspective. Pro-life. Pro-choice. Democrat. Republican. Pro-Obamacare. Anti-Obamacare. I suppose for all of us, myself included, it is easy to identify with our group of choice when we are sitting at home watching or reading our ...

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The doctor who has to do the laundryThe doctor who has to do the laundry An excerpt from So Long, Marcus Welby, M.D.: How Today's Health Care Is Suffocating Independent Physicians - and How Some Changed to Thrive. Ripley Hollister has been president of his county's medical society in Colorado Springs, Colo., and a director of the Colorado Medical Society. He has been a unit commander ...

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7 ways patients can help reduce medication errors I just got off the phone with a very upset patient who had just discovered that her pharmacy had been giving her the wrong medication for the past 5 months, substituting a similarly spelled antibiotic for her rheumatoid arthritis med. She was tipped off when she realized how bad she had been feeling of late and decided to check the expiration ...

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10 potential benefits of robot caregivers My recent New York Times op-ed on robot caregivers for older adults has elicited curiosity, enthusiasm and controversy. I have to admit that my own first reaction to the topic was captured in the Times' letter from Sherry Turkle whom I mention in the piece. I was in a meeting and turned to a colleague, clumsily patted her on the back and said, “It … ...

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A wise friend who had completed residency told me prior to my starting training that the key to having fun was “never sit down when you get home from work.” Three years out of fellowship and practicing as a psychiatrist in Brooklyn, the words still resonate today.  The residents and medical students that rotate with me marvel at the stories of my full time acting career as a resident performing in ...

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Question: What do you do when presented with abnormal lab results? Answer: Ask lots of questions. The nursing home just sent over a urinalysis on a patient of Dr. Carlyle. I am covering his practice for a few days. The test showed that an 82-year-old woman had 3+ white blood cells in her urine. “NKDA” was written in the margin, indicating she had no allergies. I sighed internally and called the nursing home. ...

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“Doc, can I ask you one more thing?” These words are classic symptoms for those patients suffering from the “one more thing” syndrome. We’ve all been there. The visit has ended, your hand is on the doorknob, and you’re about to leave the room. Precisely at that moment, your patient stops you and says he has one more thing to discuss. You think to yourself, "No! I almost made it out of ...

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Part of a series. Primary care need not be expensive and until the past few decades it was paid for out of pocket. Heretical perhaps, but it would be very useful to go back again to paying the PCP out of pocket directly by the patient, preferably with a tax-advantaged health savings account (HSA). A County Doctor wrote on his blog:

I can freeze a couple of warts in less than a ...

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I love old people, but I will not accept Medicare I love caring for patients -- young and old. And though I may not accept your insurance, I will always accept you. I’m still happy to care for Medicare patients even though I opted out of Medicare in 2006. Why don’t I accept Medicare? Let me fill you in. I do not accept Medicare because: Medicare treats physicians as criminals -- guilty ...

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