Poor bored government. So much time on their hands; so little real work that needs to get done, all they can do is micromanage poor physicians like me to death. Well, they can try. For its first forty-five years, Medicare was (in)famous for the very narrow limits on things it covered. It would pay for medical care when you were sick or injured, and that was basically it. No preventive care. ...

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The following excerpts will give you an idea of what life can be like while practicing emergency medicine in very beautiful, very coveted areas of the United States. I will not name towns or hospitals, as the situations are highly reproducible from place to place and season to season. We’ll just call it St. Resort hospital. If you doubt me, call up your friends who work in such locales, with ...

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What should we call the people who get medical care? Are they “patients,” the traditional term for anyone receiving medical attention from physicians, nurses, pharmacists, therapists, dentists and other providers? Or are they “consumers,” people who purchase goods and services for personal use? The debate about nomenclature is growing, and it’s more than a matter of hair-splitting semantics. Among passionate advocates on both sides of the argument, emotions run high. Sometimes we ...

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Every weekday during lunch time, I scurry out of my clinic and head towards the doctor’s lounge because the food is free. (Even though most of the time I am not sure what it is!) But more appealing than the costless lunch are the conversations that I have in that lounge with other physicians from the hospital. Being a pediatrician, I am more inclined to pay closer attention to stories ...

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From ancient times, doctors have appreciated that, for all their similarities, no two patients are exactly alike. This understanding is what made physicians act like, and earn society’s respect as, professionals. The commercialization of health care has brought in managers from other industries and other branches of academia, and their rise to power has been predicated on their ability to treat patients and doctors not as individuals, but as small cogs ...

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“What is the term we use to describe the cells that help us diagnose papillary thyroid cancer?” the attending pathologist asked a room full of residents at a noon didactic. “Orphan Annie Eyes,” they nearly all responded at once. “And does anyone here know who Orphan Annie was?” he asked next. It is something memorized by every medical student -- the papillary thyroid carcinoma cells with cleared out nuclei are called “Orphan Annie ...

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When I was pregnant with my first child, I worked full time as a physician in the emergency department.  I worked mostly 9-hour shifts, but some 12-hour shifts as well. Days, evenings, nights, holidays and weekends were divided up amongst the entire group of physicians. I worked my share of those shifts as well. I have worked in the ER while pregnant twice now, and while I am proud to be ...

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You all have prostates. Seriously.  But let me explain further to those people who simply can not fathom as to how a woman could dare ask for maternity leave and expect her other team members to “pick up her slack, because she chose to get pregnant.”  (Yep, check the comments section on my last post. Pretty entertaining, in fact!) Life happens to everyone. If my profession as a trauma surgeon has ...

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I sit at my desk in a cubicle with high ceilings and an open entryway.  It is dark except for the somewhat eerie glow of light emitted by CRT monitors.  With concentration and some sense of urgency, I methodically plow through the queue of studies to be interpreted.  Some are marked STAT, some not.  I address the former first. Our ER is a busy one.  Many cases come from that department.  ...

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Last year, I retired from full-time practice and moved to a new area. At about the same time, my wife was diagnosed with breast cancer, and because she was in good health prior, she had relatively little contact with the health care system as a patient. Before our move she worked as a part-time school nurse, so we were able to share provider horror stories from different perspectives. Since we moved ...

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