The patient, I surmised, was the one in the wheelchair with nasal oxygen and an unhealthy red color of her cheeks. The younger woman in the room with her looked like she might be a daughter. I introduced myself. I had been right about the other woman being her daughter. It was Saturday clinic, urgent care at our country doctor practice, and the plastic holders with “express check-in” history forms and a ...

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My voice recognition software insists on typing “when needed” when I say “PRN,” and the other day I saw an orthopedic note that said, “before meals joint.” I was sure that the straight-laced orthopedic surgeon did not intend to tell the world anything about anybody’s cannabis use. Instead, it was obvious he had spoken the words “AC joint,” meaning acromioclavicular (on top of the shoulder). But AC can also mean ...

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When a new doctor joined our clinic, she spent a week learning our electronic medical record. She had used two other systems before, so she was no stranger to EMRs, but that’s how different they can be. That’s crazy! EMRs should be like cars, which range from the likes of Smart, Mini Cooper, and Skoda to Mercedes Maybach, Rolls Royce, and Porsche. They range from simple to sophisticated, from nimble city cars ...

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“I was surprised when the emergency doctor at Cityside Hospital said he was going to call you to discuss my case," Farmer Carr said when I saw him today. “I figured you’d be asleep at that hour.” I smiled as I recalled the cell phone call that had come in at 9:30 the night I had sent him back to the hospital for a reassessment. “No, I was sitting in my camping ...

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  Think about it; athletes aren’t the ones who document their performance. It’s other people that keep the score. That’s a whole science in itself. People talk for hours after the game or tournament is over about how each athlete did this or that in whatever way they did it, and the numbers are in many cases captured by extremely sophisticated electronic equipment. Physicians work hard to diagnose and treat their patients, ...

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“I am not on call,” Dr. Brian Stoltz said over a lot of background noise through what must have been the speakerphone in his car. “I know,” I said. “Cityside ER said there is nobody on call for ophthalmology this weekend. I have a 54-year-old woman with intense tearing, discomfort and only 20/70 vision in her right eye.” “And she’s not a patient of our office?” “No, she has only had to see ...

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The SOAP note isn’t what it used to be. And what it has become needs to be scrapped, because it has made the office practice of medicine cumbersome and unsafe. In simpler times, when medical records were written by and for doctors, the SOAP note represented a significant leap forward in expanding and organizing office notes and also notes from emergency rooms and walk-in clinics. Before that notes sometimes only documented ...

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My colleague, Dr. L.T. Kim, was off this week and I covered for him. On Friday afternoon, I dealt with two of his patients and learned — or relearned — two important lessons. I saw a man with thoracolumbar back pain. He had fallen off a ladder a few years earlier and suffered from recurring bouts of back pain — sometimes with tingling in both legs. He had been to the emergency ...

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When I read a case report in a journal or whenever a patient comes in to see me about a new symptom, all my senses are tuned in, and I know there is a diagnosis to be made. But on regular clinic days with “routine” follow ups, I find myself not being as tuned in as I would like to be. I know my patients well; we are all growing older ...

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As a physician with a strong sense of calling, I always see myself working for each patient, regardless of who pays the bill. Following in the footsteps of role models like Hippocrates and Osler, how could I do anything else? Ted has been my patient for decades. He can’t seem to lose weight. John has admitted he doesn’t know how long he can keep doing the kind of work that has supported ...

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