“How are you feeling?”
It’s a question we frequently ask patients — on rounds, in the clinic, post-operatively — and with all good intentions and gentility. But, do we ever stop to think: What is really the point of this question? What information are we trying to glean? I think for most of us, we’re asking the question with a cognitive bias towards the physical. How are they “physically” feeling: better, …
There you are in your father’s arms. He is practically running to keep up with the triage nurse. The nurse is walking quickly toward the room that we leave open for true emergencies and the sickest patients. Your father’s eyes are full of fear, and the nurse’s tone is worrisome.
I look down at you all snuggled up to your father’s chest. You are beautiful. So small and bright-eyed. You don’t …
A few months ago, I got the dreaded 2 a.m. consult from the emergency department. I met Mr. Smith, a man with a very strange looking and inflamed gallbladder. The abnormal appearance on ultrasound meant we had to discuss the possibility of malignancy. Instead of the usual 15-minute spiel about removing the gallbladder, I spoke to the patient and his wife for nearly an hour. I drew the anatomy. I discussed …
I took a fantastic emergency medicine (EM) job when I finished residency. There was no question in my mind that it was the best job within a hundred mile radius, maybe more. When I first started, my expectations were met. My group held a contract to staff a busy but well-staffed suburban emergency department, and had held that contract for almost 20 years when I signed. The hospital was independent, …
If you are a doctor, everywhere you hear or read about all that is wrong in medicine. Please do not get me wrong, the medical profession is under assault. Change is occurring all around us, and much of it has the potential to be disastrous to not only us and our families, but more importantly to our patients. For many of us in the profession, we feel helpless. We feel …
I learned that the 148-year-old community hospital that I did my residency at will be closing, and I am angry. Who am I angry at? Myself. Oh, and you. I’m angry at us because we as a country have turned our backs on one another. And in the end, your relationship with your own doctor is in jeopardy.
Pawtucket, Rhode Island, home of Memorial Hospital, used to be a prosperous mill …
Doctors have an interesting problem. They have an ingrained professional obsessive-compulsive habit; they fixate on the care of individual patients and on the science of healing. This is an admirable trait; it results in high-quality care. However, when physicians need to change their attention from healer to leader, from medicine to the business of medicine, from health care to the health care system, they falter. Stuck in silos, they fail to …
I just finished reading a very delightful A Piece of My Mind essay in JAMA. JAMA is primarily a research journal, filled with new scientific or semi-scientific studies and comments on those, plus reviews of the literature and editorials on science or politics. There are also letters and announcements and educational sections for doctors or patients, even poems, but the part I like to read all the way through is …
Recently, former reality television star Kristin Cavallari released a potentially lethal recipe for homemade baby formula in her new lifestyle book, Balancing in Heels. Cavallari, who rose to fame as high-schooler on MTV’s Laguna Beach, is attempting to rebrand herself as an all-organic Suzy homemaker and offering dangerous medical advice along the way.
In her book, Cavallari goes against all conventional medical wisdom, advocating for feeding young babies a homemade concoction instead …
No, customer service in the U.S. is terrible when it comes to health care. No, the customer service in the U.S. health care system is horrendous. No, health care has the worst customer service of any industry in the U.S.
There. That seems about right.
What makes me utter such a bold statement? Experience. I regularly hear the following from people when they come to my practice:
An excerpt from What It’s Like to Become a Doctor: The Year-by-Year Journey From Medical Student to Practicing Physician, Greenbranch Publishing, 2016.
I passed the board exam in November 2011 to become a gastroenterologist. This is the last exam I have to take until I recertify in internal medicine in 7 …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
With the recent expansion of ambulatory surgical centers, the number of outpatient surgical procedures has increased at an exponential rate. Coupled with the rise in volume has been the increasing complexity of procedures and underlying diseases of patients. The convergence of these factors …
Over the last several years since I graduated from residency, I’ve worked in many different hospitals up and down the east coast. These have ranged from large urban medical centers to rural community outposts. In all of these places I’ve felt the inevitable conflict that exists between physicians and administrators — to varying degrees.
It almost seems like a rite of passage that the world of clinical medicine and administration are …
Physicians today are increasingly viewed and treated as skilled workers instead of professionals. The difference is fundamental and lies at the root of today’s epidemic of physician burnout.
Historically, there have been three learned professions: law, medicine, and theology. These were occupations associated with extensive learning, regulation by associations of their peers, and adherence to strong ethical principles, providing objective counsel and service for others.
Learned professionals have, over many centuries, worked …
Hope is a tricky thing. On the one hand, false hope can lead patients to opt for painful, futile treatments at the end of life. On the other, unnecessarily bleak outlooks can lead to depression and inaction. When health is at stake, presenting information with the right amount of hope can guide patients away from both suffering needlessly and/or succumbing to treatable disease.
I was reading a sad story about a …
It is exactly 49 steps from my bedroom to my garage. It is a 23-mile drive to the hospital and 75 steps to the unit. It takes 10 seconds to walk to the nursing station. I can measure what it takes to get me to work each morning with absolute certainty. I know because I have measured it a million times hoping something will prevent me from reaching my destination. …
You may be aware of Ezekiel Stephan, a 19-month-old boy, who died in 2012, after his parents chose home remedies and naturopathy for the treatment of viral meningitis. The parents currently are on trial in Canada for failing to provide the necessities of life.
Over the course of many days, Ezekiel’s condition rapidly deteriorated, but his parents chose to “give him as much natural product as possible,” including syrup, frozen …
Pamela Wible, M.D., takes on physician suicide in her TEDMED talk (delivered on November 18, 2015). Learn more about Dr. Wible and her talk at TEDMED.com. Full transcription below:
I love the three things that people fear the most: death, disease, and public speaking. Here’s how it all started. At four, I was so talkative (and bossy) no babysitter would stay with me. So I tagged along with Mom, …
In the hour after I heard the news, I experienced the full spectrum of typical reactions to a physician suicide.
One end of the spectrum came from the attending in a clinic, who when asked if the residents could go home and mourn their friend who just committed suicide, proceeded to tell me a story of how when her grandpa died before a final exam in medical school. She decided to …
There are several Tumblr sites where people submit their actual name and compare it to the name the Starbucks employee writes on the cup. There’s “Starbucks Name Fail,” “The Starbucks Name Game,” “Starbucks Can’t Spell My Name,” and “That’s Not My Name, Starbucks.”
There aren’t Tumblr sites for calling out Starbucks when they biff your drink. “Starbucks F***** Up My Drink,” “Would You Just Look at This Beverage,” and “There’s No …
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