Author's posts
Physicians are not incentivzed to talk with patients on the phone
Talking to patients on the phone can be very efficient and quite rewarding, like when I called a worried patient today and told her that her chest CT showed an improving pneumonia and almost certainly no cancer, but a repeat scan some months down the r…
When primary care handles the consequences of psychiatric medication prescribing
If my hypertensive patient develops orthostatism and falls and breaks her hip, I fully expect the orthopedic surgeon on call to treat her. I may kick myself that this happened, but I’m not qualified to treat a broken hip. If my anticoagulated patient h…
A physician shares the computer screen with patients
I ran late the other morning. My first patient, an internal transfer, was already waiting. Booting up my laptop seemed to take forever. Usually, I try to poke around at least a little in the EMR before I enter the exam room, even when I know the patien…
Most medical offices are hopelessly old fashioned
Imagine if your bank handled all your online transactions for free but charged you only when you visited your local branch — and then kept pestering you to come in, pay money and chat with them every three months or at least once a year if you wa…
Happiness has become a selfish pursuit
Earlier this month Ross Douthat wrote a piece in The New York Times titled “The Age of American Despair” where he posed the question “Are deaths from drugs and alcohol and suicide a political, economic or spiritual crisis?” Douthat writes: The working …
Physicians have to inspire their patients
The Swedish word for physician is läkare, which literally means healer. That seems a lot more glamorous than the American word physician, which is derived from physic, the old fashioned laxatives that were thought to rid the body of poisons and impurit…
Experience and in-depth knowledge can empower you with an appreciation for nuances
In medicine, contrary to common belief, it is not usually enough to know the diagnosis and its best treatment or procedure. Guidelines, checklists, and protocols only go so far when you are treating real people with diverse constitutions for multiple p…
Doctors shouldn’t be horse whisperers
I scribbled my signature on a pharmaceutical rep’s iPad today for some samples of Jardiance, a diabetes drug that now has expanded indications, according to the Food and Drug Administration. This drug lowers blood sugar (reduces HbA1c by less than 1 po…
How this physician does less in primary care and accomplishes more
So many primary care patients have several multifaceted problems these days, and the more or less unspoken expectation is that we must touch on everything in every visit. I often do the opposite. It’s not that I don’t pack a lot into each visit. I do, …
Why doctors need to be chameleons
Doctors need to be true to themselves, but at the same time, they must be chameleons. A doctor fills certain roles in the lives and stories of patients. It is a two-way relationship that looks different to each person we serve throughout every workday …
