Author's posts
Why physicians should adopt the roles of guides
The family doctor used to be almost the only source of medical information patients had access to. Now, few people need us to bring them the latest news. It’s there for everyone to see. There’s even too much of it. Today, our role is to help make sense…
Why primary care will soon only treat chronic conditions
In most other human activities, there are two speeds, fast and slow. Usually, one dominates. Think firefighting versus bridge design. Health care spans from one extreme to the other. Think code blue versus diabetes care. Primary care was once a place w…
Physician office notes should have an executive summary
I have advocated before for putting a visit synopsis at the beginning of each visit note. I have called that the aSOAP note. I think that works immensely better than APSO notes that only rearrange the order of the elements. The reason I say that is tha…
The answer to physician burnout isn’t resilience training
The answer to physician burnout is purported to be resilience training. That’s like glorifying the natural ability of frogs to tolerate gradually heating and boiling water. Unfortunately, health care today has some toxic ingredients, and physician burn…
When physicians fear for their lives
The receptionist interrupted me in the middle of my dictation. “There’s a woman and her husband at the front desk. She’s already been seen by Dr. Kim for chest pain, but refuses to leave, and her husband seems really agitated. They’re demanding to spea…
The sensitive topic of physical contact during exams
Touch is a sensitive thing. No pun is intended here, but whether and how we touch our patients deserves our careful thought and deliberation. So much interpersonal contact these days is virtual, with emojis, abbreviations and whole words thrown around …
When Medicare stops covering a test without warning
There are two versions of “the conversation” we have with men: One is for teenage boys, and it is about wet dreams, sexually transmitted disease, unwanted pregnancy and at one point also about testicular self-examinations. Those have now been edited ou…
A doctor survived a day without a computer. Here’s how he did it.
It wasn’t even nine o’clock when the screen on my laptop suddenly froze. From that moment until my last patient left the building, my clinic had no internet. For my part, the day went pretty smoothly, mostly because of some of my own work habits. It al…
Too many “experts.” Not enough family doctors.
It’s a funny world we live in. Lots of people make a handsome living, defining their work and setting their own fees and hours with little or no formal education or certification There are personal and executive coaches, wealth advisers, marketing expe…
Instead of speed, focus on the value of each patient encounter
In business literature, I have seen the phrase “getting paid for who you are instead of what you do.” This implies that some people bring value because of the depth of their knowledge and their appreciation of all the nuances in their field, the author…
