Non-clinicians skip over some of the most necessary underpinnings of doctoring and speak too much about housekeeping issues: blood pressure targets, aspirin use, mass screenings, immunization rates and so on. People without medical degrees could do those things. But there are steps that must be taken before we worry about the measurables. These are the […]
I don’t want to be unclear here. I don’t want to mince my words. But I’m mad about an interaction I had on Facebook. I was commenting on the Physician Side Gigs group page when someone riffed on one of my statements. They mentioned that my opinions could be a slippery slope towards a future […]
A common proverb teaches that, “The road to hell is paved with good intentions.” Medicine is a world where people are well-intended. Yet they fail to change a system that is broken and continues to produce burned out, depressed, and suicidal doctors. We can see their final destination, look back, and realize that we helped pave the road that […]
Computed tomography, or CT scanning, is one of the most powerful diagnostic tools to emerge during my medical career. Just look at the detail in the brain images above, taken at 90-degree angles through the brain. And I was there at the beginning. I remember well when I was a medical student taking neurology, and […]
Some days in medicine seem like an epic saga in which the world seems to be playing whack-the-doctor. It is easy to vilify doctors and cast much blame at them. And true, we bring some of this onto ourselves. Today was one of those days, and by the end, I was just all too ready […]
A physician recently recalled to me a situation he found himself in on the last National Doctors’ Day. Those of you reading who work in health care, will already be aware that this is on March 30th every year. I have seen this day celebrated in every hospital I’ve worked in since I first came to […]
At some point in your investing career, you’ve likely heard of a stock that’s gone on a ridiculous run or a certain part of town that has now become the trendiest in the area, and you’ve kicked yourself for not investing. We’ve all been there. Well, the cliche is true: hindsight is indeed 20/20. In […]
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated for a 12-year history of refractory constipation. Her symptoms began after a difficult childbirth. She has constipation marked by straining, bloating, and a constant sensation of incomplete emptying. She sometimes has 4 or more days between […]
I love the idea of turning a negative approach to improvement in health care — looking for problems — on its head. Appreciative inquiry, a process of focusing on a group’s inherent strengths and fostering positive interactions among group members, is one way of fostering change with a positive approach. Positive deviance (PD) is another. Basically, […]
“Those who suffer illness learn by hearing themselves tell their stories, absorbing others’ reactions, and experiencing their stories being shared.” – Arthur Frank We stand together at the clinic room door, preparing to enter. “Tongue cancer. This is a 78-year-old man with an oral cavity mass and some memory loss. He had an ulcer on […]
