When we think of bullying, we’re usually worrying about our school-age kids or remembering bad experiences from high school. We learn quickly in the health care field that bullies don’t change once they enter the clinical world. Health care, with its incredible differential in knowledge, authority and pay creates large power differentials and easily generates […]
Before managed care became the dominant force that it is, patients and doctors had the opportunity to get to know each other well. Doctors treated multiple generations within families. This helped establish a strong bond among patients and their doctors. While it might have intended to mean preventing expensive care, managed care began to mean […]
We live in incredible times. A time when a millennial with a YouTube account clears six-figures a year (sometimes, seven figures!) with just a computer and a webcam. A time when a small-town girl with a love of fashion and an Instagram account can go from Nowheresville, America to front row at New York Fashion […]
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated during a follow-up visit for systemic lupus erythematosus. She was diagnosed 3 months ago after presenting with pericarditis and arthritis. She was initially treated with prednisone, 40 mg/d, with improvement of her presenting symptoms. The prednisone […]
Altruism is killing us. Take a second to let that sink in. Truly think about it. Resist your conditioning to refute this claim and try to apply it to your life. Still having trouble? Let me try to explain. In order to understand the truly destructive force of altruism on medicine, one must first define […]
It’s a Sunday evening in a local South Texas emergency room with the expected ER traffic for a weekend evening. Lots of simple traumas: ankle sprains, abrasions, lacerations, falls, common URI symptoms, and fevers. The EMS radios in with a call of a five-year-old male who has altered mental status. The patient is brought in […]
Why does she work? It’s a question that she must answer, for it begs itself every time she picks him up from daycare. She always finds him happy there. And yet that — selfishly? — is part of what tears at her. Shouldn’t she be the one making him happy at 11 months? It’s more […]
I am frequently asked what I do at social gatherings. My response, naturally, is that I am a physician. The individual then asks what your specialty is and I respond that I am a board-certified family physician. Then, I hear, “Oh, you are a GP.” Really! After all these 35 years, I am perceived as […]
The initial doubts first surfaced mid-way through our flight bound for Montego Bay, Jamaica. In fact, we were not entirely sure that this trip was such a good idea after all. Our eldest son, 13 and in eighth grade, was already complaining about how much school he was missing and how much homework he had […]
Often a stay at home mom, like we have in our house, is not thought of as a contributor to wealth. Too often, only the person who “really” works and brings home an income is considered to be generating wealth. This is a case of incorrect thinking. The non-working spouse is a very big factor […]
