First, do no harm. For physicians, these are hallowed words. Within religion, they are akin to the Golden Rule and are, in fact, quite similar. In the realm of ethics, Kant’s categorical imperative, to only do what you would have seen done universally …
Seven years ago, I vividly recalled a patient saying, “It needs to be as easy to schedule with you as OpenTable.” For most health care systems, this request is now a reality. Yet, how far has the restaurant metaphor moved into patient expec…
There is constant tension to remain on-time working in a primary care clinic, seeing patients every twenty minutes back-to-back. It takes an incredible ability for the front desk staff, medical assistants, and the physician to be able to keep this flo…
“So, the next step in the history taking process is to define the pain. You start this by asking for site, with questions like, “Where are you experiencing the pain? Can you pinpoint the site or is it more general? Does the pain radiate (spread anywher…
Currently, in America, there are only three legal groups of prescribers, the physicians (which include MDs, DOs, DPMs), the nurse practitioner (NPs), and the physician assistant (PAs). The first class of physician assistants, in 1965, was also the year…
“I wish this were not the case, but I am concerned that your disease is getting worse, and your time may be very short.” “I know you are angry and upset at how you were treated — I will do my best to make sure that does not happen again.” “I am s…
In medical school, physicians learn how to diagnose and treat medical conditions. We learn about all the different presentations and revel in catching a complex or rare diagnosis. In essence, we learn to categorize disorders based on a cluster of sympt…
During a particularly long stretch of being on call, of spending my days caring for patients, documenting in the EMR, and sleeping – I was spent. I felt like a horrible doctor. The blooper reel of my medical misadventures ran through my mind – th…
This is not the career path I set out to practice when I left medical school; in fact, it’s a career path that didn’t even exist. But after making a number of lifestyle choices this is where I find myself today. I am sitting writing this ar…
“What diagnosis do you want to use for those ear drops you sent on Mr. Johnson,” Jenn texted me. “ICD-L21.8 for seborrheic dermatitis?” Sigh. Welcome to prior-authorization hell. These are generic ear drops I ordered for presumed fungal infection of th…
