When I was a third-year resident, I was invited to join a practice owned by a doctor who had once been my chief resident. This was considered by all of my fellow residents to be the plum job in town, and I was thrilled. The doctor, whom I shall call “J…
Perhaps the most important aspect of a physician’s role is our diagnostic capabilities. Truly, if we cannot identify and diagnose a patient’s pathology with reasonable accuracy, we cannot effectively treat them and may even cause greater harm. Let’s lo…
To do the math right, you have to get your numerator and denominator correct, or else things just don’t work. Recently, in the midst of a large patient safety and quality improvement project trying to bridge gaps in breast cancer screening among …
I recently received a scathing email criticizing an article I wrote about the care of patients in underserved areas. “Should you really even get to write articles about poor, underserved populations when you run a concierge practice?” the author wrote….
Eye contact is one of the most basic mammalian traits that signals an interaction. Anybody who has a dog or cat at home sees on a daily basis how much animals value eye contact (and with dogs, it signals you’ve lost the battle!). In the case of health …
Often people (mostly residents and medical students) ask why on earth did I choose to do a geriatric fellowship? My response is because it is the medicine of the future. While we are all aging, the fastest growing age groups are those born between 1946…
Driving north in a snowstorm Tuesday of Thanksgiving week I certainly took my time. I left after our Suboxone clinic wrap-up conference, around 7:30 p.m., and arrived at my unplowed driveway in Caribou about 1 a.m. On the way up, I saw two ambulances, …
Years ago, I was contacted by a health plan about an elderly nursing home patient who had not been screened for osteoporosis. While brittle bones are a big problem in skilled nursing settings, the real problem for this health plan was its low HEDIS sco…
Several patients seen in our practice recently were significantly and dramatically transformed by the electronic health record (EHR). And not in a good way. Take, for instance, the patient whose outside chart was reviewed when she showed up in our offi…
I’ve huddled since before we used the word for it: You want to be prepared for the patients coming in that day. “Followup MRI” – did they have it and what did it show? “Ankle pain” – do we have X-ray today? “Eye pain” – be sure to check her acuity and …
