Mea sententia...

Communication failure

George Bernard Shaw said: “The single biggest problem in communication is the illusion that it has taken place.”  

Ignorance and black cats

Science is not a linear or predictable path to truth.

When the doctor is biased

recent commentary in the New York Times eloquently addressed the phenomenon of psychiatric diagnoses biasing clinicians and resulting in poor care. One concern that arose in the comments was that this might increase the likelihood that patients would withhold crucial diagnostic and therapeutic information, to their detriment. 

Wisdom of a centenarian

I made an extra trip to the nursing home to visit him on his hundredth birthday. 

Trust but verify

Trust but verify (Doveryai no Proveryai) is a Russian proverb that underlies an important principle in medicine. We need to trust our patients, our tests and our knowledge - but must also always remember to check and verify.

Trust. But verify.

Trust but verify (Doveryai no Proveryai) is a Russian proverb that underlies an important principle in medicine. We need to trust our patients, our tests and our knowledge - but must also always remember to check and verify.

Why do EHRs suck?

They don’t. They are excellent tools for billing, which is what they are designed to do.

One reads and hears many conversations about the poor quality of EHRs (electronic health records) from the perspective of patients and their clinicians. These discussions often go to great lengths to describe the short comings of these expensive and complex tools, but rarely spend much time talking about why they are so dysfunctional.  It’s not hard to figure out. Follow the money

In praise of diversity

Recent debate about the new definitions of psychiatric conditions raises some interesting questions about the difference between normal in a natural sense and normal in a statistical sense. As I read through the DSM-5, it seems to me that it reflects the regrettable and increasingly destructive tendency to demonize eccentricity and mislabeloutliers as pathologic.

Lessons from a granddaughter...

Playing with my three year old granddaughter is teaching me to be mindful of whose world I am in, and to behave accordingly. 

 

In her world, she is the native and I am a tourist. The rules and customs are hers. Things go well when I can relax and let the native guide me. My attempts to impose customs or rules from my world on her world fail spectacularly. As they should.

The panic attack

One has to ask the right question in order to get the answer.

The chief complaint on the encounter form said ‘panic attack’ and a quick review of the chart before I entered the room showed a healthy 28 year old woman with no health or emotional issues who came in every year for a routine birth control visit. She told me she had had a ‘panic attack’ the day before and was sure there was nothing serious wrong, but came in at the insistence of a colleague. “It’s probably a waste of time, but Seeley made me promise to come.”

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