Today's thought

Advice is like snow - the softer it falls, the longer it dwells upon, and the deeper in sinks into the mind. Samuel Taylor Coleridge

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Mea sententia...

Dec 15, 2014

Meetings: a tool to create apathy

A physician friend commented recently that he was being ‘meeting-ed to death’ and wondered if it was intentional. It turns out, he was on to something.


Categories: Medicine

Dec 08, 2014

Chart review

Chart review is one of my occasional clinical responsibilities.  The charts I see overwhelmingly document good quality medical care. Last week I saw a chart that gave me pause. 

Categories: Medicine

Dec 01, 2014

Guinness Book of World Stupid

You can’t make this stuff up. I pulled into our local BJ’s gas station on a recent rainy morning. It was quite busy and I looked around for the shortest line to join, Seeing a woman in her early 20s who appeared to be finished fueling as she re-holstered the nozzle in the pump and returned to her car, I pulled in behind her, expecting to promptly be able to pull up and buy gas.  A car pulled in behind me, so I was now committed.

 

Categories: Humor

Nov 29, 2014

The perfect storm of discontent

A friend recently explained why he retired from a long and rewarding career in medicine and medical education, despite still loving his one-on-one interactions with patients. 

 

Categories: Medicine

Nov 22, 2014

The innovator's prayer

Words of wisdom…


Categories: Philosophy and ethics

Nov 15, 2014

Workplace Wellness Programs: sense or nonsense?

Workplace wellness and chronic disease management programs (now encouraged by the ACA) are quite common, but being a $6 billion dollar industry doesn't make them useful. Recent personal experience with one such program has led me to look more closely at the topic.

 

Categories: Medicine

Nov 08, 2014

Two very different cultures in medicine

Was the surgeon a princess, complaining about a pea under her mattress? Or am I a sheeple, accepting a woefully inadequate system? What do you think?

 

Categories: Medicine

Nov 01, 2014

The admission ticket

Why does the ‘chief complaint’ make me think about  pancakes and fig newtons? The chief complaint may just be an admission ticket.

Categories: Medicine

Oct 29, 2014

Is the patient always right?

Patient satisfaction has become a prominent goal in health care. Is this a good thing?

 

Categories: Medicine

Oct 22, 2014

The ice-pick headache

Categories: Medicine

Oct 15, 2014

Why I decided against pediatrics

I love children. I won’t claim to ‘understand’ them, but I am comfortable with them, and happy to work in their universe rather than asking them to be part of mine. I find them easy to work with. The ED nurses occasionally referred to me as the “child whisperer.” I am often asked by friends and colleagues why I did not become a pediatrician. 

 

Categories: Medicine

Oct 08, 2014

She thinks I'm real

As a child, I looked forward to the infrequent family outings that involved a restaurant. As the eldest of three, it gave me a chance to strut my stuff in front of my sisters: I was allowed to order without much interference, so it was a rare opportunity to have a cheeseburger, fries and the most chocolate item available for dessert. 

 

Categories: Medicine

Oct 01, 2014

When the improbable becomes inevitable

“Just keep doing tests. Eventually you are bound to find something.”  She was right, of course. But not in the way she meant.

 

Categories: Medicine

Sep 29, 2014

Infested...

After decades of hiking, camping, canoeing, kayaking and swimming in various back country environments, it finally happened. I have been colonized. Beaver fever, also known as giardiasis, caused by the protozoan Giardia lamblia.  Enjoying my metronidazole.

 


Sep 22, 2014

Stranger in a strange land

I find myself a stranger in a strange land, or (more prosaically) a square peg being forced into a round hole.

 

Categories: Medicine

Sep 15, 2014

Incrementalism and the status quo

I was recently told that ‘the problem’ underlying my often strained relationship with the institution where I work is that I am a revolutionary working in an institution committed to incrementalism.

 

Categories: Management

Sep 08, 2014

Quality goals and flipped priorities

What would you think if you received this message from management: “You can ignore chlamydia…it is not one of the quality goals for this year.” Or if you were told at a meeting to discuss a mandated quality initiative: “All you have to do to get credit for BMI screening is just click the box that says you will talk about it at the next visit.” (Both true stories.)

Categories: Medicine

Sep 05, 2014

Thanks for forty four...

Forty four good years, with more to come.  I’ll honor it with some words we started with…

 


Sep 01, 2014

Thoughts for Labor Day

I don’t consider myself a laborer, though I surely work very hard. I work because I love to.

 

 


Aug 29, 2014

Problems are not the problem

Having problems is not a problem.

Believing or pretending there are no problems, and then punishing or marginalizing those who want to fix the problems - THAT is a problem.



 

Categories: Management
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