Medicine

The model of the expert physician making decisions for a compliant patient and giving orders to obedient nurses and technicians is thankfully disappearing, being replaced by a patient-centered team approach. 

The need for autonomy is one of the most basic and powerful intrinsic motivators of human behavior. One sees this in the plaintive cry so often heard in institutions, large and small:  Why Wasn’t I Consulted (WWIC)?

We all tend to confuse probability with uncertainty.  We shouldn’t.

It happens at least once a week: a patient who equates natural with beneficial. 

Two weeks into my third year psychiatry clerkship at the University of Rochester, I was summoned to the Dean’s Office to meet with Dr. Orbison.

One of the characteristics of a long medical career is the kaleidoscope of educational experiences one draws upon. This afternoon a three year old boy and his father benefitted from one of my early lessons, courtesy of Mary Mahotka, an x-ray tech in the Verona Family Practice Residency Clinic. 

He came in to discuss testing because he wanted medications as treatment for adult attention deficit disorder (ADD). 

This started out as my Ten Rules for Patients (to parallel my Ten Rules for the Primary Care Physician) but I just didn’t feel comfortable making rules for patients.

Clinicians like making the diagnosis of strep (streptococcal) throat (and patients hate being told they have a viral sore throat) for the same reasons: a belief in the ability of antibiotics to shorten the illness and prevent serious complications That’s what we doctors were taught, and that’s what we’ve taught our patients. How justified is this belief?  Well, there are problems.

Sometimes the answer comes from an unexpected place, and only after we stop looking.