My blog represents my personal experiences and perspectives. This includes many anecdotes from my life and from my medical practice. I have been scrupulous to anonymize all medical anecdotes and to avoid ever belittling or making fun of patients. (I often make fun of and criticize myself, my colleagues, and the institutions where I have worked.)
I am constantly amazed at how many smart people in medicine and in medical leadership or policy positions fail to grasp the difference between association and causation, and end up focused on a surrogate rather than the issue.
"We live in a society absolutely dependent on science and technology and yet have cleverly arranged things so that almost no one understands science and technology. That's a clear prescription for disaster." (Carl Sagan)
I have a message for my colleagues and co-workers: don’t let them Pick(er) on us.
The distinction between marketing and patient education can be very subtle. Or not.
In medical school, I was taught to TAKE a medical history in such as way that I didn’t MAKE a medical history.
At the time this seemed burdensome and inefficient, another of many unmeetable requirements whose justification was either ‘that’s how I was trained’ or ‘you’ll understand when you have more experience in medicine.’ Well, now I understand. And I no longer chafe (much) at the patience and work involved in letting the patient tell their story, in their own words, and largely at their own pace.
It was the summer before my last year of medical school and I was traveling around the US for family practice residency interviews. My wife and I were staying with some of her college friends while I looked at a program in Denver.
Leadership can focus on making sure everyone does their job. Or leadership can focus on making it easy for everyone to do their job. The former is more common, the latter is more effective.
I recently finished reading Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together by Peter Ubel, MD. It should be required reading for all the following...
In medicine, unlike much of the world, it is the questions one doesn’t ask that lead to trouble. When taking a medical history, the biggest enemies are time and fear. Time, because there is never enough to ask all the questions, listen carefully to all the answers, and pursue all the possible clues. Fear, because the natural reluctance to ask certain questions is a trap.
I was taught that being an asymptomatic carrier of strep in the throat was not associated with either illness or risk of complications. That’s not always true. The schedule said ‘strep throat x 5 weeks and diarrhea.’ Handing me the encounter form, my nurse warned me: ‘Mom’s not a happy camper.’