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Last Build Date: Sun, 23 Jul 2017 12:00:01 PDT

 



Doctor, we can’t read your writing

Sun, 23 Jul 2017 12:00:01 PDT

“Dr. Fraser, the pharmacy is on the phone for you. Line one.” I answer the call, pressing the gray, rectangular button with one hand while writing in a patient’s chart with the other. “Sarah Fraser speaking.” “Oh, hi, Doctor, we just got in a prescription of yours, but we are not quite sure what it […]



What can the U.S. learn from Dutch health care?

Sun, 23 Jul 2017 08:00:37 PDT

As an American internist and expatriate in the Netherlands, I still follow the unfolding U.S. health care drama. Critics of the Better Care Reconciliation Act (BCRA) are numerous, including doctors, patients, policy experts, and the former top U.S. health administrator — even President Barack Obama. The Dutch and other developed nations must be wondering (again), […]



Don’t call me “Mrs.” Call me “Doctor.”

Sun, 23 Jul 2017 04:00:46 PDT

My smile freezes on my face as my patient says to me, “I’m so glad you’re back – that I get to see Mrs. Lycette today!” He has been my patient for several years, and I am perplexed to hear him address me as “Mrs.” rather than “Doctor.” At the same time, I really do […]



He was fine when I discharged him, now he might die

Sat, 22 Jul 2017 16:00:04 PDT

It’s 1 a.m., and I’m afraid this guy is going to die. He’s gasping for air, hunched over a table as I poke his chubby back and try to find a rib. Oxygen is flowing through nasal prongs at six liters per minute, and it’s barely making a difference as his oxygen saturation hovers around […]



The problem of generic regurgitation

Sat, 22 Jul 2017 12:00:04 PDT

I spent 20 minutes listening to Michelle and asking her questions to understand why she was not taking her insulin as recommended. The appointment was for 15 minutes, 5 of which were used by the medical assistant who had to check the vitals and “do an A1c.” I did not ask Michelle whether her feet […]



Physician spouse speaks out against dangers of prescription opioids

Sat, 22 Jul 2017 08:00:12 PDT

The impact of the opioid crisis struck home within the Missouri physician community on Dec. 15, 2014. That’s the day when, just two months shy of his 30th birthday, Derek succumbed to an opioid overdose. The news was devastating for his mother, Kelly O’Leary, a longtime volunteer with the St. Louis Metropolitan Medical Society Alliance, […]



MKSAP: 25-year-old woman with type 1 diabetes

Sat, 22 Jul 2017 04:00:27 PDT

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman with type 1 diabetes presents to clinic requesting more information about use of a closed-loop insulin-delivery system (artificial beta cell). Although her HbA1c is at goal, she notes frequent hypoglycemia as an issue. In addition, she would like […]



Algorithms and detective work in medical care

Fri, 21 Jul 2017 16:00:20 PDT

Dr. Leon Pedell discusses algorithms and detective work in medical care. Courtesy of Before the Floors. Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.



The decline and fall of informed consent

Fri, 21 Jul 2017 12:00:14 PDT

Margaret Edson’s 1999 Pulitzer Prize winning play, Wit, tells the story of the final hours of Vivian Bearing, PhD, an English professor dying of cancer.  Early in the course of her disease, one of her doctors sees the value of her case from a research point of view and asks her to enroll in a […]



Residency as a series of mini-interventions against physician suicide and depression

Fri, 21 Jul 2017 10:00:11 PDT

They say you never forget your first crush. Or your first date. Or your first kiss. And you don’t. Just as we have landmarks events that shape us in the adolescence of our personal lives, physicians also have landmark events that shape them in the adolescence of medical training: residency. Continue reading ... Your patients […]



Health reform everybody could love

Fri, 21 Jul 2017 08:00:32 PDT

As our new president has said, health care is complicated. Republicans call for Obamacare’s repeal, but are hard-pressed to come up with a workable alternative. Democrats recommend improving Obamacare, but are largely silent as to how they would do that. Americans are caught in the middle of this apparent health care quagmire. But for America […]



Physicians must treat patients with the utmost respect with regards to their spiritual beliefs

Fri, 21 Jul 2017 06:00:42 PDT

Scientific evidence pointed to an extremely poor prognosis. Numbers and statistics emphatically declared her imminent demise. My 33-year-old patient was not going to survive. The physicians presented the data to the mother and recommended withdrawal of care, but she remained indecisive. She struggled for two days with the possibility of her young daughter dying. Her […]



Want a cure for physician burnout? Take care of yourself.

Thu, 20 Jul 2017 16:00:38 PDT

The recent celebration of Employee Well-being Month got me thinking a lot about how physicians are treated as employees with regard to well-being. There is a general consensus that the issue of physician well-being needs to be addressed at both the level of the individual physician and the level of the system in which physicians […]



We need a more comprehensive approach to investigating medical mistakes

Thu, 20 Jul 2017 12:00:04 PDT

From the wrong diagnosis to the incorrect medication, medical mistakes kill as many as 250,000 people annually in the United States — and injure thousands more. This figure could be much higher, considering there’s never been an actual count of how many patients experience preventable harm. We only have an approximate figure, which may indeed […]



Having a baby in a hospital? Here are 10 things you must know.

Thu, 20 Jul 2017 10:00:05 PDT

1. You might get sent home. If you show up pregnant with your first baby, and it turns out you aren’t 4 cm dilated yet, you will get sent home because you aren’t in active labor. Please don’t cuss out the charge nurse. Yes, you are in pain — we aren’t denying that. But, there are […]