Musings of a Distractible Mind
Thoughts of an odd, but not harmful primary care physician.
I will be hosting Grand Rounds next week! I have been assured that my head won’t open up in the process. I hope not, as it would creep out my kids. So how am I going to do grand rounds this time? I am not going to tell, but I will promise the following: I [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.I guess I am no longer “old school.” In medical school I was repeatedly told of the importance the face-to-face encounter with patients, and how we avoid it at our peril. The physical exam, I was told, is neglected by the younger physicians in lieu of scans and studies. This, I was told, was a [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.I was talking to a patient a few days ago who was raving about a local grocery store. ”They get it,” she said. ”They understand how to take care of their customers.” It made me think about how far medicine has drifted away from the same idea. Ironically, despite the fact that our “customers” (people [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.One of the big changes recently in my practice has been the addition of preventive care visits for Medicare patients (more on this later). Of the greatest benefits has been the opportunity to talk about advance directives. Because of this opportunity, I have talked about it far more than than ever before. But because I [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.It’s great to be back to blogging. Part of it is that I just like to write, but a bigger part of it is that I am back among friends. My time away was fruitful in many ways, but one of my biggest regrets was to pull away from the blogging community – people who [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.I got dealt a hand of hearts this week. A mother brought her infant for a well-baby visit, and my heart leaped. Last I heard, she had such bad postpartum heart failure that the word “transplant” was being mentioned. Her heart “ejection fraction” (how well her heart was pumping) was reported as an impossibly low [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.Lipitor can destroy your liver. Back surgery can leave you paralyzed. People who take Chantix might kill themselves. You may never wake up from a simple surgery. These statements are all true. They also are very confusing to many of my patients when I am prescribing drugs or recommending surgery. What should they do when [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.I was recently posed with the question: “who do you work for?” Since I am self-employed (as part of a partnership), the easy answer would be to say I work for myself. That is not, however, what was meant by the question (and it would make a dull blog post if it was); the intent [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.My patient was angry, confused, and frustrated. He had transferred his care to me because I take care of his kids and he badly needed help with a terrible pain in his leg that wasn’t getting any better. He went to another doctor – an orthopedist – who predictably focused on the joint as being [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.
Llamaricks