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Failure For A Doctor

I went to a patient’s funeral this past weekend. I generally don’t do that for people whose relationship I’ve built in the exam room. It’s a complex set of emotions, but invariably some family member will start telling others what a nice doctor I am and how much the person had liked me as a doctor. It’s awkward getting a eulogy (literally good words) spoken about me at someone else’s funeral. This patient I had known prior to them becoming my patient, and his wife had been very nice to us when we first moved here from up north.

But that’s not why I am writing this. As I was sitting in the service, the thought occurred to me that a patient’s funeral would be considered by many to be a failure for a doctor. Certainly there are times when that is the case — when the doctor could have intervened and didn’t, or intervened incorrectly, causing the person to die earlier than they could have. Every doctor has some moments where regrets over missed or incorrect diagnosis take their toll. We are imperfect humans, we have bad days, and we don’t always give our patients our best. We have limits. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

“Team Care” In The Patient-Centered “Medical Home?”

“Team care” has become a rallying cry for those who think the patient-centered medical home is bad for healthcare reform. Comments on a recent blog post in the New York Times provide a good example of this. When patients get sick, as the argument goes, they want to see their doctor — not some nurse or PA who they don’t know. I agree.

There are a whole bunch of things wrong with all the current focus on team care in the patient-centered medical home. Read more »

*This blog post was originally published at Mind The Gap*

8 Things You Shouldn’t Keep From Your Doctor

It’s important to have an open relationship with your primary care physician because the more he or she knows about your health and lifestyle, the better able he or she is to diagnose illnesses as they come up.

You wouldn’t take your car to a mechanic and not tell him that the brake is sticking, and a human organism is thousands of times more complicated than a car. But patients are shy. They’re embarrassed. They don’t want you to think badly about them, so they often leave out important information that’s critical for the physician to know. Read more »

*This blog post was originally published at EverythingHealth*

Is “Minimally Disruptive Medicine” An Emerging Field?

I recently stumbled onto the “Minimally Disruptive Medicine” blog maintained by Dr. Victor Montori from the Mayo Clinic. I have to admit that the name caught my attention so I scoped it out.

According to Dr. Montori, “minimally disruptive medicine refers to the practice of medicine that seeks to design effective treatment programs for patients while minimizing the burden of treatment.”  He describes this as an emerging field.

I have to admit that I was simultaneously puzzled and intrigued. After all, how is this different from the way good medicine is practiced? I, for one, like to think that I create individually-tailored programs that meet my patients’ needs while minimizing their treatment burden. Read more »

*This blog post was originally published at 33 Charts*

I’m Your Doctor, And I’m Worth It

Rx Vending MachineI saw the note on the patient’s chart before I opened the door: “Patient is upset that he had to come in.”

I opened the door and was greeted by a gentleman with his arms crossed tightly across his chest and a stern expression. I barely recognized him, having only seen him a handful of times over the past few years. Scrawled on the patient history sheet in the space for the reason for his visit were the words, “Because I was forced to come in.”

My stomach churned. I opened his chart and looked at his problem list, which included high blood pressure and high cholesterol –- both treated with medications. He was last in my office in November — of 2008. I blinked, looked up at his scowling face, and frowned back. ”You haven’t been in the office for over 18 months. It was really time for you to come in,” I said, trying to remain calm as I spoke.

He sat for a moment, then responded with very little emotion. “I’m doing fine. You could’ve just ordered my labs and called in my prescriptions. I don’t know why I had to be seen.” Read more »

*This blog post was originally published at Musings of a Distractible Mind*

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