You ever wonder what doctors really think but are afraid to say out loud? Here’s one example:
“I wish all my patients were on a ventilator”
There’s a reason vented and sedated patients are considered desirable. In addition to the obvious economic benefits of
There are the less talked about, but equally pleasant side effects most hospitalists, ER doctors, cardiologists, gastroenterologists, pulmonologists, surgeons, infectious disease doctors, endocrinologists, psychiatrists, rheumatologists, dermatologists, nurses, respiratory therapists and physical therapists wouldn’t admit, but would agree, without hesitation. As a general rule:
- Patients on ventilators are just faster, easier and more pleasant to take care of. Read more »
*This blog post was originally published at The Happy Hospitalist*
I believe that those controlling the purse strings are steering modern medicine towards the practice of seeing patients more as the sum of their medical problems than as individual people. Patients have become streams of data as opposed to real human lives.
Consider the dynamics of a family: a wife may worry about her husband while their child adores a father she instinctively knows to be irreplaceable. Modern medicine, however, may only see a diabetic with hypertension and a cholesterol-level running too high. The computers programmed for those advocating the power of data to revolutionize medicine would boil this man down to his “meaningful” essence — numbers, for the above imaginary man: 250.00, 401.0, and 272.0. Read more »
Most experienced physicians expect uncertainty in caring for real people with average everyday problems. Yet those inexperienced or uninitiated in medicine tend to see the practice of medicine as exact or even absolute.
I remember waiting in vain as a medical student and resident for my instructors to illuminate a path towards certitude. Instead, I was given something far more real and lasting: An acceptance of the indeterminate mixed with the drive to be compulsive on behalf of my patients.
During my internal medicine internship, I remember a more-senior resident during our daily morning report bemoaning her uncertainty by saying, “But I just don’t know what’s wrong with my patient.” Although she was visibly upset, our program director’s reaction to her comment bordered on amusement, culminating with, for me, an unforgettable response: “Well, you certainly have chosen the wrong profession.”
Read more »
A recent JHM study found that hospital staff often don’t recognize cognitive impairment in patients age 65 and older. This was especially true for patients on the younger end of the spectrum, and those with more comorbidity.
Of the 424 patients (43%) in the study who were cognitively impaired, 61% weren’t recognized as such by ICD-9 coding. Interestingly, there was no significant difference between patients with documented and undocumented cognitive impairment as far as mortality, length of stay, home discharge, readmission rates, incidence of delirium, or receipt of anticholinergics. One troubling finding: a significant number of patients with cognitive impairment received anticholinergic medication, even though it’s not recommended for patients with any type of CI. Read more »
*This blog post was originally published at ACP Hospitalist*