Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Family Practice, Internal Medicine, and General Practice: What’s The Difference?

I get mail, this from a healthy 20-something reader who’s just moved to a new city:

What’s the difference between doctors listed as Family Practice, Internal Medicine, and General Practice?  Also, what are some things I should consider (that I might not already be considering) when finding a primary care physician?

That’s a bit of a loaded question, not because of any bias of mine (perish the thought!) but because each of those terms is used in different ways, by different people, at different times, for different purposes. So here’s the rundown on each of them in turn.

Family Practice

What it’s supposed to mean: Designates a physician who has completed a three-year postgraduate training program in Family Medicine, trained to provide primary care to patients of all ages, presenting with conditions of any organ system, including care of acute conditions and ongoing management of chronic diseases.

What doctors hope people think it means: Read more »

*This blog post was originally published at Musings of a Dinosaur*

Revisiting the Intern Survival Guide

I wrote this post a long time ago when I first started blogging. I’m recycling the post because this information bears repeating. I’ve been seeing some behavior lately that is inappropriate, and I’m telling you this stuff for your own good. Please, never roll your eyes at a nurse who is old enough to be your mother. She may be going through menopause, and it could be the last thing that you ever do. Just sayin.’ Don’t make waves at the nurses station.

I worked as a neurosurgical nurse many years ago at a teaching hospital in the Midwest, and twice a year a new crop of interns descended upon our unit. It was the best show in town. The spectacle began with the chief of neurosurgery, Dr. Holier Than Thou, strutting on to the unit with his entourage marching behind him. He stood before the crowd in his impeccable white lab coat, telling everyone within earshot of his importance, and how he held the power of life and death in his hands. I would sit at the nurses station and snicker at the biannual parade, and remembered my first day in the hospital as a nursing student. Two interns had asked me to go into a patient’s room to get a set vitals signs. They didn’t tell me that the patient was cold, stone dead. I walked into the patient’s room, saw the dearly departed, and calmly walked back to the nurses station to find the interns laughing their fannies off. I told them they were going to make damn good doctors one day, but first they had to learn what rigor mortis looked like. Nonetheless, because every new group of interns looked like lambs being lead to slaughter, I pitied them, and I gave them information to use as a survival guide. These are the rules I taught them about working with nurses.

1) Nurses deserve respect. We are with the patients twenty-four hours a day, seven days a week, while doctors are only able to see patients a few minutes a day. Smart interns forge alliances with the nursing staff, and understand that nurses can save their butts when something goes wrong with one of their patients.

2) Don’t take the last piece of pizza in the nurses lounge unless you are invited to do so. Nurses are territorial about food.

3) Nurses do not tolerate interns with a budding God complex. Nurses have no problem calling arrogant interns every hour on the hour for Tylenol orders, especially at night. Arrogance breeds contempt.

4) Don’t be stupid. If you want to complain about nursing care, be careful when you approach a nurse who is working the last half of a double shift. Refer to rule #3.

5) Nurses are your friends. We want to see you succeed, and if we like you, we will make sure that Dr. Holier Than Thou doesn’t find out that you order Demerol 1000 mg, instead of 100 mg, IM q 4 hours PRN because you were dead on your feet after being on call for three days in a row.

*This blog post was originally published at Nurse Ratched's Place*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »