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

Article Comments

The cardinal sin of medicine?

An Emergency Medicine physician blogger calls laziness the “cardinal sin of

How did this quality achieve such status?
TrenchDoc explains:

Simple. It is the ONE thing that we as
physicians can control. We cannot prevent patients from smoking and driving
their minivans into light poles. We cannot help that patients have myocardial
infarctions without any symptoms whatsoever. We certainly can not force them to
take medicine or have routine checkups. We CAN however be careful,
double-checking and unassuming diagnosticians. I don’t mean by this that we
should order a whole boatload of tests on each patient… quite the contrary… I
mean we should SPEND THE TIME with the patient to find that one unlikely detail
that is the key to solving the problem.

Honestly though, being lazy, quick and
cheap are the easiest of sins to commit in our vaunted system. We pay
physicians in this country basically upon the number of procedures or the
amount of patients they care for per hour. Eventually, poorly directed
efficiency gives way to poor quality of care and to be honest, I am as guilty
as anyone when it comes to missing important clues from a patient.

In his blog post, TrenchDoc goes on to describe a terrible
case of a mentally disabled woman who fell out of an electric shopping cart at
a Value Mart.  She complained of severe back
pain and got every imaging study under the sun (which showed a normal
spine).  She was discharged from the
Emergency Department, only to be readmitted to another ED weeks later when her
pain was still too great to bear.  This
time she said it was her leg that hurt… take a look at the horrible fracture
she had that was missed at the first ED.

I have argued that one of the major causes of decreased
quality of care is reduced patient-physician interaction time.  We are so pressured to rush through our
history and physical that we often miss the diagnosis, furiously documenting
everything without mentally processing what we’re doing.

I agree with TrenchDoc’s call to spend more time with
patients, though time doesn’t come easily.
How do you think we can help physicians find more time to be with their

This post originally appeared on Dr. Val’s blog at

You may also like these posts

Read comments »

Comments are closed.

Return to article »

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 »