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The Stories In Medicine That Need To Be Told

I can’t help but think that as time passes we’ll forget about how much medicine has changed with the introduction of the Internet.  We’re witnessing a transition that hasn’t been seen in generations.  We live with the end result but the memory of how we got here is fading quickly.  Like any kind of cultural shift, once we’ve arrived it’s hard to remember what it was like along the way.

How did patients think before the information revolution?  And how did it go down when patients began to search?  How specifically did information clash with the old model of doctor and patient and how did we deal with it?  There are stories here that need to be told.  I think the real stories are in the small details of what went down between doctors and patients. But as early adopters, most of us spend our time looking forward, not back. Read more »

*This blog post was originally published at 33 Charts*

The Age Of Medical Disconnect

It’s the age of medical disconnect.

The disconnect describes the emotional and intellectual detachment that physicians feel from their patients and patients from their doctors.  This disconnect is the result of a confluence of factors, some from within the profession itself, others are more broadly social and economic.

To understand the disconnect you need look no further than your neighbor or your parents.  Dissatisfaction is evolving as the norm.  Patients feel increasingly marginalized in their experiences with physicians.  Shrinking length of visits, indifferent attitudes, poorly coordinated evaluations, difficulty obtaining test results, an institutional feel to the patient experience, and the overall sense of not feeling at all important.

The truth is that many of us are really not aware of the disconnect. Most of us have been born into a system of dysfunctional provider relationships and we know nothing else.  As physicians we’ve been trained to be detached.  As patients we’ve been conditioned to live happily detached.

Of course there are plenty of physicians who Read more »

*This blog post was originally published at 33 Charts*

Advice For New Doctors

It’s the cusp of a new medical year and there’s no shortage of advice on how to succeed as a house officer.  The White Coat Underground and Wes Fisher will put you in the right direction.  And I love Mary Brandt’s Advice for New Interns.

But just a couple of more points to keep in mind:

Keep your options open.  Medicine is changing quickly.  You’ll start your career training as a 20th century doctor and retire in a place none of us can imagine.  Your ultimate success will be determined by your ability to adapt to a shifting foundation.  Keep an open mind.

Quiet your fingers.  You are the first generation to have publication tools that make it dangerously easy to breach your patient’s trust.  Keep their business off the public forums.  Better yet, find a way to apply all this wonderful technology to really move the chains forward. Read more »

*This blog post was originally published at 33 Charts*

Physicians And The Evolution Of Twitter

There’s a temptation to think of Twitter as it once was.  As recently as 3 years ago there were very few physicians using Twitter.  Early physician adopters enjoyed a tighter experience than today.  Everyone followed everyone and actually finding another doctor was cause for celebration.  It was a cocktail party – less a tool as much as a place to goof off.  It was easier in many respects.

But Twitter seems to be evolving from a curious toy to a more focused space of sharing among the like-minded.  I see new docs play out this broader evolution of Twitter:  near obsessive early preoccupation gives way to the question of how it can actually work for them.  Experimentation with relationships gives way to connections that are more likely to give us what we really need.

We’ve hit a point where many physicians on Twitter are looking beyond the cocktail party.  There are simply too many of us.  As a consequence of nothing other than our numbers, we’re increasingly divergent.  Values, interests, and motivations vary – we gravitate to the like-minded.  In some respects Twitter’s evolving practicality is a good thing.  But it comes with a cost.  I don’t know how and if it can be countered.

As much as Twitter is different now compared to 3 years ago, don’t get used to it.  Things never stay the same.

*This blog post was originally published at 33 Charts*

The Boundaries Between Doctor And Patient

This post from Kelly Young on Howard Luks’ blog asks when patients cross the line with respect to their own advocacy.  It’s worth a peek.

The question of boundaries between doctor and patient is interesting.  All of my patients are empowered in some way.  The extent and level of that empowerment is personal.  On our own there are few lines and little with respect to boundaries.  We have effectively unlimited access to information and resources.  And how far we go to look after ourselves and our kids has few limits.

But when we enter into a relationship with a provider, we’re no longer alone.  It’s unreasonable for a provider to tell a patient Read more »

*This blog post was originally published at 33 Charts*

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…

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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…

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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…

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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…

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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…

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