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The Flu Vaccine: A Break Up Letter

Dear Influenza Vaccine:

I am sorry to be so formal, but using your pet name, “flu shot”, doesn’t seem appropriate in a letter like this.  I am also sorry to be writing this letter; I don’t want you to be hurt and I don’t want others to think bad of you.

I just don’t love you any more and want out of our relationship.

Don’t get me wrong; I still think you save lives.  You are strong, noble, and deserving of appreciation.  You give to my patients what I seek to give them: a longer life with less sickness, and you do so without much cost.  I will never think badly of you in that way.  I even want to continue meeting with you every year.  I don’t want to lose touch.

But things have gotten hard for me.  You give so much to others, yet you make my life so very hard.  I never know how many people will want you, and yet I have to order you six months or more in advance.   Read more »

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

When Bad News Surprises Us

It’s that part of the job that I’ve never gotten used to.  I hope I never do.

I saw a man recently with an unexpected finding on his exam – a “lesion” that should not have been there.  I was seeing him for his diabetes and blood pressure, and was doing my “ritual” physical exam, when the “lesion” blared into my vision.

I say “ritual” exam because the exam itself had little to do with his medical problems.  It is just my practice to do a cursory  exam of the head, neck, chest, and lungs of most everyone who comes to the office.  I guess it’s the “laying on of hands” part of the practice of medicine that makes me do this; there is something about the human touch that makes a doctor’s visit different from a visit to the accountant. Read more »

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

Top 10 Ways Doctors Annoy Patients

Someone suggested I was being mean or making fun of patients in my previous post. Those of you who read this blog regularly (aside from needing serious psychiatric evaluation) are aware that I am quite sympathetic of my patients’ position in this relationship.  Mine is a position of power, while they are coming to me with an admission of weakness.  There is no doubt that I would rather sit in the doctor’s chair than that of the patient – and that’s not just because my chair has wheels on it.

My intent in writing this blog is to show the doctor/patient interaction through the eyes of a physician – a perspective most people don’t get very often.  Even though I have lots to be thankful for in my profession, I still have things that regularly annoy me.  For me to voice that annoyance in a light manner is meant to both educate people of my perspective, and entertain those who share it.

Enough of that.  Now it’s time to move on to the strategies we physicians use to get back at patients for their shenanigans.  You may not realize it, but we have a special class in medical school dedicated solely to the ways to annoy and embarrass our patients.  It’s an art, really. Read more »

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

Ten Ways to Annoy Your Doctor

Top 10 lists are back!

I forgot about this kind of post, and a reminder by a reader is bringing them back.  They are really a fun and easy kind of post to write, so you may see a fair number of them (read: Rob is getting lazy).  I thought I’d start back with some suggestions for disgruntled patients (or gruntled ones, for that matter) to make their doctor’s day much worse.

1.  Require the doctor to keep things secret from your child or your elderly parent. Insist that they can’t know about their cancer, depression, ADD, or foot fungus.  Call the medication the doctor prescribes “vitamins.”  Alternatively, you can threaten your child by saying that if they don’t behave better, the doctor will give them a shot. Read more »

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

Using ICD-9 Codes To Describe Your Morning

PLACE OF OCCURRENCE, HOME ICD-E849.0

6:00 AM

Alarm goes off.  Hit snooze button. CIRCADIAN RHYTHM SLEEP D/O IRREG SLEEPWAKE TYPE ICD-327.33

6:30

  • Alarm goes off for third time.  Ready to hit snooze button, but knee in ribs from wife prevents more snooze button procrastination.  CONTUSION OF CHEST WALL ICD-922.1, ADULT MALTREATMENT UNSPECIFIED NEC ICD-995.8
  • Feeling tired, go to make a pot of coffee. CAFFEINE ADDICTION ICD-304.40
  • Fill bowl with Lucky Charms and start eating. UNSPECIFIED NUTRITIONAL DEFICIENCY ICD-269.9, HYPERGLYCEMIA ICD-790.29

6:45

  • Realize that coffee pot needs to be turned on for it to make coffee. ATTENTION DEFICIT DISORDER, ADULT ICD-314.00, LISTLESSNESS ICD-780.79
  • Read more »

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

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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