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Luddism And Internet-Based Medicine

My recent post on the subject of email from patients raised more eyebrows than I expected. It also put me in a position I’m unfamiliar with: Looking like a luddite.

Perhaps I’m not forward-thinking enough in my reluctance to embrace this advance. Perhaps I’ve gotten conservative as I’ve grown grey. Electronic communication is a great idea (I’m doing it right now), so why not apply it to my medical practice? Has Ned Lud gotten into my circle of influence?

This is, of course, extremely ironic. I lived so much on the cutting edge that my butt developed calluses. The calluses, however, were not just put there by the edge, they also came from occasional kicking.

The problem is I have an addiction: I’m addicted to change. I’m constantly looking for new and perhaps better ways to do things, then impatiently going after anything new and shiny. This served us well in the sense that I got us on EMR, got it working well, and have continued to keep us away from repeating mistakes too often. If something doesn’t work, I’m quick to look for the cause, and more importantly, how to fix it. Read more »

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

Sports Physicals For Kids: Why So “Ducky?”

Dear American Academy of Pediatrics,

I think there is a mistake. Kids have recently started coming into the office with forms for sports physicals, and the form is different. See below:

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Someone added stuff to the form! Not only do we have to continue the inexplicable obsession with the hernia check (for maximum humiliation of boys, we try to use only female examiners for this), there’s a bunch of new stuff. Read more »

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

“E-Visits” With Patients: For Greedy Doctors Or Not?

Dr. Wes (a cardiology blogger whom all should read) wrote a very compelling post about technology and the bondage it can create for doctors:

The devaluation of doctors’ time continues unabated.

As we move into our new era of health care delivery with millions more needing physician time (and other health care provider’s time, for that matter) –- we’re seeing a powerful force emerge –- a subtle marketing of limitless physician availability facilitated by the advance of the electronic medical record, social media, and smartphones.

Doctors, you see, must be always present, always available, always giving.

These sound like dire words, but the degree to which it has resonated around the Web among doctors is telling. Read more »

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

Anatomy 101: Are You Up To “Snuff?”

It’s time we get away from all of the serious nonsense and back to something I am far more comfortable with: Taking otherwise-useful information and twisting it into utter nonsense. Yes, it’s time to journey back to the wonderful world of the physical exam.

My ongoing mission is to explore the human body from my unique (albeit moderately unstable) perspective. For an overview of my previous posts on the physical exam see this post which features Dick Chaney on a Segway (reason enough to click on the link). Please visit a psychiatry blog to aid in recovery once you have done so.

My most recent post in this fine series covered the topic of psychics and about the examination of the hand. It was mainly about psychics examining the hand, but I did slip in a little doctor stuff to keep the cops off of me. But then I got a call from the department of homeland security and they said that if I didn’t shape up, I’d no longer be able to use the picture of Dick Cheney on the Segway. It’s hard to resist such harsh tactics. Read more »

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

A Doctor’s Feelings About Caring For “Abnormal” Kids

I’ve been practicing for sixteen years now, doing both internal medicine and pediatrics. One of the joys of that is watching kids under my care grow up and not having to give up their care just because they get older. The spectrum is wide, with some kids growing up in “normal” families with “normal lives,” others in “abnormal” families, and yet others with inherently “abnormal” lives due to illness or disability.

But the kids aren’t the only thing that has changed over the past sixteen years. Their doctor has changed as well. My comfort zones have widened, not getting rattled by “abnormal” as I once did. I used to feel uncomfortable with the mentally and emotionally disabled, now I am not. I used to feel sorry for parents with “abnormal” children. I used to feel bad for kids who were “abnormal.” I still do now, but not nearly as much. 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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