April 20th, 2011 by Dr. Val Jones in Humor, True Stories
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Every once in a while we physicians make an astute (or perhaps lucky) observation that becomes a turning point in a patient’s life.
I’ll never forget the time that I placed a hand on an elderly woman’s belly after she said that she felt a little bit dizzy – the pulsatile abdominal mass that I discovered set in motion a cascade of events that resulted in life-saving surgery for an disecting abdominal aortic aneurysm (AAA). It was incredibly gratifying to be involved in saving her life – and now anyone who so much as swoons in my vicinity gets a tummy rub! (Yes, Dr. Groopman I know that’s not necessarily a rational response to one lucky “exam finding.”)
Last week I made a fortunate “catch” on the order of the AAA discovery from years ago. I was giving a close friend of mine a hug (he’s significantly taller than I am) when I noticed that his heart was beating rather quickly through his shirt. I instinctively grabbed his wrist to check his pulse, and voilà – it was irregularly irregular. My friend had new onset atrial fibrillation – and although he was initially resistant to my idea of going straight to the ER, I eventually convinced him to come with me. An EKG confirmed my clinical diagnosis, and blood thinners (with Pradaxa) and a rate control agent were administered. He will undergo cardioversion in a couple of weeks. We were both relieved that our intervention may well have averted a stroke, heart failure, or worse.
My peers at the hospital have been poking fun at me for my hug diagnosis, and my reputation as the “hug doctor” now preceeds me. I continue to protest that I do know how to use a stethoscope – but alas, there have been more requests for stat hugs from me than cardiopulmonary exams.
I don’t know if I’ll ever be able to top this clinical diagnosis, but a life of trying to find my next case of atrial fibrillation through hugging will likely make a few people smile.
April 20th, 2011 by DrRich in Health Policy, Opinion
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For some time now, numerous loved ones and dear friends have been advising and occasionally urging DrRich that, perhaps, it has become a bit inappropriate, and even unseemly, for him to continue in his longtime position as President and sole member of Future Old Farts of America (FOFA). For a not unsubstantial interval DrRich ignored this advice, feigning incipient deafness. But finally, after some focused study of that which these days returns his gaze in the mirror, and reluctantly concluding that maybe his loved ones have a point (and not wishing to seem Cranky), DrRich has reluctantly decided to resign from (and therefore disband) FOFA.
DrRich is pleased to announce that he has accepted a new position as President and sole member of Glorious Old Farts of America (GOFA).
And it is in this new capacity that DrRich has become alarmed at some of the dire warnings now being sounded by respected leaders of the Democratic Party, to the effect that the Republicans’ proposed federal budget for fiscal year 2012, released last week by Congressman Paul Ryan (who serves, DrRich believes, as Deputy Whippersnapper of the House Republican caucus), proves that Republicans are trying to kill old people. Read more »
*This blog post was originally published at The Covert Rationing Blog*
April 20th, 2011 by BobDoherty in Health Policy, Opinion
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According to some state legislators, the answer is yes. Lawmakers in South Carolina are pushing legislation that would “make it illegal to transport immigrants anywhere, including a hospital” reports the New York Times. Fox News Phoenix reports that in Arizona, a bill has been introduced to “require hospitals, when admitting nonemergency cases, to confirm that a person seeking care is a U.S. citizen or in the country legally. In emergency cases where the patient isn’t here legally, the hospital would be required to call immigration authorities after the treatment is done. Hospitals in non-emergency situations would also be required to contact federal immigration authorities, but they would have more apparent discretion about whether to treat illegal immigrants.”
Such ill-advised efforts by states to criminalize health care for undocumented persons has led the American College of Physicians, the nation’s second largest physician organization, to speak out against “Any law that might require physicians to share confidential information, such as citizenship status to the authorities, that was gained through the patient–physician relationship conflicts with the ethical and professional duties of physicians.” ACP made this statement in a new position paper on immigrants’ access to health care released yesterday at its annual scientific meeting in San Diego, California. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
April 19th, 2011 by Nicholas Genes, M.D., Ph.D. in Opinion
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Reading the ER Stories blog is often a guilty pleasure for me. Today’s post, however, struck a nerve:
Very often I ask patients about their recent visits to other doctors. While I am taking a history, it’s important for me to know if you’ve recently been seen by another provider for the same or similar complaints and what they did, what they diagnosed you with, what they prescribed, etc.
I often get a kind of irritated response such as “Oh, he didn’t do anything” or “he said it was nothing” or “he didn’t say anything to me”. Although I know my share of layzee doctors, I bet the vast majority of times, the doctor DID do something and DID say something.
Just not what the patient either wanted to hear or that their perception or comprehension was wrong. …
… Now, maybe he is not a good communicator. Maybe he doesn’t have the time to sit there and explain the pathophysiology of viruses or something like benign peripheral vertigo – and thus you feel short changed. After all he “just asked me a few questions, listened to my lungs and told me to go home and rest”.
Early on in my training I was fortunate to be taught that proper communication is the responsibility of both doctor and patient. So when a patient shows up in my ED and says their last doctor “did nothing” — when I can see with a few clicks that they got labs, a CT, and two prescriptions — well, there’s a failure to communicate. And the other doctor carries at least some of the blame for this. Read more »
*This blog post was originally published at Blogborygmi*
April 19th, 2011 by Michael Kirsch, M.D. in Health Tips, True Stories
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Your humble Luddite Whistleblower has leapt across the sea to reach the Isle of Technology. I now own and operate an iPhone, which identifies me as groovy, hip and cool, three adjectives that none of our 5 kids ever use to describe their technophobic father. I’m told that my text messages are too long and too frequent. I am admonished that it is not necessary for me to photograph moments of high drama, such as a kid eating breakfast, and then to disseminate the image to my contact list. I am reminded often that I am slow to grasp the mechanical intricacies of the device, such as switching from ring to vibration mode.
You may wonder how it was possible that I, who consider using an ATM to be a high level computer operation, could make the iPhone, my phone. I knew I couldn’t fail, despite my trepidation of all things cyber. I had a secret weapon, a ‘Plan B’. Actually, I had Plan Z, the most powerful asset that anyone in my situation could hope for. Z stands for Zachy. One sentence will explain all and may provoke screams of envy from those who have no available similar resource. Read more »
*This blog post was originally published at MD Whistleblower*
