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Posts tagged doctor

If you had to write a prescription for balance for your patients, what would you include?

Greater effectiveness at work? More time to play? Better relationships with others, as well as his/her self? Or all of the above? Like other prescriptions, a prescription for balance is not “one size fits all” but a customized approach that is based on ambitions, goals, circumstances, and preferences.

As the term “work-life balance” is used more frequently in healthcare these days, what does it really mean for you?

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This is the age of intellectual democracy. In a frightening departure from millennia of human tradition, everyone is now an expert in everything. Turn on the television or surf the Internet. We somehow believe that polls of individuals are useful for guiding policy, in everything from international politics to morals and religion. Legislators and marketing experts trust this information, as if masses of humans had extensive experience in diplomacy and warfare, in economics and federal tax structures, rather than what so many do have expertise in; video games and the accumulated out-takes from American Idol.

It’s especially odious in the world of medicine. How many times do we argue with patients that they don’t need an antibiotic or x-ray, admission or laboratory test? A family once skeptically asked me to show them the x-ray I had taken of their child, who swallowed a coin. Once they saw it, they were satisfied that I hadn’t missed anything. They weren’t radiologists, but they were experts. Because any idiot can be a physician, right?

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All these stories are borrowed (and cleaned up, which is my contribution) from the forums over at SDN.

They’re just too good to pass up…

1. Never, ever leave flashlights, beer bottles or any other long, circular object on the floor because someday you will fall on it… and it will somehow impale its way up your rectum.
2. Always do woodwork with your skill saw before using meth.
3. White latex paint, despite being luxuriously thick and creamy, does not coat your stomach and provide relief like pepto bismol does.
4. If you have taken 7 home pregnancy tests, and they’re all positive, when you come into the emergency department… chances are our test will come back positive too.
5. If you are given a prescription for narcotics, at least have the courtesy of leaving the lobby before you try to sell the pillz.
6. Drinking diluted Pine Sol with 5 friends is not a good way to get drunk.
7. When attempting self-circumcision, do not use dry ice to numb the area. As a corollary, when the dry ice sticks to your parts, do not attempt to remove it with boiling water.
8. When stealing a prescription pad, please fill it out correctly before turning it into the pharmacy. They know something’s up when you write for “1.2 pounds of morfeen x 1000 refills”
9. Carefully weigh your options before inserting a toilet brush wrapped in duct tape and saran wrap into your rectum and breaking off the handle. There are better ways to spend your Saturday afternoon.
10. When your 15 year old daughter gives birth to a bleating, underweight infant 30 minutes after presenting with “gas pain”, try not to run around the ED loudly proclaiming, “I don’t know what y’all did or who that baby is, but my lil’ girl warn’t pregnant when she come in here!”

I’m a doctor, and I’m damn good at it. Why? Because I learned to be a doctor the old-fashioned way: gumption, elbow grease, and trial and error. I’m not one of these blowhards in a white coat who’ll wear your ears out with 10 hours of mumbo-jumbo technical jargon about “diagnosis” this and “prognosis” that, just because he loves the sound of his own voice. No sir. I just get the job done.

….

You want to know where I got my doctor’s degree? At the Medical School of Hard Knocks, that’s where. No matter what they say, advanced graduate studies won’t teach you when somebody needs a shot of whiskey. Yale and Harvard don’t tell you when to throw a bucket of water on a patient. And they can never teach you how to tell when someone just needs a good solid punch in the nose to bring them around.

…

Jesus, you ever look at one of those scans? They’re just a lot of crazy shapes. The only sure-fire method for figuring out what’s inside a man’s body is to go in there and take a look for yourself. And if you want to put a shunt or a valve into a person, you don’t rely on gimmicks like tubes and syringes. You get your hands a little dirty, you open them up, and shove it right in there where it belongs.

Read more at: The Onion

(Source: drjeff)

Every physician I have spoken with recently has smiled and nodded in understanding when we talk about our wonderful patients and their adventures with the Internet. There is an emerging phenomenon where folks are showing up in medical offices across the country locked and loaded with endless streams of data they’ve managed to retrieve from the Internet in their pursuit of answers — where did these red spots on my tummy come from; what does this persistent cough mean; what do you mean oatmeal doesn’t lower cholesterol? These Internet interludes result in what I refer to as the “Internet Printout Under the Arm” sign. As soon as we enter the consultation room, the patient will whip that wad of wisdom out from their armpit, and then there are three of us in the room — the patient, the physician and the Internet.

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With knowledge comes responsibility, and while physicians have insight into the inner workings of the human body and how it responds to disease (more than just a neat party trick), they’re also charged with using that information to make sure they don’t miss the cardinal signs of problems that can lead to the rapid deterioration of a patient.

In our classes we learn about a number of problems that are slow to progress - important to catch but not immediately threatening to life or limb. But as we go through our training, once in awhile we’ll learn about the classic presentation for a problem which, if missed, will result in the patient dying or being seriously disabled within a relatively short period of time, and the physician being in serious trouble if they had the opportunity to catch the problem early but didn’t.

Whenever these come up I try and make a mental note of them, mostly because I don’t want my patients to suffer because of a preventable error on my part.

I’ve racked my brain for what appear to be some of the common ones, most of which I had never heard of before starting medical school. Coming in, most of us already knew that chest pain that radiates down the left arm and up to the chin could be a myocardial infarction (medical speak for heart attack), which usually comes up in first aid classes. On the other hand, I never realized that green vomit could be the sign of something quite ominous, or that what might seem like a minor bump on the head needs swift medical attention.

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The debate over whether there really is a physician shortage is starting to heat up.

A commentary in CNN makes the argument that we don’t need more doctors, instead primary care should be shifted more to nurse practitioners:

However, we submit that these actions lead us in the wrong direction, and there is, in fact, no doctor shortage — as long as we accept the fact that health care can work differently, and better than, the current system.

What’s your take on this issue?

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