Mea sententia...

Mea Sententia translates roughly as 'My Opinion' and has been my intermittent blog since 2011. Much of my writing is about medical issues, but my topics range through philosophy, behavioral and decision making, management, humor, and personal/family anecdotes.


PCP pet peeves

Ask any primary care clinician for a list of pet peeves and one of the top three will be: “Doing my consultant’s work.”

Just to be clear, the overwhelming majority of specialist consultants DON’T do this. But some do it occasionally and a few do it as a matter of routine. Every time it happens, it rankles.

A few examples:

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The 'spam sign'

Obsessive compulsive disorder (OCD) is both familiar and common.  This week in the office, I came across a manifestation that I think warrants reporting. I call it the Spam Sign.

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The postcard relationship

I met Wes when were both counsellors at the same summer camp in Rhinebeck, NY. I had just graduated from high school and he was a graduate student, a gifted musician, and willing to help me find my way through a troublesome summer.

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Association, causation, and the worship of surrogates

I am constantly amazed at how many smart people in medicine and in medical leadership or policy positions fail to grasp the difference between association and causation, and end up focused on a surrogate rather than the issue.

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This can't end well

"We live in a society absolutely dependent on science and technology and yet have cleverly arranged things so that almost no one understands science and technology. That's a clear prescription for disaster." (Carl Sagan)



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Don't let them Pick(er) on you

I have a message for my colleagues and co-workers: don’t let them Pick(er) on us.

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Patient education? Or marketing?

The distinction between marketing and patient education can be very subtle.  Or not.

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In praise of the history

In medical school, I was taught to TAKE a medical history in such as way that I didn’t MAKE a medical history.

At the time this seemed burdensome and inefficient, another of many unmeetable requirements whose justification was either ‘that’s how I was trained’ or ‘you’ll understand when you have more experience in medicine.’  Well, now I understand. And I no longer chafe (much) at the patience and work involved in letting the patient tell their story, in their own words, and largely at their own pace.

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The interview tell

It was the summer before my last year of medical school and I was traveling around the US for family practice residency interviews. My wife and I were staying with some of her college friends while I looked at a program in Denver.

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Two kinds of leadership

Leadership can focus on making sure everyone does their job. Or leadership can focus on making it easy for everyone to do their job. The former is more common, the latter is more effective.


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