Mea sententia

I made an extra trip to the nursing home to visit him on his hundredth birthday. 

Trust but verify (Doveryai no Proveryai) is a Russian proverb that underlies an important principle in medicine. We need to trust our patients, our tests and our knowledge - but must also always remember to check and verify.

Trust but verify (Doveryai no Proveryai) is a Russian proverb that underlies an important principle in medicine. We need to trust our patients, our tests and our knowledge - but must also always remember to check and verify.

They don’t. They are excellent tools for billing, which is what they are designed to do.

Recent debate about the new definitions of psychiatric conditions raises some interesting questions about the difference between normal in a natural sense and normal in a statistical sense.

I was in line, registering to have lab done in preparation for my coming annual physical, and the person in front of me asked if the lab would send her a copy of her result to her in addition to the ordering physician. 

Playing with my three year old granddaughter is teaching me to be mindful of whose world I am in, and to behave accordingly. 

In her world, she is the native and I am a tourist. The rules and customs are hers. Things go well when I can relax and let the native guide me. My attempts to impose customs or rules from my world on her world fail spectacularly. As they should.

I have written before of my belief that P4P as often practiced is unethical because it attempts to tilt the clinician away from shared decision making with an autonomous patient, and towards directed decision making serving the interest of the clinician or the institution.

In health care, replacing volume based economics with value based economics is essential.

One has to ask the right question in order to get the answer.

The chief complaint on the encounter form said ‘panic attack’ and a quick review of the chart before I entered the room showed a healthy 28 year old woman with no health or emotional issues who came in every year for a routine birth control visit. She told me she had had a ‘panic attack’ the day before and was sure there was nothing serious wrong, but came in at the insistence of a colleague. “It’s probably a waste of time, but Seeley made me promise to come.”