My blog represents my personal experiences and perspectives. This includes many anecdotes from my life and from my medical practice. I have been scrupulous to anonymize all medical anecdotes and to avoid ever belittling or making fun of patients. (I often make fun of and criticize myself, my colleagues, and the institutions where I have worked.)
Overheard this week at a conference: “Progress doesn’t come because you work hard to sell your creative new ideas. It comes when the old farts die off.”
This explains a great deal.
One of the characteristics of a long medical career is the kaleidoscope of educational experiences one draws upon. This afternoon a three year old boy and his father benefitted from one of my early lessons, courtesy of Mary Mahotka, an x-ray tech in the Verona Family Practice Residency Clinic.
There is a push afoot to use evidence based medicine (EBM) to generate standards of care and then use pay-for-performance (P4P) to Nudge people towards better behavior.
Problems worthy
of attack
Prove their worth
by hitting back.
(Piet Hein)
Worry is like a rocking chair…it gives you something to do, but doesn’t get you anywhere!
(anonymous)
He came in to discuss testing because he wanted medications as treatment for adult attention deficit disorder (ADD).
This started out as my Ten Rules for Patients (to parallel my Ten Rules for the Primary Care Physician) but I just didn’t feel comfortable making rules for patients.
Clinicians like making the diagnosis of strep (streptococcal) throat (and patients hate being told they have a viral sore throat) for the same reasons: a belief in the ability of antibiotics to shorten the illness and prevent serious complications That’s what we doctors were taught, and that’s what we’ve taught our patients. How justified is this belief? Well, there are problems.
Sometimes the answer comes from an unexpected place, and only after we stop looking.
I understand the concept of the hospitalist and I’ve seen the data. There is no doubt about their value. But...