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.)
I love taking care of patients and have enjoyed my 37 years (and counting) as a primary care physician. When I stop, it won’t be because I am rich, bored, or have lost interest. It won’t be because I am tired (though I am). It will be because of friction.
The 15 minute appointment slot is dead. To borrow from Monty Python, it is not resting, stunned or pining for the fjords, but definitely deceased, stone dead, is no more, has ceased to be, expired and gone to meet 'is maker, a stiff, bereft of life, run down the curtain and joined the bleedin' choir invisible.
As medical institutions roll out one new broken quality protocol after another, I have struggled for a way to point out the irrationality of this approach.
When this happens, I never know whether I should be frightened or enraged.
It’s been four years since my Dad died.
Information is the currency of medical care. Transparency is the way it is vetted. Communication is the way it is shared. Collaboration is the way it generates patient-centered outcomes. The right information must always be available to the right people at the right time in the right format.
And, by ‘available to the right people’ I don’t just mean the PCP or the consultant.
I mean the patient.
When your clinician suggests a test, here are seven questions you should consider asking. (And if you are a clinician, you should be asking yourself these questions before you recommend the test.)
Today on the trip from Auburn (Maine) to Montpelier (Vermont) my wife spotted the Snowy Owl she had heard was hanging out near the Elk Farm just north of Snow Falls.
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:
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.