Medicine

When this happens, I never know whether I should be frightened or enraged.

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:

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.

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.

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

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

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.

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.

I recently finished reading Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together by Peter Ubel, MD.  It should be required reading for all the following...

In medicine, unlike much of the world, it is the questions one doesn’t ask that lead to trouble. When taking a medical history, the biggest enemies are time and fear. Time, because there is never enough to ask all the questions, listen carefully to all the answers, and pursue all the possible clues. Fear, because the natural reluctance to ask certain questions is a trap.