More in White Coat Chronicles

The Hedgehog or the Fox: Which Doctor Are You?

The Hedgehog or the Fox: Which Doctor Are You?

And what kind of doctor do your patients want you to be?

How Technology Can Actually Help Your Patients

How Technology Can Actually Help Your Patients

In the past, many providers would have referred the child to an ER or possibly a local walk-in clinic. Instead, here's where modern technology enters.

The Lost Meaning of a Pager's Alarm

The Lost Meaning of a Pager's Alarm

A doctor experiences the misuse of a hospital pager.

Good Medicine Has Become the Exception

Good Medicine Has Become the Exception

Why are physicians practicing antiquated medicine without a modicum of evidence or common sense?

Becoming Parents - Part 1: The Decision

Becoming Parents - Part 1: The Decision

The thought of caring for a crying infant wasn't appealing. In fact, it was frightening. We did want to have kids — at some point.

Don't Listen to the Burnout "Experts" — Listen to Your Heart

Don't Listen to the Burnout "Experts" — Listen to Your Heart

"I know they never taught happiness in medical school, but you deserve happiness just as much as anyone else."

The Association Between Physical Health and the Environment

The Association Between Physical Health and the Environment

It is certainly clear that alcohol, tobacco products, and fast food don't just harm our physical health.

Sometimes, We're More Than Just a Doctor for Our Patients

Sometimes, We're More Than Just a Doctor for Our Patients

A primary care physician reflects on the different roles he plays in his patients' lives.

The Evolution of a Physician's Intent

The Evolution of a Physician's Intent

What stands in the way of the doctor-patient relationship?

Why Are We So Afraid of GMOs?

Why Are We So Afraid of GMOs?

Farmers have been intentionally changing the genetic makeup of plants for more than 10,000 years.

The Strangest of Wake-Up Calls: A Doctor's Take on Rural Health

The Strangest of Wake-Up Calls: A Doctor's Take on Rural Health

Presenting to the ER with another MI had become so routine for them that it was almost like just "another day at the office."

Simple Ways to Improve the Doctor-Patient Relationship

Simple Ways to Improve the Doctor-Patient Relationship

One of the most overlooked functions of communication is establishing the patient relationship.

Working With Multiple Attending Physicians in the Emergency Department

Working With Multiple Attending Physicians in the Emergency Department

Working with a large number of attending physicians can be one of the biggest difficulties of being an advanced practice provider.

Why I Do Not Provide Preoperative "Clearance" - And Neither Should You

Why I Do Not Provide Preoperative "Clearance" - And Neither Should You

The term clearance implies that a patient can proceed with surgery and will have no risk for complications — which is a fictional state.

How Sustainable is Your Primary Care Practice, Really?

How Sustainable is Your Primary Care Practice, Really?

Can primary-care physicians keep up with our current economic and regulatory reality?

Technology in Medicine: Friend or Foe?

Technology in Medicine: Friend or Foe?

Today's voice-recognition capability, especially for medical providers, is phenomenal.

Are Physicians the New Secretary?

Are Physicians the New Secretary?

Physicians struggle with the non-medical work we are often tasked with.

Drinking and Driving: When Will We Learn?

Drinking and Driving: When Will We Learn?

I am starting to think that our seeming acceptance of drunk driving must be because such a large percentage of the population is guilty of this behavior.

Writing Informal Prescriptions May Pose Major Risks

Writing Informal Prescriptions May Pose Major Risks

When clinicians write informal prescriptions, their supervising physicians may also suffer the consequences.

Sometimes Medical Care Requires More Than Just a Minute

Sometimes Medical Care Requires More Than Just a Minute

A primary care physician sees the peril of pharmacy-owned clinics.

Parenting and the Feelings of Helplessness

Parenting and the Feelings of Helplessness

Sometimes we identify too much with our patients and our advice becomes too personal.

Hold the Statins and Antihypertensives: Give Me a Compassion Pill — for Doctors!

Hold the Statins and Antihypertensives: Give Me a Compassion Pill — for Doctors!

The indication? Doctor attitudes and a tendency to complain. One tablet PO TID and QHS. #120, with unlimited refills.

Incorporating Mid-Level Providers to Your Practice?

Incorporating Mid-Level Providers to Your Practice?

I feel confident that PAs and NPs will continue to play a growing role in the future of primary care.

Does A Fitbit Actually Make You Fit?

Does A Fitbit Actually Make You Fit?

If you really want to give your fitness and weight loss efforts a boost, track calories — and get enough exercise.

Meaningful Health Care Reform? Don't Hold Your Breath!

Meaningful Health Care Reform? Don't Hold Your Breath!

Only way we can build a better health care system is to depoliticize it and put it back into the hands of doctors and patients.

Providing Healthcare for Lesbian and Bisexual Women

Providing Healthcare for Lesbian and Bisexual Women

Health-care providers often overlook the unique health needs of lesbian and bisexual women.

Residents Can Be Great Assets in Patient Care

Residents Can Be Great Assets in Patient Care

Despite the myths surrounding residency, many physicians-in-training are helpful and willing to learn new techniques.

Better Patient Outcomes with Improved Interviewing Skills

Better Patient Outcomes with Improved Interviewing Skills

Consider altering your interviewing style to improve relationships with your patients.

How Same-Sex Marriage is a Mental Health Issue

How Same-Sex Marriage is a Mental Health Issue

Same-sex marriage has positive mental health benefits for gays and lesbians.

Examining the Life-Saving Effects of Marriage

Examining the Life-Saving Effects of Marriage

A large study connects marriage to improved outcomes for patients with cancer.

Inside the Role of Social Determinants in Health Equity

Inside the Role of Social Determinants in Health Equity

Factors such as poverty, income inequality, violence and racism influence public health.

Appreciating the Kindness of Patients

Appreciating the Kindness of Patients

Patients who remain cheerful, despite personal drama, deserved to be recognized for the effort they put in.

Finding a Work-Life Balance as a Provider

Finding a Work-Life Balance as a Provider

It is important for providers to find time to de-stress with enjoyable hobbies.

Importance of Counseling Patients About Pap Smears

Importance of Counseling Patients About Pap Smears

It's important to counsel your patients on the difference between a Pap smear and a pelvic exam.

Hold Your Nose: Today's Medical Advertising Stinks!

Hold Your Nose: Today's Medical Advertising Stinks!

Not only do these TV ads stink, but they also drive up the cost of health care.

Encrypting Patient Health Information to Improve HIPAA Compliance

Encrypting Patient Health Information to Improve HIPAA Compliance

"There are all kinds of options for encryption that they can take advantage of. It works well."

Consequences

Consequences

A physician struggles with his own fallibility.

Reinterpreting Death

Reinterpreting Death

Doctors fumble with the art of prognosis.

Addressing Implicit Bias in the Exam Room

Addressing Implicit Bias in the Exam Room

Clinicians have overwhelmingly moved to recognize the implicit biases in their practice of medicine.

Addressing HIV Screening and Prevention in Primary Care Settings

Addressing HIV Screening and Prevention in Primary Care Settings

It is estimated that between 60% and 75% of adolescents with HIV are not aware of their infection

The Importance of Maintaining Mobility

The Importance of Maintaining Mobility

It may not be in a person's best interest to limit his or her ambulation.

How To Improve Sleep Among Socioeconomically Disadvantaged Children

How To Improve Sleep Among Socioeconomically Disadvantaged Children

Socioeconomically disadvantaged children have a higher rate of sleep difficulties than children from high-income households.

Improving Sleep Hygiene: What To Know

Improving Sleep Hygiene: What To Know

An easy-to-read handout could help patients overcome their sleep issues.

Toastmasters International: A Communication and Leadership Program

Toastmasters International: A Communication and Leadership Program

I found it refreshing that the people in my group were not in the medical field, but instead were diverse both in terms of careers and culture.

Dropping the Ball

Dropping the Ball

The number of distractions pulling physician attention away from where it should be — on patients — has increased.

Sink or Swim

Sink or Swim

We need to reconsider how we train our doctors to be sure that they acquire the skills they will need.

A Special Home Visit: They Do Still Exist

A Special Home Visit: They Do Still Exist

What Arthur and his family did not know is that that home visit had at least as much impact on me.

Opioid Prescribing for Dummies

Opioid Prescribing for Dummies

We marginalize people in pain to the point where shooting up black tar heroin under a freeway overpass makes the most sense to them.

Teleconferencing with Patients: Is it Worth It?

Teleconferencing with Patients: Is it Worth It?

Patient evaluations performed through teleconferencing may lack the accuracy of a physical exam.

Addressing Patient Behaviors on Social Media

Addressing Patient Behaviors on Social Media

Commenting about patient behaviors on Facebook is becoming a common practice among clinicians.

Opting Out of Medicare: A Physician's Perspective

Opting Out of Medicare: A Physician's Perspective

This physician discusses her experience with opting out of Medicare and offers advice to physicians considering doing the same.

Sticking It to the Man

Sticking It to the Man

Battle-worn and weary, we were hungry for news, and any sign that the tide was starting to turn gripped our attention.

Safe Zone

Safe Zone

I have come to realize is that it was never the sanctity of the exam room, nor the long white coat that droops from my shoulders.

My Top 10 EHR Wish List

My Top 10 EHR Wish List

EHRs continue to spread untold misery, and with each year a new EHR comes along that promises to be "better" than the last.

How Should Physicians Discuss Use of Off-Label Medications With Patients?

How Should Physicians Discuss Use of Off-Label Medications With Patients?

Patients can be confused by such off-label use, so providing informed consent becomes a challenge.

Many Forms of Caffeine: Worth Asking About

Many Forms of Caffeine: Worth Asking About

This got me wondering what actual amounts of caffeine are safe to consume, and how much is too much.

How Photography Made Me a Better Doctor

How Photography Made Me a Better Doctor

But here's the weird thing—photography has helped me to be a better doctor.

There Are Better Ways to Win Than to Win a Game

There Are Better Ways to Win Than to Win a Game

Is winning the primary goal? Or should coaches be aware of a bigger responsibility?

Urgent Care or Family Practice: Which Offers You Better Work-Life Balance?

Urgent Care or Family Practice: Which Offers You Better Work-Life Balance?

To say that primary care physicians are squeezed for time these days is a grossly negligent understatement.

Write, Doctor, Write!

Write, Doctor, Write!

If you've ever dictated a progress note or a discharge summary, you can write an article. Just get the basic idea down to start.

Words

Words

An accent on a particular syllable, even if done unconsciously, is significant and draws attention to hidden information.

How To Begin Again

How To Begin Again

I was worried that the hectic, high-pressure process of medical education was somehow diminishing my humanity.

Divorce Surgery?

Divorce Surgery?

I have noticed that my patients who undergo successful bariatric surgery seem to get divorced at a higher-than-average rate.

No Doctor in the House

No Doctor in the House

The art of medicine doesn't matter anymore. All that matters is checking the right boxes and attaining some minimum customer satisfaction score.

Who, Really, Would Want to be a Doctor These Days? Who Really?

Who, Really, Would Want to be a Doctor These Days? Who Really?

Doctors see patient volumes and administrative burdens increasing in an ever more complex, fragmented, disjointed and dysfunctional system.

Let Sleeping Dogs Lie?

Let Sleeping Dogs Lie?

A physician laments his last interaction with a patient.

What Happened To Hope?

What Happened To Hope?

It's time hospitals and doctors re-branded themselves.

Affordable Care Act: Fix One Thing, Break Another?

Affordable Care Act: Fix One Thing, Break Another?

One of the goals of the ACA was to end coverage discrimination for preexisting conditions. However, even if it is unintended, the ACA does still discriminate against other groups.

Be Not Brave

Be Not Brave

Bravery is the crutch of the buffoon and a poor substitute for knowledge and skill.

Uncle Dennis Was Right

Uncle Dennis Was Right

I pondered the phenomenon. Why do we perceive time to pass more quickly as we age?

Medicine Can Continue to be a Noble Profession, If We Fight For It

Medicine Can Continue to be a Noble Profession, If We Fight For It

There is no profession more worthy. There is no pastime more challenging. There is no calling more sacred.

Behind Every Doctor Is A Patient

Behind Every Doctor Is A Patient

Behind every doctor is just a person: You and your doctor have much more in common than what separates you.

Complementary and Alternative Treatments: Worth Considering or Not?

Complementary and Alternative Treatments: Worth Considering or Not?

There is an increasing body of evidence suggesting at least mild efficacy and safety of certain complementary supplements for specific conditions.

Being Mindful of Meditation

Being Mindful of Meditation

Mindfulness meditation is a frequently studied, complementary tool for managing anxiety, depression, and ill health

Finding a Place for Antipsychotics in Nursing Homes

Finding a Place for Antipsychotics in Nursing Homes

Why this physician supports the use of antipsychotics in palliative care.

The Space Between Sickness And Death

The Space Between Sickness And Death

A physician sings the praises of a much maligned medical institution.

The Intimacy Gap

The Intimacy Gap

The ever-growing gulf between doctors and patients is due to disjointed, unnatural intimacy.

Once Upon a Time

Once Upon a Time

The fictional story of a dying breed: the independent practitioner.

Are You Proud of Your Patients?

Are You Proud of Your Patients?

A physician expresses appreciation of his patient's struggles.

The Crazy Brand Names of New Medications

The Crazy Brand Names of New Medications

Attempting to make sense of new brand names of medications is more like an exercise in futility.

My First Dead Body

My First Dead Body

A physician recounts one of his first experiences with death.

MU (Meaningful Use) With or Without You

MU (Meaningful Use) With or Without You

A physician laments the absurdities of Meaningful Use.

Physician vs Patient and Avoidance of a Missed Diagnosis

Physician vs Patient and Avoidance of a Missed Diagnosis

Clinicians are often faced with patients who are certain they know what is plaguing them, but it takes courage, concentration, and determination to make the right diagnosis.

Does Your Primary Care Physician Feel Like A Doctor Anymore?

Does Your Primary Care Physician Feel Like A Doctor Anymore?

A travelling patient experiences the ravages of the primary care health system.

The Annual Physical: Is There Benefit?

The Annual Physical: Is There Benefit?

An article was recently published in USA Today discussing the importance or lack thereof of the annual physical exam.

Can We Calculate the Price of Human Dignity?

Can We Calculate the Price of Human Dignity?

A physician reaches his limit while trying to get a motorized scooter covered by Medicare.

Flu Shot or no Flu Shot: That Is the Question

Flu Shot or no Flu Shot: That Is the Question

This time of year, several times per day I ask patients if they would like to receive a flu vaccine. This elicits a variety of responses. I am often impressed by the passion that some patients display against the flu vaccine.

The Anatomy of a Hospital Admission

The Anatomy of a Hospital Admission

The practice of medicine takes time and concentration, something that is often lacking in today's healthcare system.

The Doctor-Patient Relationship Can Be Difficult

The Doctor-Patient Relationship Can Be Difficult

The doctor-patient relationship can be both rewarding and trying for all parties involved.

Unsolicited Request

Unsolicited Request

We have all seen an increase in direct-to-consumer advertising from pharmaceutical companies over the last several years.  Now, durable medical equipment suppliers are getting in on the act.

Does Your Physician Practice in a Silo?

Does Your Physician Practice in a Silo?

A private practitioner discusses the benefit of existing in a silo.

Reflections on ADHD

Reflections on ADHD

In family practice, attention-deficit/hyperactivity disorder (ADHD) is a condition that is diagnosed and treated on a regular basis. Often people express their opinion that it is overdiagnosed and overtreated.

Eviction

Eviction

The winds of change are driving primary care physicians out of the hospital.

Something People Do Every Day

Something People Do Every Day

A physician struggles to reconcile the difficult aspects of doctoring with normal everyday life.

Marijuana Legalization and Its Impact

Marijuana Legalization and Its Impact

Over the last few years there has been a significant push toward the legalization of marijuana.  Marijuana is now legal for medicinal purposes in 23 states plus the District of Columbia.  Four states—including Colorado, Oregon, Washington, and the District of Columbia—have now legalized marijuana use for recreational purposes.

Are Primary Care Physicians the New Nurses?

Are Primary Care Physicians the New Nurses?

A primary care physician opines on how he has become like a nurse to the specialists who see his patients.

Humility Is a Two-Way Street

Humility Is a Two-Way Street

A medical student poignantly learns the meaning of humility when dealing with a difficult patient.

Dancing With the Doctors

Dancing With the Doctors

Several months ago a colleague asked me to participate in the fundraising event, Dancing With the Doctors, at the Twin River Casino in Lincoln, Rhode Island. He had participated a year earlier and had a wonderful experience.

What Do You Need Right Now?

What Do You Need Right Now?

We are constantly bombarded with messages in the media and in our own minds about things we need to have or do. But what if true happiness lies in needing nothing at all?

Automatic Refill or Automatic Profit?

Automatic Refill or Automatic Profit?

A few years ago several of the large pharmaceutical chains started offering automatic refills for convenience. On the surface this seems like a great idea for patients, as they no longer need to call the pharmacy for refills.

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