Many believe that a long visit with the doctor is a good medical visit. This is the long visit fallacy. Years ago I had a partner who related poorly to parents. So after some discussion and counseling he thought he’d fix the problem by spending more time with families. Time, of course, is correlated with compassion. And caring doctors take lots of time, we ... Continue Reading about The Long Visit Fallacy – The Right Attention for the Patient
One of my biggest challenges is bridging the doctor patient divide. It’s the gap that separates the way doctors and patients see a problem. What parents under my care think is typically different from what I think. Their concerns and fears are often removed from the reality of my thinking. That’s not a judgment, it’s a recognition of differences of how we frame and ... Continue Reading about Bridging the Doctor Patient Divide to Improve Communication
Tom Peters inspired me this with The Speed Trap: When Taking Your Time (Really) Matters. So much of his thinking in management can be translated to medicine. So it got me thinking ...what are the things in medicine that should be methodical? What should be done slowly? To the uniformed reader, the answer will seem obvious: everything. But in medicine there is ... Continue Reading about Methodical Medicine: Things That Should be Done Slowly
I’ve heard it a thousand times. 'The patient wanted testing done.' So the doctor ran a blood test. But few people really want a blood test. What they want is to know that they don’t have something horrible. I’ve seen it a thousand times with young parents. Anxiety competes with their trust in me as we discuss what could be going on with their child. I never ... Continue Reading about The Request for a Blood Test – Why More Testing May Not be Better
One of the most important roles I play as a physician is the management of patient expectations. The reason it’s so important stems from the nature of my work. As a gastroenterologist to small people I work in a grey-zone. I live in the space between intestinal pathology and the complicated lives of growing children and families. And if you know anything about ... Continue Reading about How to Manage Patient Expectations
When I evaluate a new patient, I work to compress data collection and screen time on the front end of the visit so I can free up the remainder of the visit for face-to-face discussion and shared decision making. This intentional visit design is necessary because of the realities of modern clinic schedules. And so the questions I ask and their sequence is important to ... Continue Reading about Clinical Interview Question: What Do You Think is Going On?