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
The Request for a Blood Test – Why More Testing May Not be Better
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
How to Manage Patient Expectations
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
Clinical Interview Question: What Do You Think is Going On?
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?
Touch | Beyond the Physical Examination
I read recently about a patient who spent 4 hours in an ER but was never experienced touch by a human. Not surprising, really. Technology is doing a lot of what we used to do with our eyes, ears and hands. For better or worse. While physicians often associate touch with the physical exam, it can facilitate more powerful things. Here are a few things the hand can ... Continue Reading about Touch | Beyond the Physical Examination
Small Doctors in Big White Lab Coats
After some deliberation, Johns Hopkins Hospital leadership has determined that their medical interns may wear long white lab coats. Until now the short white lab coat defined medical interns and the age old pecking order of postgraduate medicine in Baltimore. Woulda killed to hear that debate. Although I know how important this stuff can be to young ... Continue Reading about Small Doctors in Big White Lab Coats