Before every upper endoscopy I spray a local anesthetic in the mouth to minimize a child’s gag. It’s pretty nasty tasting stuff. So I have this little charade I pull before every scope: I apply the spray, look at the bottle, then announce in shock that the nurses have mistakenly given me bug spray. As quickly as I deliver the punch line I make it clear that ... Continue Reading about Bug Spray and the Doctor-Patient Disconnect
It’s happening more frequently: Requests for medical advice by email. The more I do, the more people I meet. The network grows and friends of friends learn about what I do. So junior has a little pain and shows at the local ER where the requisite CT shows a little thickening of the ileum. Someone suggests that the family drop me a line. Here’s the problem: ... Continue Reading about The Problem with Casual Medical Advice
The reason I love grand rounds is that it offers me the opportunity to see stuff that I might normally overlook. No themes here, per se. Just some good stuff from around the web. The response was great and all offered something unique. I have chosen, however, to select some of the best material for your reading pleasure. Rather than generate a massive dung heap ... Continue Reading about Grand Rounds – Voices from the Medical Blogosphere
I used to think they didn’t but they do. Clinical judgment is the application of individual experience to the variables of a patient’s medical presentation. It’s the hard worn skill of knowing what to do and how far to go in a particular situation. It’s having the confidence to do nothing. Clinical judgment is learned from seeing lots of sick people. Good ... Continue Reading about Phronesis: Do Patients Have Clinical Judgment?
The Internet has threatened journalism. Clay Shirky has said that everyone is a media outlet. An Internet connection and blogging platform makes everyone a publisher. Can the mass professionalization of journalism be applied to medicine or health? Can access to a broadband connection outfit a citizen to think and act like a physician? There are pieces of what ... Continue Reading about Is Health 2.0 a Threat to the Medical Profession?
It seems some doctors want to keep their patients quiet. Some practices have imposed mandatory gag orders that prevent patients from posting commentary on rating sites like Yelp or Angie’s List. This is insane. Let the patients speak. The suggestion that you can control public dialog reflects an embarrassing misunderstanding of the how the world shares ... Continue Reading about Let the Patients Speak