I recently saw a patient for the first time who was referred to me for evaluation and treatment of chronic hepatitis C. In my urban clinic, this is something that happens quite frequently, at least a few times a week. In general I prefer that the referring physician do only the hepatitis C antibody test […]
When Your Client Nods and Smiles Read More »
Yesterday, a patient told me that “nothing was being done” to treat the cancer that had been diagnosed four months ago. I pulled up the most recent oncology note in the computer and read the details to him. Of course the oncologist had told him everything I was telling him. Why did the patient not
Palliative Care Is Like Memory Foam Read More »
Several years ago, Atul Gawande spoke to the graduates of Harvard Medical School. His address was published in the New Yorker under the title of “Cowboys and Pit Crews”. In his articulate way, Dr. Gawande described the necessary cultural transition in the way health care teams operate and cooperate. His article came to mind as
It Takes a Pit Crew Read More »
Work life in health care is filled with stress. There’s time stress, lack-of-sleep stress, role stress, and computer stress. One of the most challenging stresses for caregiver professions, though, is people stress. Every student at her medical school interview will say she wants to be a doctor to help people. That remains true at some
“Difficult” Patients Read More »
Legend has it that a frog will jump out if placed into hot water, but if you raise the temperature gradually it will stay until it’s cooked. This is an apt analogy for how older physicians currently view their jobs. If we were to jump from college graduation into our current high-stress, low-control jobs, many
Don’t Be a Cooked Frog! Read More »
The whole Palliative Care community was saddened to hear of the death of Dr. Andy Billings. You can find his obituary here, and you can learn more about him in this article from the New York Times on “How Doctors Die.” I learned of his death just hours before I was scheduled to present a journal
Teaching the Skill of Empathy: The Legacy of J. Andrew Billings, MD Read More »
The physician leader literature is full of references to “the disruptive physician,” the one who openly humiliates and bullies other providers on the health care team. Often, one thinks of an older male physician denigrating a younger female nurse. Lack of open communication in health care, though, with team members failing to speak up on
Does a Physician Have to Be Disruptive to Be a Bully? Read More »
For me, physical symptoms are a clue to something I don’t want to know about myself. If I have a sore throat, I wonder if there’s something I need to say that isn’t being said. If I get a neck pain, I might attribute it to stress or a virus, but I also think, “Who
Cold Hands, Warm Heart Read More »
I am in the process, as many of you are, of helping to launch a young man into successful adulthood. One thing my husband and I decided a long time ago was to try to nurture our son’s true interests rather than force a path on him based on financial prospects. This has turned out
Follow Your Passion Read More »
“We must accept finite disappointment, but never lose infinite hope.” –Martin Luther King, Jr. “Just as the tumultuous chaos of a thunderstorm brings a nurturing rain that allows life to flourish, so too in human affairs, times of advancement are preceded by times of disorder. Success comes to those who can weather the storm.” –I
