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Thursday, January 24, 2019

Chronic pain

5 ways to get out of the physician burnout black hole

Practicing medicine with all of its responsibilities often reminds me of a black hole. It seems each time something new is added it gets pushed into the vast vortex of the black hole, hidden from those around you and jumbled with everything you are expected to do. People around you see the world as...

Are family physicians the best weapon against opioid crisis?

As the national opioid crisis takes center stage, I want to make a case for the authority of the family physician in managing and treating this problem. I am a family physician and have been treating patients with opioid dependence and addiction for 12 years. These patients comprise about half of my practice. The...

Doctors and patients are drowning in data. What can be done about it?

Too much data, big and small. Every morning when I log onto our electronic health record, one group of messages are from patients with their self-recorded health information data that they’ve sent to me for review. Here’s my home blood pressure over the past 24 hours. Here are my fingerstick glucose readings over the past...

Safe pediatric dental anesthesia is the right of every child

When you tell anyone in health care that “sedation” to the point of coma is given in dentists’ and oral surgeons’ offices every day, without a separate anesthesia professional present to give the medications and monitor the patient, the response often is disbelief. “But they can’t do that,” I’ve been told more than once. Yes,...

The physician’s relationship with the beeper

If you’re thinking about a career in medicine, there’s a piece of technology you’ll come to know intimately. It’s small and sleek, with excellent battery life and remarkable durability. It’s not an iPhone; it’s not a Pixel. It’s a beeper. You will come to know, and to respect, this tiny black rectangular prism. It will govern your...

Lessons from 38 years of being an internal medicine ward attending

Finishing my 38th year of internal medicine ward attending, I wish I knew then what I know now.  I estimate the equivalence of at least ten full years of ward attending; I think this meets the magic 10,000-hour number.  Hopefully, these notes to myself will help some newly minted ward attendings.  The job...

It’s a shame so many doctors want to leave medicine

It’s just after six o’clock on a Sunday morning in December. The barn animals have fresh hay and warm water. My wife and the dogs are asleep. The cats are gathered around me as I sit down to write. One of them has jumped up in my lap and is pawing and clawing...

7 reasons why being in pain is a pain

I’m now walking the second mile in another man’s moccasins, and it’s no more enjoyable than my first mile. Many doctors cringe when they see a chronic pain patient on their day’s schedule or at least certain chronic pain patients. Some of that dread isn’t directly caused by the patient but rather the deluge...

Do hospitalists improve patient outcomes? The answer isn’t quite clear.

Steven Reznick, MD | Physician | December 26, 2017 A study published recently in JAMA Internal Medicine looked at 650,651 Medicare patients hospitalized in 2013. It showed that when patients were cared for by their own outpatient physician, they had a slightly better outcome than when the patients were attended to by full-time hospital-based specialists who had not...

During the holidays, we should take time to be a little kinder

As I walked into the room, I see my patient lying in bed, eyes closed. His wife of 50-plus years sat in the recliner next to him grasping his right hand. The holiday season was upon us. My patient has spent the better part of the last month in the hospital. His wife was...

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