Adventures in ‘Prior Authorization’
“Dear Doctor. We are writing to inform you that a prior authorization is required for the medication you prescribed.†That’s usually where I stop reading. More
Why Doctors Don’t Take Sick Days
From day one in medical training, the unspoken message is that calling in sick is for wimps. Most doctors ignore their symptoms and resist taking the day off unless they are sick enough to be hospitalized in the next bed over. What explains this toxic brew of denial, ignorance and bravado? More
Doctors’ Bad Habits
We doctors constantly lament how difficult it is get our patients to change their behavior. But the truth is, we are equally intransigent when it comes to changing our own behaviors as caregivers. More
Medical Errors and the Culture of Shame
It was probably our eighth or ninth admission that day, but my intern and I had given up counting. I was midway through my medical residency, already a master of efficiency. You had to be, or you’d never keep up. This one was a classic eye-roller: a nursing home patient with dementia, sent to the emergency room for an altered mental status. When you were juggling patients with acute heart failure and rampant infections, it was hard to get worked up over a demented nonagenarian who was looking a little more demented. More
Lab, Interrupted
All academic medical centers rest on a tripod — patient care, education and research. The effect of Hurricane Sandy on the third leg of that tripod — research — has gotten the least attention, partly because rescuing cell cultures just isn’t as dramatic as carrying an I.C.U. patient on a ventilator down flights of stairs in the dark. But, of course, there is an incontrovertible link between those cell cultures and that patient. More
Imagine a World Without AIDS
The beginning of the end of AIDS? Could it really be?For those of us who did our medical training in the late ’80s and early ’90s, AIDS saturated our lives. The whole era had a medieval feel, with visceral suffering and human decimation all around. More
Doctors Have Feelings Too
Doctors should be aware of emotions that may lead them to be less than honest with patients or reluctant to admit errors. More
