Ethics of Money in Medicine
Just because money is a reality in medicine, doesn’t mean that we have to blindly accept all the consequences. There is a code of ethics in medicine. More
My Patient Doesn’t “Do” Vaccines
When my patient told me that he doesn’t “do” vaccines, I decided to try to understand his reasons, More
Should Med Schools Be Renamed for Donors?
More and more medical schools sport a donor’s name rather than the plain old university name. The pace is increasing, as are the number of eyebrows being raised. More
Board Recertification: A Waste of Time?
It used to be that you tackled the medical board exams just once after residency. Then you went into practice and never looked at a No. 2 pencil again. More
Giving the Doctor a Second Chance
“Someone had said you were a good doctor,” my patient said derisively, “but I was not impressed.” What had I done? More
The Little Things
Although technically these are the little things, in a sense they’re actually the big things. Indeed, for some patients, the little thing may be the only thing that matters. More
Physician Suicide and the Tyranny of Perfection
Doctors have the highest suicide rates of any professional group. But losing two of our newest members within a week of each other is a painful reminder of the dangers of our profession. More
Medical Memoirs
Given the epidemic of doctor-writers out there, one could be forgiven for assuming that a book titled “Internal Medicine: A Doctor’s Stories,” written by a practicing physician, would be a work of nonfiction (and indeed, it is being marketed as such). But in the introduction, Holt writes that he is “recreating experience as parable,” More
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
The Physical Exam as Refuge
There are few situations where we expect to disrobe and have our bodies touched by relative strangers. But the physical exam is often the first moment that patients and doctors can talk directly, without the impediment of technology. More
Incidental Illness
How, in the quiet world of outpatient medicine, does one know when a life is saved? More
Our Silence Around Dementia
Dementia is not something we doctors talk much about. We all have many patients with dementia— and more every year— but we never seem to chat about it the way we discuss kidney disease or cancer treatment. Why the silence? More
Doctor Priorities vs. Patient Priorities
The patient cheerfully admitted that he hadn’t been paying attention to his diabetes for the last few years. He’d stopped taking his medicine, stopped seeing his doctors, stopped thinking about the disease altogether. What happens when the patient’s priorities and the doctor’s priorities conflict? More
Acne
A young Navajo woman files silently into my office, making no eye contact. As she slips into the chair errant strands of black hair spill across her face. Through the breaches I catch glimpses of her rich dark skin riddled with the pockmarks of severe acne. More
The Small Costs
We all hear about “health care costs,” a lumbering behemoth that dominates the news. But it is the smaller amounts, literally the pocket money, that often has the strongest effect on the concrete currency of health. Sometimes doctors find themselves in the position of offering their patients a few dollars to help with a co-pay or transportation home. More
