doctor-patient communication
Getting the Diagnosis Right
If I had the luxury of an hour with each patient, I would have the time to carefully sort through every diagnostic possibility. But the reality is that I, like most doctors, have five to 10 minutes to push the majority of diagnoses to the bottom of the list, come up with the most likely few at the top. 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
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 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
History & Physical podcast series
Danielle Ofri discusses preserving empathy as a medical student, how she started writing, the role of narrative medicine, and the consequences of algorithmic medicine. 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
When Doctors Share With Patients
Doctors often “self-disclose†to patients in an attempt to empathize. But contrary to what might be expected, such self-disclosures often turned out not to be helpful in addressing patients’ concerns or building rapport. More
The Raw Fear of Being a Patient
At that moment, my faith in science plummeted from beneath me. My decades of medical training, my Ph.D. in biochemistry, my grounding in the scientific method, all evaporated in the blink of an eye. More
More Power to the Placebo
The hospital ward was quiet for the night, except for “the howler.†The patient and I were both pretty exasperated with each other. He was sullen and cranky; I was exhausted and at my wits’ end. More
The Doctor Will See Your EMR Now
Like the milkman of yore, the doctor makes rounds every day in the hospital. Alas, this image would be true today only if a computer terminal were plunked in the bed instead of a patient More
The Immigrant Healthcare Imperative
Legalizing “undocumented” immigrants might be a boon for our healthcare system. Immigration reform makes both economic and medical sense. A young immigrant from Tibet offers first-hand lessons. More
Tolerating Ambiguity
When faced with ambiguous situations, most of us — quite humanly — want to run for the tantalizing veneer of the certain. We doctors pride ourselves in the scientific girders of modern medicine. Much of the time, though, we function in an ambiguous zone, without clear-cut answers. 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
