doctor-patient communication

Incidental Finding?

A small adrenal mass was “incidentally noted” on my patient’s CT. But once the incidentaloma had been given life, so to speak, it was no longer incidental. We were now obliged to run some highly complicated — and expensive — lab tests. More

Medical Check-Ups: Waste of Time?

A new report concluded that general health checkups for adults did not help patients live longer or healthier lives. So is it time to scrap the annual medical check-up? 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

Doc, How Much Time I Got?

There are few situations more horrible than having to tell another human being that he or she is going to die. And it doesn’t get any easier with experience… More

Doctors, Patients, and Computers

The presence of computers in the exam room has had another consequence. Both physically and psychologically it has placed a wedge in the doctor-patient relationship. More

A “Difficult” Patient’s Journey

Chloë Atkins is the type of patient that every doctor dreads—presenting with a plethora of symptoms that don’t offer any obvious medical explanation. There are multitudes of such patients in a general practitioner’s roster and most, thankfully, will not turn out to have a serious illness. But there are a few who do, and as Atkins’ book points out, this can be a harrowing experience. More

“Noncompliant” Patient?

It was a year into our relationship when my patient finally told me the truth. No wonder he couldn’t keep his medications straight. More

Medicine Out of Context

I ducked into the ladies’ room at La Guardia Airport in New York for a pitstop before boarding my flight. Inside I encountered a housekeeper washing the floors. She flashed me a broad smile.

“Doctora,” she said, and then hesitated. I could see that she was waiting for a response. “Recuerdame?” More

Neuron Overload

Sometimes it feels as though my brain is juggling so many competing details, that one stray request from a patient—even one that is quite relevant—might send the delicately balanced three-ring circus tumbling down. One day, I tried to work out how many details a doctor needs to keep spinning in her head in order to do a satisfactory job, by calculating how many thoughts I have to juggle in a typical office visit. More

Voice Mail: Blessing and Curse

Voice mail is both a blessing and a curse. When we were first given voice mail in our clinic, it was a revolution–patients could actually get in contact with their doctors. But sometimes voice mail is a ball and chain. More

The Emotional Epidemiology of Vaccination

The only preventative medicine that actually prevents disease are vaccinations. Our world is an immeasurably better place since the advent of vaccines. Yet there is a complicated psychology that hovers like a fog around the idea of vaccination. More

Drowning in a Sea of Health Complaints

The patient was a classic “worried-well” type of patient. When she unfolded a sheet of paper with a brisk snap, my heart sank as I saw 30 lines of hand-printed concerns. More

The Patient’s Voice

Not long ago I learned that these side effects listed on the package insert are not the ones the patient actually complains of. No, they are the symptoms the patients’ doctors choose to report, the doctors’ impressions of what the patients are describing. More

Why Patients Don’t Take Their Meds

For a substantial number of people, medicine from a prescription is automatically suspect. But if it comes from a health food store, there’s not a hint of concern. More

Sometimes, Doctors Find Answers Far Off the Charts

Sometimes it is only when the patient is halfway out the door that the important information spills out. The “hand on the doorknob” phenomenon is well known in medicine. More