A Modest Proposal to Address Burnout
I like Art Caplan a lot. He’s a respected medical ethicist who does a pretty good job of describing why physician burnout is, or should be considered, a public health crisis. The video and transcript are behind a Medscape paywall, but here’s the gist:
More than half of all doctors in this country are saying, “I really feel that some aspect of my work as a doctor is making me feel burned out.”
This is really trouble. It’s trouble because a doctor who feels this way can commit more errors. They suffer from compassion fatigue, or just not being able to empathize with others because they have thei...
Source: Musings of a Dinosaur - May 20, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Really Smart Phone
I was showing off my phone to a friend who isn’t quite a Luddite, but who only carries a “dumb” phone. He was impressed with all the things I could do with Siri, even though I don’t really use her much at all in my day-to-day life. However, there are other voice-controlled features that I do use sometimes, with particularly amusing results in this case.
DDS was out to dinner (yes, without me; it happens) and I wasn’t sure if he’d given the dog his second dose of medicine before he’d left. No biggie, I thought; I’d just shoot him a text. Just to save some time, I decided to us...
Source: Musings of a Dinosaur - May 19, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Funnies Source Type: blogs
Science & Religion
The great divide: science and religion. One of my new favorite blogs, Science ACEs, recently took on this topic. Here’s what they said. This is my take:
There is no conflict between science and religion (or at least there shouldn’t be) because they have fundamentally different purposes.
Science is the word we use to describe the process of discerning the physical world around us. We use our senses to make observations, which we then use to make hypotheses, which we then test with further observations, which we call experiments. Gravity, temperature, microorganisms, photosynthesis, and many other things and proc...
Source: Musings of a Dinosaur - May 13, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Science & Religion
The great divide: science and religion. One of my new favorite blogs, Science ACEs, recently took on this topic. Here’s what they said. This is my take:
There is no conflict between science and religion (or at least there shouldn’t be) because they have fundamentally different purposes.
Science is the word we use to describe the process of discerning the physical world around us. We use our senses to make observations, which we then use to make hypotheses, which we then test with further observations, which we call experiments. Gravity, temperature, microorganisms, photosynthesis, and many other things and proc...
Source: Musings of a Dinosaur - May 13, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Medical School is NOT where You Learn to be a Doctor
There seems to be a great deal of misunderstanding about Medical School. There are valid questions about curriculum, defined as what should be taught, and when, and who should teach it. But recent calls for students to “gain fluency in [health] systems” are completely misplaced. Here’s why.
What do you need to know to be a doctor?”
IT DEPENDS.
What kind of doctor are you going to be, and what kind of setting are you going to practice in (if you’re going to practice at all)? Because what you need to know to be a self-employed general surgeon in a rural area is completely different from what you...
Source: Musings of a Dinosaur - April 27, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Sugar Wars
There’s a proposal in Philadelphia to tax sugar, specifically sugar in beverages like soda, sweetened iced tea, energy drinks, and other sugary beverages, and I know you’ll be shocked — shocked! — to hear that there’s a robust advertising campaign gearing up against it:
The American Beverage Association, a national trade group, has been running radio ads since March calling it a “grocery tax on the kind of drinks we buy for our family.”
I’ve heard the radio commercials: a woman’s voice (I’m pretty sure she’s supposed to sound “black”) complaining...
Source: Musings of a Dinosaur - April 12, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Updating Medication Lists
Reconciling medication lists — keeping them up to date with a patient’s correct meds — is an important task that I try to do at each visit. Sometimes a patient has stopped taking a pill for some reason: it was too expensive, or another doctor told them to. They may be taking new meds from different doctors. Sometimes, thanks to the way my EMR handles electronic refills, I have duplicate entries on the list.
True story:
Reconciling the med list for a diabetic lady the other day, I noticed that I had two entries for metformin. The first was correct and had her current dose (two pills twice a day, increased ...
Source: Musings of a Dinosaur - April 9, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
“System” Nonsense
Being a doctor is hard. There’s a lot you have to know, whatever specialty you go into, and that includes rote information about how the body is put together, how it works, how it goes wrong, and how to fix it. We also must always keep in mind that these are people we’re dealing with, not just bodies, so we need to learn how to take care of sick people.
As doctors, our job is to figure out what is wrong with our patients (diagnosis) and what to do about it (treatment.) We don’t necessarily do this all by ourselves. We have colleagues who help us by performing consultations, studies, and procedures. But th...
Source: Musings of a Dinosaur - March 20, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Clinical Trials; Where the Rubber Meets the Road
This post is by request from a long time reader:
Dear Dr. Dino:
Would you consider writing a blog entry on medical trials? Clearly medicine wouldn’t make much progress without them, but to put it in patient vernacular, they seem very scary…[Details about a specific medical condition and a chance to participate in a clinical trial that]…[I]nvolves a cutting-edge technology and drug which might at some future date be shown to cause serious, unanticipated health problems. I am at a loss trying to balance the benefits with the hazards…
…[W]ould you be willing to write a column that details an organi...
Source: Musings of a Dinosaur - March 7, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Excellent Birthday
There are several things you need for the perfect birthday. One, of course, is to survive another year. <check>
Then you need people you love to celebrate with you:
Finally, you need a kick-ass cake:
Done, and done. (Complete with my age in binary from left to right on the spine.) (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - March 4, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
“Still More Logical than the Converse”
So grateful to the NinjaBaker for turning me on to the web comic, Saturday Morning Breakfast Cereal:
The title is in quotes because it’s also one of the alt-texts for the cartoon.
The other is, “I await your hatemail, pertussis enthusiasts.”
I love this guy. I recently supported the Kickstarter for his latest book Religion: Ruining Everything Since 4004 BC, and got great use out of the Mini Bible (“Abridged Beyond the Point of Usefulness”) on my recent trip to Israel. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - March 3, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Why Concierge is Not Right for Me
Apologies to Mark Twain, but reports of the death of private practice are somewhat exaggerated. There are still plenty of us around and most of us are making out quite well. Not all, though. I’m quite sure the howls murmurs of discontent have reached many ears by now. So much so that many doctors unhappy with the status quo have taken action. One such action is to “go Concierge.”
“Concierge” practice, also known as Retainer medicine, is basically an arrangement where the patient pays a fee up front (generally quoted as an annual figure, often payable in monthly installments) for the doctor&#...
Source: Musings of a Dinosaur - February 29, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Second Postscript
Now and then I get requests for guest posts on my blog. To date, I have never allowed them. However this time, I am prepared to make an exception for my Dearest Darling Spouse, who asked if he could add to the Back-Dated Travelogue on our Israel trip:
I think Dr. Dino’s travelogue posts provided a nice overview of our trip, some of the marvelous sights we saw and things we experienced. I’d like to thank her for the opportunity to add some of my observations.
Several people both before and after our trip asked us if we had concerns for our personal safety. Beforehand, we responded that we felt confident the tour...
Source: Musings of a Dinosaur - February 11, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Back-Dated Travelogue; Postscript
The flight back was much calmer than the one over. We even got to sleep some, though of course not nearly enough. Having left New Jersey in over two feet of snow, we were less than thrilled to return during another snowstorm. At least this one was slated for more northerly climes, and it stopped the moment we crossed the Delaware river. Still, it was a gray, messy, slushy, miserable drive.
We were both seriously jet-lagged for several days. We even ducked out of our traditional Super Bowl party at halftime to go home and pass out. The nice part about conking out between 7:30 and 8:00 pm was that I awoke on my own, refresh...
Source: Musings of a Dinosaur - February 10, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Back-Dated Travelogue, Day 11: Mt. Herzl
The last day of the tour, and it was back to Mount Herzl, this time for to see the tomb of Herzl himself, the guy who started the ball rolling toward what is now the State of Israel. We also toured the military cemetery there, which included the graves of many of the Prime Ministers.
Herzl’s tomb was a square black marble slab sitting in a circular plaza, itself surrounded by enough wide open space to accommodate the annual Israeli Independence Day festivities held there. Herzl never actually lived in Israel, as it wasn’t founded until after his death. So at his tomb the irreverent thought came to me that h...
Source: Musings of a Dinosaur - February 4, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
