Once upon a time, there were six doctors in a hospital. One day the admission clerk told them, "Hey, there is a patient in the hospital today."
They had no idea why the patient was in the hospital. They decided, "Even though we have no old chart, let us go and examine the patient anyway." All of them went to where the patient was. Every one of them touched the patient.
"Hey, this is atopic dermatitis," said the first doctor who touched his skin, for he was a dermatologist.
"Oh, no! it is acute lumbago," said the second doctor who touched the back, for he was an orthopedic surgeon.
"Oh, no! it is paroxysmal tachycardia," said the third doctor who touched the chestof the patient, for he was a cardiologist.
"It is temporomandibular joint syndrome" said the fourth doctor who touched the jaw of the patient, for he was an otolaryngologist.
"It is spastic colitis," said the fifth doctor who touched the belly of the patient, for he was a gastroenterologist.
"No, it's lacrimal duct obstruction," said the sixth doctor who touched a tear from the eye of the patient, for he was a ophthalmologist.
They began to argue about the patient and every one of them insisted that he was right. It looked like they were getting agitated.
A seventh doctor was passing by and she saw this. She stopped and asked them, "What is the matter?" They said, "We cannot agree on the patient's diagnosis." Each one of them told what he thought the patient had.
The seventh doctor took a good look at the patient and said, "I know this man. This is Joe, and he is having an acute stress reaction because he just lost his job and his wife is being treated for breast cancer." And she shook his hand, offered some reassurance and made Joe feel better, for she was his family doctor.
Not only is this a fascinating read but it is a remarkable TRUE story.
Tea had the pleasure of working with Dr Catena in Kenya. Since that experience and after hearing her stories about the remarkable skill and determination that Dr Catena has I am humbled beyond belief.
This CNN report shows how telemedicine is beginning to expand into retail medicine. Here in Florida there are state laws that will not allow this kind of "telemedicine."
I certainly think that telemedicine is an important area of medicine and has a role... somewhere. But in retail stores?!?!?
I cant imagine that this can POSSBILY be equal care to an actual doctor visit. I think time will show this.
Smells of more McMedicine to me. I guess we are all going to get what we want to pay for.
When will the public and the government understand...
Fixing Primary Care is the Heart of the Healthcare crisis
When will people understand. The primary care if the heart of a good medical system and amazingly... it is the most cost effective. we can not continue to run primary care practices into the ground and expect ANY meaningful reform in our health care system.
most interesting point about this article is that you can give people all the insurance they need, but it is worthless if you do not pay your doctors well enough to stay in practice. just something to think about.
I think this New York Times article does a nice job of showing how insurance companies use an "illogical" system to pay for healthcare services. Of course, as long as it is saving them money and they can continue to turn a nice quarterly profit, why should they change?
For anyone interested in San Francisco's efforts to promote intracity Universal Healthcare, this is the best article I have seen to date explaining the process.
Certainly a aggressive and "brave" program. I actually applaud their efforts. However, fear what it will mean for the cities economic health. It will be interesting to see how this plays out over the next few years. I'm also interested to know what will happen the first time the program is sued for malpractice.
Good luck San Francisco.
If you have never heard this before, or it has been awhile. I encourage you to listen again.
Advice isn't worth much. But Mr Baz Luhrmann is right about it being nostalgic.
his song still makes me feel good about human spirit and the common goals we all share.
I recently found this Site and Thought I would share....
it is a site dedicated to putting like minded people together to form specific support groups. Great idea.
If your looking to talk to someone about a special problem, then give them a try.
dailystrength.org
Some interesting videos on many different health topics.
Good stuff, but as always, remember that the information is not "validated" and is not guaranteed to be factual.
Watch, Enjoy, and be suspicious. :)
Let me first start by saying that I often dismiss Gallop polls. I believe they are usually performed via telephone and therefore biased purely due to limited number of people that will actually sit and participate in these surveys. To be honest, I worry about the credibility of someone that is not "to busy" in life to participate in these surveys.
Regardless, Gallop polls are flung around in the media constantly as verbal fodder, and whether I like it or not they do have an affect on the viewing public.
This poll released yesterday (as flawed as it may be) certainly points toward a problem.
Not that I believe teachers, nurses, and pharmacist do not deserve their ranking, I do! But that physicians did so poorly. The professionals that should be the most connected and personal adviser someone has, comes in 5th. Well, maybe I should be happy the profession is "in the top tier" but somehow I feel disappointed.
I'm sure I could postulate for hours about why we physicians have fallen from public grace in recent years but honestly it is of little consequence. The entire health care system is broke and Doctors as the health care leaders must take responsibility.
Responsibility to get back in touch with our patients.
Responsibility to remove insurance and corporations influences on our relationships.
Responsibility to be accountable to our patients and to earn their trust again.
I should not act surprised to hear that people are beginning to look to YouTube and Wikipedia as "reliable" sources of information, but honestly, I'm shocked and even disgusted by it.
I even hear that college students are even using references to Wikipedia for college papers and research. This is terrifying.
This recent Canadian report suggest that YouTube videos (related to vaccinations) are filled with faults and these misinformed videos are viewed MORE often than educated videos.
The Internet is a wonderful thing and I FULLY support online research. However, we must view all information as suspicious and consider it's source. Wikipedia, YouTube, and other openly populated informational sights can be a good starting point of information, but they should not be considered factual without further study.
What makes Wiki and YouTube great, is also it's downfall.
Remember: Knowledge determined by the majority does NOT make it true.
I think Galileo & Copernicus would agree with that.
This Article from Scientific America is one of the best summaries I have seen about how to encourage children and not blindly "praise" them.
We have for years been so worried about our children's self-esteem that we have forgotten to teach our children to constantly strive for better. As Ernest Hemmingway put it,
"Contentment is the foe of heresy." i.e.- Those who are content will never question anything.
Ran across this amusing cartoon. It is a scary truth that seems more and more prevalent. I for one am trying to educate my patients about this pitfall. Medicines are wonderful but maybe we use them as a crutch to often? or... Maybe all the commercials we see on TV are really true.... you decide.
Teachers apply for a school project, you get to choose a project and help fund it. Then the teacher will perform the project & you get feedback about how the project went. And of course... it's tax deductible.
If your looking for a way to give back to this world. This may be a nice and rewarding way to do it.
Pentagons New Death Ray, or at Least Hurt Real Bad Ray.
This is kind of scary. The military has created a new weapon that is like a focused microwave ray. it can target groups of people of even a single person from 500 yards away. It cause intense heat and pain but is reported to not be lethal.
They are suggesting it may even be used soon in Iraq.
How can they possibly understand what the long term (or even short term) consequences of this thing? what about pregnant women?
Well, it gets points for the awe factor but I'm afraid of what will happen. will this be another "Agent Orange" or "Gulf War Syndrome?"
It has been brought to my attention once again that the American public has a poor misconception of what is medicine.
Whether it is the "natural" supplements that patients forget to mention to the doctor, or the 7 cups of coffee that the anxiety patient has each day. There is one simple truth about medicine.
It is ANYTHING you put on or into your body for a desired effect.
well, you may say... that seems silly Dr B. think about it.
We take medicine into our body to produce some specific effect.
Water? of course it's medicine. without it we die. We use water to treat people all the time in the hospital. it can even make you sick if you take to much (an adverse side effect.)
Food? almost the same as above. we eat so that we feel good and not hungry. To much and we again, can become sick.
Sun-Tan Lotion? applied to the skin to protect from the sun and prevent aging and burns.
what about the Sun? some people chose to allow the suns rays to enter their body so they can change their skin color or to feel "rejuvenated." But of course, to much and you burn and even can get cancer.
I hope readers can understand. Obviously I have taken this to an extreme, but the point is that we are surrounded by medicine. it is everywhere! And it is silly for us to believe that side effects and adverse reactions are somehow limited to the "medicines" that you buy at a pharmacy.
I encourage people to always consider everything in their lives when they have medical problems. The source of the problem may lay with the simplest and most natural thing in your house.
Remember that everything that goes on or into your body can potentially harm you. Even "natural" things. Rattlesnake poison is natural, doesn't make it good for you!
Once again... I am reminded of how good we have it in the US. Even the poorest in our country are better off than so many people in the world. We worry about who will pay for our MRI and yet clean drinking water ( a true basic right) is not a reality for so many.
On my first day of medical school, the professor walked in and she said, "Despite my best efforts, I know that by the end of your four years here, 75% of what I will tell you will be wrong."
Sobering and terrifying for me on a daily basis.
Once again, I have found a great article written in the New York Times to help me with my thoughts.
Science and medicine are all to often looked at as "sterile" and absolute. I would like to challenge this assumption. Is Science really all that different from Religion? Religions seek God and choose to do so through belief and faith, avoiding the need for rationality. But what about science? Is science really doing more than just looking for God (or The Answer, if you will.) Instead of blind faith, scientist do this through rigid rationality, but they still MUST have faith. Faith that the universe follows certain rules. Faith that "The Answer" is worth finding. Faith that knowledge will lead them to "salvation" when in actuality it is only going to lead them to more questions (not to different from religion, but that is another topic:)
But what does that mean for medicine?
well, it's back to medicine being an art. Just like traditional art often reflects and commentates on religion, medicine reflects and commentates on science.
We take an immense amount of information and reflect our best guess as to the right answer. But given the sheer complexity and almost infinite variables in our biology and our lives it's a miracle that we get anything correct. Alas, modern medicine (for all it's faults) has been successful. Average life span and quality of life have all risen over the last 50yrs, despite rapid declination of "healthy" lifestyles in America.
Do we know what makes someone healthy? Well.... no. but, we have a good guess and I'm confident our jobs as physicians are to make people comfortable and to help them enjoy their lives. A job that we can do if people have a good relationship with their doctor and faith.
Faith of good intentions and the will to live and be healthy. This is what makes us healthy. (I hope.... :)
I recently had the pleasure of being closely involved with my dying patient and her family. It was not unexpected and the family was very clear about their wishes. These are powerful moments in life and something I have come to cherish. It seems strange but I find easing someone from this life with comfort and respect to be one of the most satisfying experiences of being a doctor. The only comparison is birth. A funny ying and yang. It reminded me of a concept I had in medical school.
I was a theatre minor in college and active in community theatre in medical school. A fact that most people find unusual (although I'm not sure why.) I once was asked in Med School, "How can theatre and medicine have anything in common?" After thought, I responded, "Lots!" Theatre is the study of Life in an attempt to mirror life. Medicine is the study of Life in an attempt to understand it. To be honest, clinical skills are relatively straight forward and easy. I have found that being a good doctor is about UNDERSTANDING my patients and the life around them. A task that has been made easier by a theatre background more often than my ability to do a physical exam. Now to be fair, I think this is probably true for most arts. A fact that is horribly misunderstood and unfortunately neglected by our children's education. A reminder to me and my colleagues of the importance of a "fulfilled" life and taking the time to look past the differential diagnosis.
This brings me to my last thought.
Many people have lots of opinions about what exactly a doctor does. I personally think we are like Theatre Ushers. We (doctors) Usher people into the show, help them find their place, and do everything we can to make their experience enjoyable. We have nothing to do with what show they see! It could be a love story, a comedy, a tragedy, or a horror. It may be a long epic or (unfortunately) only a short film. But one thing is constant. We are there for them. To support their experience. Not to define it. And... when the show is over, we are their to show them the way out.
In this job as a theatre usher, we (doctors) are truly blessed. For not only do we get to experience our own show, but we are privileged to experience the shows of thousands. A gift we should never take for granted.
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