I have an easy solution to a vexing problem in today’s healthcare crisis. A problem so widespread it is worth hundreds of words in the WSJ: long wait times at the doctor’s office. But first, before I give my simple, pragmatic, master-of-the-obvious solution let me say something truthful. I try. I try really hard—to run […]
Category: Doctoring
Sometimes it is easy. The problem is in front of you and the solution is clear and defined. Sometimes though, the solution requires a journey–an odyssey, with a faithful companion. The experienced clinician knows this but the new patient does not. Recently, I found myself in a stressful situation; stressful for many reasons, not the […]
It has been a very busy few weeks. Â Â Medicine is like that; seldom is ‘business’ steady. Â Like rainy weeks in the southeast when you think it will never be sunny again, there are weeks when you think everyone’s atria are fibrillating. So, there were shocks, and burns, and wires installed. The heart rhythm was rocking, […]
Sudden death in a young athlete is surely a tragic event. Sadly, many of the afflicted had an underlying undiagnosed heart anomaly that might have been detected with a screening ECG. On the surface, the idea seems so simple: just add an ECG to the routine pre-sport’s history and physical exam. ECGs are painless, non-invasive […]
Categories
Dear Nurses…Thanks
This came today from a social media stream. It was penned by a hard-working conscientious nurse. “Somewhere right now, a nurse is getting yelled at for being late with meds, holding their bladder because they don’t have time to pee, starving cause they missed lunch, being puked on, pooped on, bled on, yelled at, and […]
“Did you sign those (three) consents?” “This patient needs a short form; your office letter was done 30 days and one hour ago.” (just over the legal limit) “The insurance ‘people’ in area code (***) denied the stress test.” “Mr Smith’s son, an alternative medicine specialist in California wants a phone call to discuss herbal […]
“I’ve read that…” “Did you hear about…” “So and so (publication) said this…” These days, medical information is like Kudzu in the Smoky mountains. But just a few years ago, or so it seems, researching a medical topic took personal initiative and a not inconsequential time commitment. Now, on an elevator at work with a […]
The case involved a 70 year-old man with an eight year-old medical device. He suffered the abrupt onset of chest pain and shortness of breath. His ECG is here: Click to enlarge The Answer: First, the ‘medical device’ is an eight year-old Medtronic dual chamber pacemaker. Second, as was correctly stated, the ECG shows a […]
Categories
A Doctor’s Touch
How important is a doctor’s skill in the physical examination of a patient? To the lay person, a doctor’s examination might seem really important. “Of course it is, Dr M…Come on.” But is it so? Or, perhaps, is the examination a charade, a show, a necessity to complete the medical record. It turns out […]
As if we need more evidence that schools should bring back daily gym class. Researchers at the University of Illinois studied 9-10 year-old children with MRIs (no radiation exposure), VO2 treadmill testing, and memory evaluations. Their findings should spank those in the educational elite who give regular gym class only lip service. “Dr M, you […]
Categories
Middle-age…
“It was the best of times, it was the worst of times…” An intermission, the curtain has closed on youth, but the next act awaits. Caring for hiccups of the heart, like atrial fibrillation for example, often throws me in front of the mirror, of middle-age that is, and sadly the reflections show imperfections. Since […]