In just a few days I’ll be leaving the clinic where I’ve practiced pediatrics for the past six years. The last months have been a flurry of last visits with families, paperwork, and tying up loose ends. There have been many, many goodbyes. I’ve been deeply moved by the expressions of gratitude and affection that many families have shared with me. It seems it is always in these times of change and endings that we are most open with each other. Continue reading
Category Archives: On Medicine
Copy and Paste Medicine
I’ve been working with the latest electronic medical record (EMR) for almost a year now. You know the one. There are many positive changes, to be sure. It has helped me more than a few times with calculating doses for kids’ medications. I can now easily check in on my patients’ progress when they are admitted to the hospital. And, of course, the notes are far more legible.
But what do the notes actually tell me? Sadly, sometimes, not much. Continue reading
Can Someone Please Hack the Clinic Day?
hack (verb): to create a usually innovative solution to a computer hardware or programming problem or limitation
This past weekend I again had the opportunity to attend the excellent Medicine X conference. Despite the conference focus on the convergence of medicine and emerging technologies, the main message I left with had nothing to do with technology. It had to do with listening. Continue reading
A while back I was working in pediatric urgent care and had occasion to do something I have done many times since starting out in medicine. I called a consult. The reason, like many consults, was an abnormality on a study that required a specialist’s opinion. I paged the resident on call for this particular specialty. When they called back I was treated, right from the get-go, to some serious attitude. This was a legitimate consult and I had a question that I needed answered, so I pressed on. I also called him on it, which seemed to surprise him a bit. Now, I have a sense of humor and a fairly thick skin at this point. Feel free to point out something I’m missing or rib me a little good-naturedly. But I can’t abide downright disrespect. This isn’t just about a bruised ego. Doctors disrespecting each other or dismissing a request for help isn’t just rude, it’s bad for the patient.
But, I’m getting ahead of myself. Let me start from the beginning. Continue reading
It Is The System, Not The Patient, That Is Difficult
As a pediatrician at a busy county clinic with close proximity to pediatric specialists, I care for a significant number of children with special health care needs. Instead of colds and ear infections (though there are those too), my days are often filled thinking about gastrostomy tubes, tracheostomies, and ventriculo-peritoneal shunts. I sign orders for specialty formulas and nebulizer machines. Many of my patients have thick charts and diagnoses like hypoxic-ischemic encephalopathy, chronic renal failure, and achondroplasia. And, I wouldn’t have it any other way. These kids and their families have taught me more than I can possibly put into writing. About medicine. About life.
But, all too often these families are labeled “difficult”. Continue reading