Ebola

“If I get a call about smallpox from the ER I’m not coming in,” an Infectious Disease doctor said to a colleague in the hospital where I was working.  It was the early days of 9/11 and anything seemed possible. “Are you all OK with providing care for Ebola patients?” our section chief asked.  Our ICU is the … Continue reading

Time to bring back morbidity and mortality conferences

My post on the changing culture of medicine as reflected in the way we talk about our errors in M&Ms is up at kevinMD. http://www.kevinmd.com/blog/2014/07/time-bring-back-morbidity-mortality-conferences.html

A New Therapy for Asthma

I first met Carol* (name and identifying details have been changed) when she came to my clinic after a severe asthma attack had sent her to the Intensive Care Unit.  After a few days, she had been extubated and had acquired a new diagnosis, asthma.  When she saw me in clinic, she felt better than … Continue reading

What I Learned at the ATP Reunion Conference February 2014

I. Capitation is coming Although Brent was careful to stress that despite this being gospel among those who “have drunk the kool-aid” it is not universally accepted. Still, the alternative narrative is just more of the same – more efficient fee for service – or aspirations for competing as one of a handful of fee-for-service … Continue reading

The State Fair

“I got run over by a golf cart at the State Fair,” my five-year-old cheerfully says to the Emergency Department technician who is checking us in. A utility cart knocked him down – he is a five-year-old running along the grass by the path, and some asshole wasn’t looking as he turned into my kid … Continue reading

Genetic Testing

“If you want CVS, you’ll have to decide within the next three days,” the genetic counselor told us. My husband and I were sitting in the upscale office of the maternal fetal medicine (MFM) practice in downtown San Francisco. Our obstetrician had referred us here for genetic testing of our twins in addition to the … Continue reading

Five Things

“What are you looking for?” I asked my supervising attending physician. I had been the intern on the bone marrow transplant service for less than a week. “Which numbers are important?” I wanted to know. “You listen every day as I rattle off hundreds of numbers in a few minutes, with no emphasis or pause, … Continue reading

What I learned at the ATP Course Spring 2011

[An email to my fellow classmates at the Advanced Training Program in Healthcare Quality and Delivery run by Brent James, MD at the Intermountain Healthcare Institute for Quality Improvement.] I hope you all arrived home safely.  It has been a real privilege taking this course with you.  After Tommy’s speech on Wednesday, my husband asked me … Continue reading