Posted by denitzablagev on August 17, 2013 · Leave a Comment
“Mom, who made the first people?” he asks me sweetly. It is already nine o’clock and well past his bedtime. Blah, blah, blah, I stumble a bit then build up to “people came from monkeys.” “Nah,” he says and gives me a sly smile as if I’m trying to trick him. My “really, they do!” … Continue reading →
Filed under evidence in medicine · Tagged with data, dinosaurs, drug company, Eli Lilly, fact, god, information, journal, judgement, medicine, monkeys, New England Journal of Medicine, people, Santa, science, scientific study, surviving sepsis, trial, trust, velociraptor
Posted by denitzablagev on May 29, 2013 · 5 Comments
“My friend said to tell you everything when I come,” she says as she opens a little zippered bag full of flakes. “My teeth are falling out and I can’t afford a dentist, so I use Gorilla Glue to glue back the pieces,” she says. She was referred to me for severe asthma, but she … Continue reading →
Filed under access to care, doctor, medical costs · Tagged with advair, asthma, bankruptcy, barrier to care, cost, expensive medicine, gorilla glue, health, healthcare cost, ICU, medical care cost, medicine, spiriva
Posted by denitzablagev on May 15, 2013 · 1 Comment
“I think he’s just anxious about it,” the medical student told me a few sentences into the presentation. His patient had had a spontaneous pneumothorax, a leak of air between the lung and chest wall, a few years ago, and now he had some uncomfortable feeling and was worried about a recurrence. I hadn’t heard the full story … Continue reading →
Filed under doctor, medical education, my tirades · Tagged with anxiety, bad apple, deconditioning, ethnicity, health, history and physical, hubris, idiopathic pulmonary fibrosis, medical education, medical student, medicine, obesity, pneumothorax, presentation, race
Posted by denitzablagev on May 8, 2013 · 2 Comments
Time heals all wounds, they say, or, in medicine, if not all, then many. But with our improved efficiency and throughput of patients, we fail to allow this most magical treatment to work. The pace and intensity of medicine has increased exponentially over the past several decades. We see more doctors, have more procedures, take … Continue reading →
Filed under doctor, evidence in medicine, medical costs, my tirades · Tagged with adrenal incidentaloma, bedside, CT scan, doctor, doctor-patient relationship, echo, emergency department, healthcare, incidental findings, incidental pulmonary nodule, medicine, patient, rationing, science, slow food, slow medicine, time heals all wounds, voltaire
Posted by denitzablagev on May 5, 2013 · 6 Comments
Need Oxygen to Smoke? my editorial in the Salt Lake Tribune on the difficulty of tobacco cessation. What do you think about the policy at the Cleveland Clinic and other large employers that refuse to hire smokers? Below are my links that were embedded in editorial, but for some reason SLC trib removes them. …Even … Continue reading →
Filed under doctor, my tirades, Salt Lake City Tribune · Tagged with choice, emphysema, ethics, free will, health, health insurance cost, healthcare, how to quit smoking, lung cancer, medicine, obesity, personal responsibility, public health, quit smoking, salt lake tribune, smoking, tobacco, tobacco cessation, utah
Posted by denitzablagev on May 1, 2013 · Leave a Comment
David Foster Wallace “Infinite Jest” Page 604 …people of a certain age and level of like life-experience believe they’re immortal: …they deep-down believe they’re exempt from the laws of physics … And they’re constitutionally unable to learn from anybody else’s experience: if some jaywalking B.U. student does get splattered on Comm. or some House resident … Continue reading →
Filed under Denial, doctor, medical education, my tirades · Tagged with counter transferrance, David foster Wallace, death, denial, Doctors, doctors to our family and friends, fear, health, hypochondria, infinite jest, medicine, neurology, old, patients, physicians, psychological denial
Posted by denitzablagev on April 26, 2013 · 3 Comments
The cost of medical care and the cost of education in general is sky rocketing. But it is much worse to be at the nexus of these two endeavors – Medical Education. The current path to becoming a doctor in the US involves four years of university followed by four years of medical school. Each … Continue reading →
Filed under doctor, medical education, my tirades · Tagged with apprenticeship, board certification, certification, core competency, critical thinking, education, fellow, graduation, health, medical certification, medical education, medical student, medical training, medicine, resident, teaching
Posted by denitzablagev on April 19, 2013 · 6 Comments
I recently changed my children’s dentist because his office was too nice. As with their doctor, it is impossible for a lay person to have any idea whether their dentist is clinically competent or good. Most of us choose our dentists the same way we choose physicians – by personal recommendations from people we know, … Continue reading →
Filed under doctor, my tirades, quality improvement · Tagged with appointment, aquarium, car dealer, cavities, customer satisfaction, dental hygienist, dentist, health, how to choose a dentist, how to choose a doctor, medicine, patient perception of quality, patient satisfaction, snacks, surrogate markers, surveys
Posted by denitzablagev on April 17, 2013 · Leave a Comment
“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 →
Filed under doctor, evidence in medicine, medical decisions · Tagged with advanced maternal age, amniocentesis, chorionic villus sampling, Dr. Google, genetic counselor, genetic testing, health, medicine, nuchal ultrasound, obstetrics, patient doctor relationship, prenatal genetic testing, prenatal testing, primary data, san francisco parents of multiples, SFPOM, trust, twins
Posted by denitzablagev on April 10, 2013 · 1 Comment
We understand very little about the human body. Sometimes I think that the more we learn, the more we learn how much we don’t know. Occasionally, our patients show us. Take Jim*, for example. He came to me complaining of wheezing and shortness of breath. He had been newly diagnosed and treated for asthma over … Continue reading →
Filed under doctor, medical education · Tagged with Africa, alternative medicine, asthma, bronchoscopy, clinical trials, eosinophilia, estrogen therapy, health, homeopath, logical fallacy, medicine, parasites, peanuts, post hoc ergo propter hoc, richard dawkins, testimonial