On becoming a caregiver

Back in the 1970s, responding to what he saw as the depersonalization of medical care, psychiatrist and cross-cultural researcher Arthur Kleinman began to examine the difference between illness as experienced by the patient and disease as diagnosed by the clinician. Such was the beginning of a hopeful attempt to reverse the trend of depersonalization in medical practice. more»

Interested readers can peruse my latest JAAPA Musings blog post, newly published in the Journal of the American Academy of Physician Assistants.

The new norm

I’ve known this mother for a long time. Far from wet behind the ears, she’s raised four other children, mostly on her own after her divorce several years ago. She’s never been one to run to the office for every sneeze and sniffle. If she brings one of her children in to be evaluated, it’s usually for a good reason. more»

Interested readers can peruse my latest JAAPA Musings blog post, newly published in the Journal of the American Academy of Physician Assistants.

N.O.Y.G.D.B.

As a country, we have always struggled with where our loyalties lie on the spectrum of individual rights versus government regulation. Somewhere sandwiched between the two extremes is the concept of community, where members share responsibility for the safety and welfare of those least able to protect themselves. more»

Interested readers can examine my thoughts on this issue in my latest JAAPA Musings blog post newly published in the Journal of the American Academy of Physician Assistants.

Learning to ingest the less than palatable

At some point in my formative years, having been brought up on traditional Pennsylvania Dutch cuisine, I was introduced to pudding. As I recall, I didn’t care much for the texture or the taste.

I quickly learned that to ingest pudding, you had to add a generous coating of pungent mustard and a saltine cracker to make it semi-palatable. To this day I do not seek it out, preferring ring bologna or souse instead.

These days I am fully grown. Far from being force fed, I can comfortably pick and choose those substances that I care to ingest — for the most part.

Which brings me to the electronic medical record, a concoction which I am forced to swallow and digest daily. more»

Interested readers can examine my thoughts on this issue in my latest Musings blog post newly published in the Journal of the American Academy of Physician Assistants.

Digital medicine: Returning to radical medical practice

The era of digital medicine has largely passed us by, leaving us firmly entrenched in the era of digital medicine.

Yes, I composed that sentence properly; I meant what I wrote.

In the first instance, I used the word digital in reference to its radical or root meaning, “of or pertaining to the digits”—in other words, the phalanges or fingers. In the second instance—well, more about that in a moment. more»

Interested readers can examine my thoughts on this issue in my latest Musings blog post newly published in the Journal of the American Academy of Physician Assistants.

The problem with primary care

Where does our job satisfaction come from? Money has been put forth as a likely determinant.

Over the course of my clinical career I’ve felt most satisfied when I’ve been able to focus on the needs of the patients entrusted to my care.

Money is a great motivator, but in my book only compassion carries the day. more»

An assessment of digital diagnoses

When it comes to charting in the medical record, nobody writes SOAP notes anymore. In fact, faced with the EHR format, very few clinicians take the time to type a short narrative. Instead, the available boxes are checked, the Next buttons are hit, the ICD codes are entered, and voila! — the health record is virtually complete!

The only thing missing is a precise description of the condition of the suffering patient. more»