Picked To The Bone
My first instinct was to yell into the phone as loudly as possible.
Run away, run away while you still have time.
But I suspected that the medical student on the the other side of the mobile would have been traumatized. She was just trying to find an attending to shadow. How was she supposed to know that at that exact moment the nursing home administrator had pulled out thousands of computer generated order sheets. Each bearing my hand written signature but apparently now needed to be dated. For ten years I had signed these documents without dating them. But all the sudden some distan...
Source: In My Humble Opinion - June 3, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
The Fallacy Of Big Medicine
Conclusion
We are left with one basic question.
Do we want big medicine, or good medicine?
I'm not sure we can have both. (Source: In My Humble Opinion)
Source: In My Humble Opinion - May 30, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Do Not Pass Go
I'll give you three nights in the hospital for a a hundred days in skilled nursing.
How bout a lung mass and a go directly to hospice minus room and board?
Oh... your stay was deemed an observation, do not pass go, do not collect a hundred dollars!
I sometimes don't know whether I'm doctoring or playing some insane nonsensical board game. The complexities of sickness and healing have been eclipsed by the administrative nightmare of our payment system. Providers no longer stress over diagnosis and treatment, we huddle with social workers and agonize over disposition. Families no longer sit a...
Source: In My Humble Opinion - May 28, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
I Should Have
There's something strangely heart breaking in the You Should'ves:
You should've treated the infection sooner!
You should've made the diagnosis faster!
You should've done more!
These words uttered accusingly from a patient's mouth can cut to the core of a physician. We've all been there. No matter how rigorous your skills and training, there will be many bad outcomes. Unfortunately, from time to time, a patient or family will point the finger directly at you.
I don't blame them. How else to deal with death, destruction, and illness. Some turn inward. Some point to the heavens and ...
Source: In My Humble Opinion - May 25, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
In Memoriam: Letting People In
They found you in death much as you had been in life.
Alone.
You once told my office manager that I saved you. I shrugged. I couldn't help but feel that I was watching you die day by day. It's not that I didn't try. I fought with you tooth and nail. Begged you to go to the hospital, for anything: a pneumonia, vomiting, I would have been willing to make up a diagnosis. But you told me that hospitals were places that people go to die.
I watched and waited. I scolded that one day I would get a call from the police telling me you were gone. You lived up to that prophecy. ...
Source: In My Humble Opinion - May 21, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Embrace The Joy
It's not exactly Dr. Jekyll and Mr. Hyde, but everybody knows my level of patience varies from time to time. So I was surprised to find myself happily telling the emergency room that I would assess the patient shortly. The kids were horsing around on the playground, and I knew I would have to call my wife and ask her to come home. It would be my second forty five minute trip to the hospital on an otherwise busy Saturday afternoon.
For some reason today, I was able to sublimate the automatic annoyance and return without emotional drama. I slowed down, listened to the pa...
Source: In My Humble Opinion - May 18, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
In Which I Respond To A Faithful Reader
Below find excerpts of an email sent by a faithful reader. I have included the whole text, but broken it down to respond to each point accordingly.
I have really enjoyed your blog postings and the sensitivity you showed toward patients. But, your new venture is a real turn off, and makes it hard for me to want to read your posts anymore.
I have been waiting for this. Expecting it. I knew that when I changed my practice model there would be anger and disappointment. For this reason, I have gone to the trouble of telling each patient face to face in the office when they come in for an app...
Source: In My Humble Opinion - May 16, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Practicing At The Top Of Your License
My son and daughter play violin. I accompany them to every class and stand over them in our living room as they practice. From the very beginning, the teachers required parental involvement. They often spent more time talking to me than my children. They instructed on posture and fingering. Eventually, I learned to read music. I even rented a violin of my own.
As the years have passed, I still play an active role. I know when my son's elbow rides too high or my daughter's wrist curves upward like when carrying a pizza. My ear can tell when a note...
Source: In My Humble Opinion - May 14, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Caring 2.0: #HCSM And The Rise Of The Empathic Physician
We have our rock stars. Our members in the healthcare social media realm who have elevated the conversation to new heights. Physicians are tweeting, blogging, and popping up on news shows across the country. We are using our singular voices to educate on vaccines, heart disease, and the quantified self movement. We are acting locally, but teaching globally. The promise of social media has amplified our voices and carried our message to the unwashed masses.
We once could affect the few thousand who passed through our office doors. We now can touch the lives of millions. This...
Source: In My Humble Opinion - May 13, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
CrisisMD Launched Today
CrisisMD.com launched today!
Our goal is to provide healthcare coaching, translational services, and advocacy to those in the midst of a crisis. Below find the post that spurred this business venture. It appeared recently on kevinmd.com.
If Only The Patient Had An Advocate
It had all been so easy when Jim was still around. Lisa’s ex-husband had many shortcomings, but being a critical care specialist sure came in handy. Any time her mom or dad had a health crisis, he was right there in the middle of it: advocating, interpreting, breaking down the complexities into easily digestible morsels of information. B...
Source: In My Humble Opinion - May 10, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Poof!
It happened once before. I logged onto the computer on a particularly challenging day to find that my blog was gone. Just like that. After countless posts, telling stories, complaining and rejoicing...poof. I was on WordPress at the time. I called the help line and frantically explained the situation. Weeks later I got the data back, unformatted and imported to a new web address.
I was crushed. Not just about the loss of all that writing, but more because the conversation had stopped. The unidirectional talk that I had been having with m...
Source: In My Humble Opinion - May 9, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Fatherhood And My Son's Kindle
It's kinda curious. For all the technology I live and breath, put me in an empty room with an IPAD and after a few minutes of browsing, I'm bored. I've tried to wile away the hours on the Internet, but I can't. I'm just not built that way. Even the games and downloads lose me fairly quickly.
My son, on the other hand, is an altogether different creature. He somehow wrangled us into allowing him to use his own (birthday) money to buy a Kindle. And at the age of eight, he is already bumping heads with his fifteen minute daily allotment. He carries the little device in it...
Source: In My Humble Opinion - May 7, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
The Power Of The Pen?
I almost fell off my chair. It was bad enough that he showed up to the ER. But what happened next really blew my mind. He fell and bruised a rib. The pain in his left chest had obvious enough origins. But triage had put in for an electrocardiogram and the interpretation apparently scared the resident. The attending took a look, and shook his head.
Left bundle branch block. Better call the Mecca.
A few minutes later a cardiologist and nurse manager were videoconferencing in and interviewing the patient. Next came an order for thrombolytics and transfer to the big medica...
Source: In My Humble Opinion - May 4, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
An Act Of Submission
As I reached for the doorknob with my right hand, I had but one and only one impulse.
Run! Turn around and run as fast as you can!
It's fair to say that being a physician requires a certain constitution. When one deals in the currency of death, it becomes second nature to hold our heads high when others fall. How else can we view the tortured realities of existence. The average life is chocked full of suffering. People die tragically, unexpectedly. Pain rips through the tender belly of humanity leaving us raw, and yet we stand our ground.
But sometimes it's different. So...
Source: In My Humble Opinion - April 30, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
