As we close out another year in our professional lives, and the last month of this millennium, we reflect on where we’ve been and envision where we’re heading. Many disgruntled physicians ask, “Are we moving forward in the cause of helping our patients, or are they worse off?” One doctor wrote me a five page […]

On a recent trip to London to visit our daughter and see the organization she cofounded (www.firsttuesday.com) go international, we were met at the airport by a driver who proceeded to drive on the “wrong” side of the street. It caused me to reflect on a recent story about an elderly lady who was increasingly […]

When I was a summer extern in a Kansas City hospital some years ago, the hospital employed Danish interns. As an idealistic third year medical student, I was struck by their comparison of American medicine with the practice of medicine in Denmark. American doctors, they said, try too hard to please their patients. In their […]

Summer is over and I hope we’ve all had some respite from our usual routines as we get down to the business of what we do best–practice medicine and surgery. Our best offense is to do it well. Otherwise we may be replaced by a Physician Assistant or a computer. While reading ECGs the other […]

An 88-year-old woman came in for a complete examination. Afterwards she said she was concerned about her late husband possibly having had Herpes and asked if I could recommend someone to check her out “down there.” She was becoming quite daffy over a 77-year-old man who lived in her complex and wanted to know she […]

The American Thoracic Society composed of 13,000 pulmonologists and physicians with related interests, met in San Diego for their annual scientific meeting. For the last 7 years, this has become an international conference with 16,000 attending this year, including 6,000 from the international community. All fifty states were represented as well as nearly 50 foreign […]

My London Correspondent: GPs in England use computers to automate their medical records; the system, however, is extremely fragmented. There are 18 different OSs (operating systems). Moves were made to privatize and allow local budgets in the British National Health Service, but when New Labour was elected, they stripped the doctors of their funding. The […]

In the 1970s, there were presentations to the Sacramento Society of Internal Medicine (SSIM) indicating that we as internists and medical specialists were not being fairly rewarded for our cognitive skills. Some of the more “enlightened” members spent a great deal of time and effort in order to come up with a Resourced Based RVS […]

During Career Day in High School, another student and I went to our local family physician to see what medicine was all about. He showed us his office, discussed a few patients, and showed us his books. He charged $1 for an office call. When I went to medical school, he told my parents there […]

Sixty-nine-year-old-Ruby came in for her annual pulmonary evaluation. Among other complaints, she was putting on weight. Her exam confirmed a 20-pound weight gain since her last evaluation. Ruby stated that the extra pounds were NOT from the food she was eating. “In fact,” she said, “I have to eat 5 or 6 times a day […]