medicine for real

I’m Shirie Leng, an anesthesiologist. I have worked in health care both as a nurse and as a doctor for 15 years. The health care industry is just that, an industry. As such it doesn’t have a whole lot of concern for the “customer”. I write about the processes, redundancies, red-tape and pure pointlessness of much of medicine, so that you can make decisions and navigate for yourself.

The doctor-patient relationship is complicated by the fact that both doctor and patient are human, and thus have two parts to their brains. Many of you will be familiar with Daniel Kahneman’s book Thinking, Fast and Slow. Kahneman, along with Amos Tversky and others,  more...

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Here is the problem with cook-book medicine. You’ll come out with something that looks like quality care, but doesn’t really satisfy anyone. It’s nice to have guidelines, but if you don’t have the freedom to use judgement gained by experience to adjust care to  more...

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It is one of the most boring truisms on the planet: “Practice makes perfect.” It is also one of the most misleading. Practice merely ingrains certain patterns after deciding on the best course of action after constant criticism and problem-solving. more...

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I was recently asked: “Can you give a specific example of how the broad knowledge of medicine gives MD anesthesiologists an advantage?” So I sent out an email/text/tweet to my colleagues specifically asking for examples of how the broader knowledge of medicine gave  more...

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How do you know who the good surgeons are? Ask their colleagues. Not their fellow surgeons. Ask the nurses they work with, the anesthesiologists or critical care doctors or radiologists. And don’t just ask them who is the best, but ask them “Who would you want to  more...

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Today we are going to talk about typing. In most professional, higher-level educational fields the guys with the fancy degrees have clerical help. It has always been thus. Lawyers have paralegals and court reporters. Businessmen have executive assistants. Baseball  more...

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Consistent with the goals of the law, the proposed rule would improve the relevance and depth of Medicare’s value and quality-based payments and increase clinician flexibility by allowing clinicians to choose measures and activities appropriate to the type of care  more...

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An immigration issue has come to my attention that I thought I would weigh in on. I was recently contacted by a reporter (Hi Alicia!) who wanted to know what I thought about admitting children of undocumented immigrants to medical school. Apparently there are at least  more...

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I was talking to a colleague of mine yesterday. (At least I flatter myself that I am a colleague. He has a writing job at a prestigious magazine while I, well, don’t.) We were talking about the doctor-patient relationship, as is our wont, and he said something that  more...

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An interesting paper came out this month in the online medical journal Open Heart about one particular area of prevention – heart attack. And researchers asked around 400 people a simple question: “Which would you choose: to take a medication that would guarantee  more...

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