Still thankful...

I trust you've all seen it by now: Physicians' Foundation Survey via CNN

Horror of horrors, Half of all primary care doctors (in survey) would leave medicine! For a specialty trying to prove our mettle in the world of evidence-based medicine (and being leaders in the field in many respects), I've heard very little from the rank-and-file disputing the media coverage of this completely misleading and unscientific survey. The response rate was a whopping 4%. Not any selection bias there; of course not.

Don't Give Up

Ever since the FMEC Conference, I've felt a heavy weight on my head. I can't think about health care without feeling overwhelmed with the hugeness of trying to hold all the social determinants of health piled in our arms, wondering how to begin building a clinical and community health foundation with our hands already full and while balancing on the tiny point of band-aid high-tech medicine that is currently, precariously, keeping most of us alive for 70 years or so.

Tonight, though, I read my first clinical blog from September, and was reminded of another patient.

Leadership and Servitude 2/20/09

I was planning to write next about my first week as an Attending in the hospital, but I will have to procrastinate on that issue a bit. Today I participated in a workshop on health for the underserved and homeless as part of the STFM-NE/FMEC Conference. I listened as many health professionals and students presented and discussed their commitment to the most marginalized people in our society. We used the forum to troubleshoot practical problems but also to envision the kind of health care system that would support justice for patients, citizens, and providers.

Clinical Reflections

Yesterday, I injected steroids into a woman’s shoulder with no help. I diagnosed her, offered her the injection, verbally consented her, re-read about how to do the procedure, and mixed the steroid and anesthetic myself. She was so hysterical at the sight of the needle I had to have the PA I work with hold her hand and head and we tried to lie her down. But in that position, I couldn’t get the needle in the right space. It was stuck in the tendon and only hitting bone, so without taking the needle out, we sat the panicky patient back up and I repositioned until the milky mixture went in smoothly.