the system

Now, I don't want to offend anyone with this post (it's already too late), but it seems these days that the only qualification that one needs to don a long white coat is to work in some patient care area of a hospital. The long white coat used to be the way patients, families, and other hospital medical staff could instantly tell who was a full-fledged attending physician. In fact, the emphasis on the white coat starts on the first day of medical school with something aptly called a "white coat ceremony."

Here in Long Island, NY where I practice, it seems to be the norm to have a precolonoscopy visit. This visit serves several important purposes in my mind: I can meet the patient, take a history, and make sure they actually need a screening colonoscopy. I can answer all of the above questions in more detail than the primary doctor can. I also get to give them my basic talk about the purpose of a colonoscopy, how and why we remove polyps, the importance of good bowel prep and how to do it, and the small associated risks of a colonoscopy. We can talk about what to do with medications, and where to arrive on the day of the test, and parking, and all those seemingly small details that can make a patient stressed-out about the test for no good reason.

In every hospital I have ever worked in, from medical school to present day, there is a noise pollution problem of epic proportions. Every medical device seems to emit at least three different types of beeps, each of them being more loud and annoying than the next.

“Hi, it’s Dr. Smith…are you taking consults today?” the voice on the other side of my short-range hospital phone said.  I recognized the callers name as one of the new hospital doctors, known as hospitalists. “Of course,” I said, “what have you got?” I guess some groups have a specific doctor for the day “take”  … Read more