Skip to main content

Clinton and Trump Give the Nation Chest Pains

Oftentimes, physicians and patients face bad options.  I wish that the choices that patients faced were all good ones, or at least had one option that was likely to yield a favorable result.   This scenario is further complicated as medicine is an uncertain discipline with moving goal posts and changing facts.  We make decisions and recommendations based on the current state of facts and our medical knowledge and experience.  We may counsel a patient against surgery, only to discover days later in retrospect that an operation would have been the right choice.  An adverse outcome may result from an excellent decision. 

There are many medical circumstances when the options are equally foreboding.   A man may be suffering frequent episodes of angina, chest pain caused by hardening of the coronary arteries.  He is on maximal medical treatment, but the symptom persists.  This is not only limiting his life activities and pleasure, but also significantly increases his risk of a heart attack.  His cardiologist has concluded that only a coronary artery bypass operation can help him.  However, the heart surgeon is greatly concerned that because of other illnesses and conditions that the patient is suffering from, that his surgical risks are substantially increased.  In other words, his condition after surgery might be worse than he is now. 


Surgery or Status Quo?

It may be that my hypothetical cardiac patient is suffering from chest pains as a result of the current state of our electoral politics.  Perhaps, his heart has been stressed from failure to accept that the two presidential candidates of our major political parties are the best that this nation produced.   In a country teaming with talent, we are left with two highly flawed candidates who most of us can’t stand.  I surmise that many Americans have developed chest pains and other ailments as a result of demoralizing and dirty politics that each week sink deeper into a slimy abyss.

I cannot count how many of my octagenarian patients - who have never missed a presidential election - are sitting this one out with disgust. 

With regard to this election, I also feel that I face two unpalatable options. How to choose between strychnine or cyanide.  Which option is better, quicksand or a cliff?    

Remember, when we read The Odyssey years ago and read of Odysseus’s ship navigating between Scylla the 6-headed monster and the deadly whirlpool Charybdis?  Two terrible options.  Many Americans today, in an electoral sense, are on a similar journey.


Comments

Popular posts from this blog

Why Most Doctors Choose Employment

Increasingly, physicians today are employed and most of them willingly so.  The advantages of this employment model, which I will highlight below, appeal to the current and emerging generations of physicians and medical professionals.  In addition, the alternatives to direct employment are scarce, although they do exist.  Private practice gastroenterology practices in Cleveland, for example, are increasingly rare sightings.  Another practice model is gaining ground rapidly on the medical landscape.   Private equity (PE) firms have   been purchasing medical practices who are in need of capital and management oversight.   PE can provide services efficiently as they may be serving multiple practices and have economies of scale.   While these physicians technically have authority over all medical decisions, the PE partners can exert behavioral influences on physicians which can be ethically problematic. For example, if the PE folks reduce non-medical overhead, this may very directly affe

Should Doctors Wear White Coats?

Many professions can be easily identified by their uniforms or state of dress. Consider how easy it is for us to identify a policeman, a judge, a baseball player, a housekeeper, a chef, or a soldier.  There must be a reason why so many professions require a uniform.  Presumably, it is to create team spirit among colleagues and to communicate a message to the clientele.  It certainly doesn’t enhance professional performance.  For instance, do we think if a judge ditches the robe and is wearing jeans and a T-shirt, that he or she cannot issue sage rulings?  If members of a baseball team showed up dressed in comfortable street clothes, would they commit more errors or achieve fewer hits?  The medical profession for most of its existence has had its own uniform.   Male doctors donned a shirt and tie and all doctors wore the iconic white coat.   The stated reason was that this created an aura of professionalism that inspired confidence in patients and their families.   Indeed, even today

Electronic Medical Records vs Physicians: Not a Fair Fight!

Each work day, I enter the chamber of horrors also known as the electronic medical record (EMR).  I’ve endured several versions of this torture over the years, monstrosities that were designed more to appeal to the needs of billers and coders than physicians. Make sense? I will admit that my current EMR, called Epic, is more physician-friendly than prior competitors, but it remains a formidable adversary.  And it’s not a fair fight.  You might be a great chess player, but odds are that you will not vanquish a computer adversary armed with artificial intelligence. I have a competitive advantage over many other physician contestants in the battle of Man vs Machine.   I can type well and can do so while maintaining eye contact with the patient.   You must think I am a magician or a savant.   While this may be true, the birth of my advanced digital skills started decades ago.   (As an aside, digital competence is essential for gastroenterologists.) During college, I worked as a secretary