The ABIM Is Trying to Be relevant; Choose Wisely

The American Board of Internal Medicine is irrelevant. It has always been. I realized this when I first certified in Internal Medicine in 2002. The test was largely fact based and filled with information that I would never need to know in practice. It did not measure my diagnostic acumen, or my physical exam skills,… Continue reading The ABIM Is Trying to Be relevant; Choose Wisely

Healthcare, News

I am your Doctor and this is my Humble Opinion

What is it like to be your primary care physician? How do day-to-day pressures, concerns and unfolding developments impact the one who looks after your health and wellbeing? What does your doctor feel about the responsibilities and nagging questions that are an integral part of every waking hour? What is it like to know that… Continue reading I am your Doctor and this is my Humble Opinion


Getting Started With a Health Blog  

Hola a tod@s, my dear friends. We would like to share today the article published on February 3 in the blog that will come out in paper in the next issue of ICU Management, the journal whose Editor in Chief is nothing more and nothing less than the Professor Jean-Louis Vincent, head of the… Continue reading Getting Started With a Health Blog  

End-of-Life, Healthcare

Doctor on Doctor Crime

Her heart was failing; her ejection fraction was unmeasurable. Her hip was broken, and she developed a pulmonary embolism post-operatively. She was painfully close to death. Yet at some point, the hospital finished, and spit her out at the nursing home. She was confused. I tried to take the best history that I could. Her… Continue reading Doctor on Doctor Crime

Health Conditions/Diseases, Healthcare

Is Meaningful Use Killing Us?

It took days to unravel what happened. The patient first presented to her cardiologist a few weeks prior. We figured that she must have doubled her amlodipine dose that morning, because her blood pressure was uncharacteristically low. He dutifully documented the hypotension and discontinued the 5 mg of amlodipine, not realizing that she had accidentally… Continue reading Is Meaningful Use Killing Us?

End-of-Life, Health Conditions/Diseases

The Final Gift of the Dying

I assumed many things that morning. For instance, I thought it was likely that Ronald's fatigue was from lung cancer that had metastasized to the liver. Or that he decided to stay in his room in the nursing facility because the decision to elect hospice had finally taken it's toll. I was sure that he… Continue reading The Final Gift of the Dying


Begin Again

It was a rather unlikely place to begin my clinical career. Shortly after starting medical school, I signed up to volunteer in the hospice unit of my academic medical center. The first few visits I relegated myself to fairly banal activities. I shredded old medical records, or I might do a load of laundry for… Continue reading Begin Again