Blog

This may sound obvious, but for goals and treatments to be aligned, patients must have an honest understanding of both their medical condition and the potential benefits/burdens of proposed treatment options. I’m pointing this out, because in our desire to maintain ‘hope’, providers often couch bad news in niceties and ambiguities, which is not helpfulRead more

A common question It took me most of my fellowship year and well into my first job as a full time palliative medicine provider to come up with a succinct description of what I do.  To me, palliative care is “a helper service, working with patients (and their families) who have complicated conditions”.  I likeRead more

a wonderful video about empathy. Dr Brené Brown has made a wonderful video about empathy. While this video is not specifically designed for medical providers, it is nonetheless a wonderful teaching tool. As medical providers, we have the privilege and responsibility of being with patients during very difficult times.  And sometimes, we are the ones havingRead more

Heresy, I know. The electronic medical record (emr) is a powerful tool.  It’s great for compiling and storing information; and another huge perk is that provider notes are now legible!  The irony is that just because notes are now legible, doesn’t mean they are true. Typical provider notes in the emr are very one sided-Read more

Hope isn’t given enough respect. Because its presence often lies in the background of our consciousness, hope’s importance and impact in provider-patient relationship/communication is underappreciated  And hope doesn’t just influence our patients and families, it affects us as providers as well. Because of this, hope will be a recurring topic on my blog. A fewRead more

Palliative medicine consultation is often ordered when there are ‘code status’ issues.  Usually this means the medical team feels the patient ‘should be DNR’ but the patient/family wants ‘everything done’.  There are a number of issues to unpack in these lines (among them that palliative teams are not the DNR team, or that DNaR- doRead more

Improved provider communication benefits our patients, but there are invaluable benefits to providers as well. There are times when most of us worry about the potential for causing our patients to suffer due to the ongoing treatments we are providing.  This especially applies to those working in critical care units or oncology settings- where theRead more

I can be a bit of a curmudgeon when it comes to palliative medicine. While I intellectually understand the need for palliative medicine providers and am encouraged by the growth of the specialty, I’m conflicted.  In my heart, I feel that the rise of palliative medicine as a specialty represents an indictment of medicine asRead more

In the middle of a fulfilling career as a reconstructive surgeon, I decided to change paths. I realized that I had become more interested in hearing my patients’ stories and helping them through the health-care labyrinth than in performing operations. This interest compelled me to switch to palliative medicine. In 2013–2014 I did a formalRead more

Plastic surgery travels. Part of what had attracted me to the specialty of plastic surgery was a desire to use my skills in resource-poor areas of the world. I am privileged that my practice, primarily in a large multi-specialty group located outside Los Angeles, afforded me the opportunity to do this work. I have warmRead more