232. Why , Doctor, Why?

"What was all the other tests you ran. You said a urine infection test when there was no reason for one and then you ran a list of tests that you did even say you were doing.  Just because I have State Insurance don't meen I'm going to put up with un nessasary and un warrentted test. This is going to stop right now from evey doctor there. Now I want an understandable breakdown of the tests you did Why and what they all ment and were for, that I can understand."

Though directed at one of my colleagues, I could well have been the subject since I frequently order tests without explanations--just a general "screening for infections," or "looking for problems with your kidney or level."  I could do more.

231. Thirty-Five

My son and his son

35 years ago today, I delivered my son, and a VBAC at that (post #128)!  Or I should say, I attended the delivery, because of course his mother delivered him. It was a month after my internship so I was a fully fledged MD though still three years shy of being an obstetrician-gynecologist.

So if any one one asks how long I've been delivering babies, I just respond with my son's age.

230. Privacy

You wouldn't think that a few days after you visit a doctor you see your story show up on a blog, such that you neighbor calls up and says she's sorry to hear about your abnormal Pap smear.

So what do I do to protect the privacy of the patients whose stories are the seeds of my posts?


1. I change the name, age and other demographic details.
2. I tweak the stories, changing details that don't impact the nature of the observations being made. 
3. Though I will write a draft soon after an encounter, the final post may be delayed for weeks or months.
4. Many stories are a composite of several patients with similar medical histories.
5. Just a handful of people know my identity.

In other words no one reading my posts would be able to identify the patient unless he had access to all of my daily clinic and hospital records, and lots of time to sort things out. If there is any concern about privacy, it should be directed at that person who has such access and uses it in that manner.