New frontiers

Dec 30 2010 Published by under Medicine

If you are a regular reader, you may have noticed a drop in the frequency of posts at this blog.  There is a good reason for that.  Several weeks ago I announced a blog hiatus, which I honored more in the breach, the reason for which was a major career conundrum.  I had been spending about half my time directly treating patients, and the other few halves teaching and supervising resident physicians.   Then, a friend called---a local internist had decided to move away (something that young, educated Michiganders do quite a bit of) and the group was looking for a full-time doc to take over his patients.

Decisions about such big changes take a lot of time and energy, and writing isn't how I make my living.  Still, I do love it, and though my posts will be less frequent, I'm not planning on quitting.

So, I moved to the new digs.  I joined up with a small group of very busy, very talented internists in an awesome location.  And our office has a window.  I like that part a lot.  From the first day, I've been very, very busy, and I've learned a few things about myself (or re-learned, perhaps). My handwriting is not wonderful, and being busier doesn't seem to improve it.  This weekend I'm going handheld voice recorder shopping.  I have to get one that uses actual magnetic tape, but in return I will have beautifully typed (and consistently legible) notes.

Oh, and did you hear about Mississippi governor Haley Barbour's foray into transplant medicine?  As many of you know, transplanting a solid organ, say, a kidney, is not like changing a spark plug.  You can't just grab one and plug it into someone else.  For a kidney transplant to work, all sorts of fancy medical stuff has to happen.  Not only that, but there are one or two ethical issues involved in solid organ transplantation, not the least of which is the risk of coercing people to give up organs for donation.

But check out what Barbour did: for unclear reasons, one of which was the financial burden of medical care on the state, the Gov released two sisters from prison---on the condition that one donate her kidney to the other.  There are, to no one's surprise, a few racial issues involved here.  But from the medical end, there is nothing remotely ethical about this.  Anyway, it's quitting time.  A happy, healthy New Year to all my readers.

16 responses so far

  • DrV says:

    Whoa. Paper charts and magnetic tape recorders. That's like a time warp. Best of luck.

    I frequently have peers throw in the towel over time commitment. Have you considered modifying your blogging to be more amenable to your schedule? Shorter, less involved posts that pack the same voice but perhaps with more focus. Seems like it would be a reasonable concession.

  • Congrats on the new job man. Just don't spend too much time staring out of that window day dreaming.

  • Bob O'H says:

    Oh wow, congrats on the new jib, and the window. They're important they are, windows. Vital for serial prevaricators like myself.

  • Speaking of transplants, did you see the first successful transplant recipient died?

  • Mary says:

    No tape! If you get a digital recorder you can email the recording to whoever is typing it. Look into Dragon (voice recognition software), too. Your practice will save tons of money and it actually works.

  • Does this change mean you might be able to attend TAM9 in 2011? (fingers crossed)

  • Dianne says:

    First, congratulations and best wishes on the new job.

    Second, he made their release conditional on WHAT? I'm stunned not just by the fact that the governor did this-politicians make strange decisions all the time-but the fact that various civil rights groups are lauding the decision. This is not a good decision ethically. It's a fairly classic example of coerced consent. Why is the president of the NAACP calling it a "shining example"?

  • Congratulations! Here in Geographic Isolation we didn't really have any internists until about ten years ago. I went to my OB/Gyn for everything. I have no idea where men went for healthcare. Now we have a really great internal medicine group practice. I have a deep appreciation for access to these practitioners.

  • Jon H says:

    From what I've seen, the transplant was the suggestion of one of the sisters in her petition, not something put forward by the state.

  • Capt. Billy Cutshaw says:

    Like your web site alot, straight and to the point. And you dont mix words, meaning you callem like you see'em.
    I would like to ask, what do you think of the recent acqusition of the Detroit Medical Center by Vanguard Health Management Inc? I am in Texas, and wondered what Michiganders thought of it? Thanks again.

    • PalMD says:

      Among many medical folks i've talked to, many of us wonder how in the world Vanguard thinks they can make a single penny from DMC.

  • Liz Ditz says:

    Dear Pal,

    I hope that the job change means: increased professional satisfaction for you & more time with Mrs. Pal & PalEtte.

    I'd like to you know that reading your writings, here and elsewhere, has made me better educated and a sharper thinker about things medical and ethical. Wishing the Pal family all the best for 2011.

  • Daniel J. Andrews says:

    Happy New Year. Congrats on the new job--windows are always appreciated (I did a 6 month cubicle job once and had to walk 30 m just to look out a window).

    Why magnetic tape? Seems rather archaic, like having a two cans and a string for an intercom system. 🙂

    If you have time or inclination, what are your thoughts on this blood test that is sensitive enough to find one cancer cell out of a billion healthy ones?


  • Steve Schonfeld says:

    I think you'll enjoy full time practice. I made the jump from academics/part time practice to full-time practice almost 20 years ago. Haven't looked back...