https://www.doccheck.com/en/profile/channels/251-medicine-for-real?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251 I’m Shirie Leng, an anesthesiologist. I have worked in health care both as a nurse and as a doctor for 15 years. The health care industry is just that, an industry. As such it doesn’t have a whole lot of concern for the “customer”. I write... en Tue, 31 Mar 2015 12:23:00 +0200 Tue, 26 May 2026 15:49:10 +0200 https://www.doccheck.com/en/profile/channels/251-medicine-for-real?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251 https://dccdn.de/www.doccheck.com/data/q4/qt/57/zl/du/df/default_thumbnail_1427812798_mdSq.jpg https://www.doccheck.com/en/detail/articles/12783-cognitive-strain?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12783 article https://www.doccheck.com/en/detail/articles/12783-cognitive-strain?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12783#comments https://www.doccheck.com/en/detail/articles/12783-cognitive-strain Wed, 17 Aug 2016 15:08:02 +0200 The doctor-patient relationship is complicated by the fact that both doctor and patient are human, and thus have two parts to their brains. Many of you will be familiar with Daniel Kahneman’s book Thinking, Fast and Slow. Kahneman, along with Amos... The doctor-patient relationship is complicated by the fact that both doctor and patient are human, and thus have two parts to their brains. Many of you will be familiar with Daniel Kahneman’s book Thinking, Fast and Slow. Kahneman, along with Amos... https://www.doccheck.com/en/detail/articles/12705-can-she-make-a-cherry-pie-billy-boy?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12705 article https://www.doccheck.com/en/detail/articles/12705-can-she-make-a-cherry-pie-billy-boy?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12705#comments https://www.doccheck.com/en/detail/articles/12705-can-she-make-a-cherry-pie-billy-boy Wed, 27 Jul 2016 13:23:45 +0200 Here is the problem with cook-book medicine. You’ll come out with something that looks like quality care, but doesn’t really satisfy anyone. It’s nice to have guidelines, but if you don’t have the freedom to use judgement gained by experience... Here is the problem with cook-book medicine. You’ll come out with something that looks like quality care, but doesn’t really satisfy anyone. It’s nice to have guidelines, but if you don’t have the freedom to use judgement gained by experience... https://www.doccheck.com/en/detail/articles/12707-practice-vs-performance?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12707 article https://www.doccheck.com/en/detail/articles/12707-practice-vs-performance?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12707#comments https://www.doccheck.com/en/detail/articles/12707-practice-vs-performance Wed, 13 Jul 2016 09:37:56 +0200 It is one of the most boring truisms on the planet: “Practice makes perfect.” It is also one of the most misleading. Practice merely ingrains certain patterns after deciding on the best course of action after constant criticism and... It is one of the most boring truisms on the planet: “Practice makes perfect.” It is also one of the most misleading. Practice merely ingrains certain patterns after deciding on the best course of action after constant criticism and... https://www.doccheck.com/en/detail/articles/12646-prove-it?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12646 article https://www.doccheck.com/en/detail/articles/12646-prove-it?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12646#comments https://www.doccheck.com/en/detail/articles/12646-prove-it Wed, 15 Jun 2016 13:19:23 +0200 I was recently asked: “Can you give a specific example of how the broad knowledge of medicine gives MD anesthesiologists an advantage?” So I sent out an email/text/tweet to my colleagues specifically asking for examples of how the broader... I was recently asked: “Can you give a specific example of how the broad knowledge of medicine gives MD anesthesiologists an advantage?” So I sent out an email/text/tweet to my colleagues specifically asking for examples of how the broader... https://www.doccheck.com/en/detail/articles/12630-quality-ask-the-right-questions?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12630 article https://www.doccheck.com/en/detail/articles/12630-quality-ask-the-right-questions?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12630#comments https://www.doccheck.com/en/detail/articles/12630-quality-ask-the-right-questions Thu, 02 Jun 2016 10:26:39 +0200 How do you know who the good surgeons are? Ask their colleagues. Not their fellow surgeons. Ask the nurses they work with, the anesthesiologists or critical care doctors or radiologists. And don’t just ask them who is the best, but ask them “Who... How do you know who the good surgeons are? Ask their colleagues. Not their fellow surgeons. Ask the nurses they work with, the anesthesiologists or critical care doctors or radiologists. And don’t just ask them who is the best, but ask them “Who... https://www.doccheck.com/en/detail/articles/12614-every-batman-needs-a-robin?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12614 article https://www.doccheck.com/en/detail/articles/12614-every-batman-needs-a-robin?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12614#comments https://www.doccheck.com/en/detail/articles/12614-every-batman-needs-a-robin Tue, 24 May 2016 15:06:21 +0200 Today we are going to talk about typing. In most professional, higher-level educational fields the guys with the fancy degrees have clerical help. It has always been thus. Lawyers have paralegals and court reporters. Businessmen have executive... Today we are going to talk about typing. In most professional, higher-level educational fields the guys with the fancy degrees have clerical help. It has always been thus. Lawyers have paralegals and court reporters. Businessmen have executive... https://www.doccheck.com/en/detail/articles/12594-macra-doubling-down-on-acronyms?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12594 article https://www.doccheck.com/en/detail/articles/12594-macra-doubling-down-on-acronyms?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12594#comments https://www.doccheck.com/en/detail/articles/12594-macra-doubling-down-on-acronyms Thu, 19 May 2016 10:43:08 +0200 Consistent with the goals of the law, the proposed rule would improve the relevance and depth of Medicare’s value and quality-based payments and increase clinician flexibility by allowing clinicians to choose measures and activities appropriate to... Consistent with the goals of the law, the proposed rule would improve the relevance and depth of Medicare’s value and quality-based payments and increase clinician flexibility by allowing clinicians to choose measures and activities appropriate to... https://www.doccheck.com/en/detail/articles/12566-no-papers-no-problem?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12566 article https://www.doccheck.com/en/detail/articles/12566-no-papers-no-problem?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12566#comments https://www.doccheck.com/en/detail/articles/12566-no-papers-no-problem Tue, 03 May 2016 10:37:49 +0200 An immigration issue has come to my attention that I thought I would weigh in on. I was recently contacted by a reporter (Hi Alicia!) who wanted to know what I thought about admitting children of undocumented immigrants to medical school. Apparently... An immigration issue has come to my attention that I thought I would weigh in on. I was recently contacted by a reporter (Hi Alicia!) who wanted to know what I thought about admitting children of undocumented immigrants to medical school. Apparently... https://www.doccheck.com/en/detail/articles/12586-expectations?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12586 article https://www.doccheck.com/en/detail/articles/12586-expectations?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12586#comments https://www.doccheck.com/en/detail/articles/12586-expectations Fri, 15 Apr 2016 09:43:38 +0200 I was talking to a colleague of mine yesterday. (At least I flatter myself that I am a colleague. He has a writing job at a prestigious magazine while I, well, don’t.) We were talking about the doctor-patient relationship, as is our wont, and he... I was talking to a colleague of mine yesterday. (At least I flatter myself that I am a colleague. He has a writing job at a prestigious magazine while I, well, don’t.) We were talking about the doctor-patient relationship, as is our wont, and he... https://www.doccheck.com/en/detail/articles/12504-gambling-man?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12504 article https://www.doccheck.com/en/detail/articles/12504-gambling-man?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12504#comments https://www.doccheck.com/en/detail/articles/12504-gambling-man Wed, 06 Apr 2016 13:23:41 +0200 An interesting paper came out this month in the online medical journal Open Heart about one particular area of prevention – heart attack. And researchers asked around 400 people a simple question: “Which would you choose: to take a medication that... An interesting paper came out this month in the online medical journal Open Heart about one particular area of prevention – heart attack. And researchers asked around 400 people a simple question: “Which would you choose: to take a medication that... https://www.doccheck.com/en/detail/articles/12499-humans-will-be-human?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12499 article https://www.doccheck.com/en/detail/articles/12499-humans-will-be-human?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12499#comments https://www.doccheck.com/en/detail/articles/12499-humans-will-be-human Wed, 23 Mar 2016 17:24:10 +0100 Two weeks ago the governor of the great state of Massachusetts, my home state, signed into law a bill that puts strict limits on new opioid prescriptions, specifically a limit of a dosage sufficient for 72 hours, among other things. This of course, is... Two weeks ago the governor of the great state of Massachusetts, my home state, signed into law a bill that puts strict limits on new opioid prescriptions, specifically a limit of a dosage sufficient for 72 hours, among other things. This of course, is... https://www.doccheck.com/en/detail/articles/12469-step-in?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12469 article https://www.doccheck.com/en/detail/articles/12469-step-in?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12469#comments https://www.doccheck.com/en/detail/articles/12469-step-in Mon, 22 Feb 2016 16:17:56 +0100 The Magic Line. The idea here is that you work really hard, spurred on by a healthy fear of failure that compels you to the practice room, but then during the performance you drop the fear and just share what you’ve learned so far. The line is the... The Magic Line. The idea here is that you work really hard, spurred on by a healthy fear of failure that compels you to the practice room, but then during the performance you drop the fear and just share what you’ve learned so far. The line is the... https://www.doccheck.com/en/detail/articles/12445-were-all-unqualified?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12445 article https://www.doccheck.com/en/detail/articles/12445-were-all-unqualified?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12445#comments https://www.doccheck.com/en/detail/articles/12445-were-all-unqualified Tue, 16 Feb 2016 14:41:01 +0100 In this election year, with so many choices to be made between so many totally insane and completely unqualified applicants, I think it would be helpful to remember how totally insane and completely unqualified any of us are when it comes to making... In this election year, with so many choices to be made between so many totally insane and completely unqualified applicants, I think it would be helpful to remember how totally insane and completely unqualified any of us are when it comes to making... https://www.doccheck.com/en/detail/articles/12447-the-condescension-will-continue-until-moraleimproves?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12447 article https://www.doccheck.com/en/detail/articles/12447-the-condescension-will-continue-until-moraleimproves?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12447#comments https://www.doccheck.com/en/detail/articles/12447-the-condescension-will-continue-until-moraleimproves Thu, 11 Feb 2016 10:44:35 +0100 Women seeking a few hours of rest after hours of labor or a caesarean section often are surprised to learn that Massachusetts hospitals are increasingly restricting nursery access or, in some states, have closed the nurseries altogether. The latest in... Women seeking a few hours of rest after hours of labor or a caesarean section often are surprised to learn that Massachusetts hospitals are increasingly restricting nursery access or, in some states, have closed the nurseries altogether. The latest in... https://www.doccheck.com/en/detail/articles/12438-how-do-i-know-if-i-really-love-it?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12438 article https://www.doccheck.com/en/detail/articles/12438-how-do-i-know-if-i-really-love-it?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12438#comments https://www.doccheck.com/en/detail/articles/12438-how-do-i-know-if-i-really-love-it Thu, 04 Feb 2016 15:25:19 +0100 Very interesting question from a med student reader the other day: How do I choose what specialty to go into? Her particular decision was worded differently, but the general idea of the query is the same: how can I possibly know what it’s going to... Very interesting question from a med student reader the other day: How do I choose what specialty to go into? Her particular decision was worded differently, but the general idea of the query is the same: how can I possibly know what it’s going to... https://www.doccheck.com/en/detail/articles/12435-post-hospital-syndrome?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12435 article https://www.doccheck.com/en/detail/articles/12435-post-hospital-syndrome?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12435#comments https://www.doccheck.com/en/detail/articles/12435-post-hospital-syndrome Thu, 28 Jan 2016 08:26:43 +0100 Imagine this: You are sick. You are the sickest you’ve ever been. You want to die. You almost did die. You want to bury your head in your cozy bed for the next two years. But you’re not in your bed. This bed has plastic for covers and sandpaper... Imagine this: You are sick. You are the sickest you’ve ever been. You want to die. You almost did die. You want to bury your head in your cozy bed for the next two years. But you’re not in your bed. This bed has plastic for covers and sandpaper... https://www.doccheck.com/en/detail/articles/12357-practice-does-not-always-make-perfect?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12357 article https://www.doccheck.com/en/detail/articles/12357-practice-does-not-always-make-perfect?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12357#comments https://www.doccheck.com/en/detail/articles/12357-practice-does-not-always-make-perfect Fri, 18 Dec 2015 10:35:25 +0100 Why are doctors, lawyers, and musicians, even the seasoned and successful ones, still practicing? Is it just to keep up our current skill level, or is there something we still need to learn? Do doctors’ work, occasionally need dismantling and... Why are doctors, lawyers, and musicians, even the seasoned and successful ones, still practicing? Is it just to keep up our current skill level, or is there something we still need to learn? Do doctors’ work, occasionally need dismantling and... https://www.doccheck.com/en/detail/articles/12279-the-wisdom-of-nursing?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12279 article https://www.doccheck.com/en/detail/articles/12279-the-wisdom-of-nursing?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12279#comments https://www.doccheck.com/en/detail/articles/12279-the-wisdom-of-nursing Tue, 03 Nov 2015 08:47:34 +0100 When I was in nursing school there was always a lot of eye-rolling when it came time to discuss “Nursing Diagnosis”. This was mostly because nursing diagnoses were followed by book-length “Nursing Care Plans” which we had to produce for... When I was in nursing school there was always a lot of eye-rolling when it came time to discuss “Nursing Diagnosis”. This was mostly because nursing diagnoses were followed by book-length “Nursing Care Plans” which we had to produce for... https://www.doccheck.com/en/detail/articles/12293-data-who-needs-data?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12293 article https://www.doccheck.com/en/detail/articles/12293-data-who-needs-data?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12293#comments https://www.doccheck.com/en/detail/articles/12293-data-who-needs-data Thu, 29 Oct 2015 10:04:02 +0100 Even when we think we have a lot of data, we have either interpreted it incorrectly or can’t pull it from our memory. Similarly, a lot of data does no good if we are unable to think rationally, as happens when we are stressed or scared. And, our... Even when we think we have a lot of data, we have either interpreted it incorrectly or can’t pull it from our memory. Similarly, a lot of data does no good if we are unable to think rationally, as happens when we are stressed or scared. And, our... https://www.doccheck.com/en/detail/articles/12245-give-me-an-easier-question?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12245 article https://www.doccheck.com/en/detail/articles/12245-give-me-an-easier-question?utm_source=DocCheck&utm_medium=rss&utm_campaign=channel-251&utm_content=article-12245#comments https://www.doccheck.com/en/detail/articles/12245-give-me-an-easier-question Wed, 21 Oct 2015 08:51:24 +0200 How do we make decisions? We substitute a hard question for an easy one. The same thing happens in end-of-life discussions all the time. The question “Do you want us to do everything to keep you alive if there is little chance of a good outcome?”... How do we make decisions? We substitute a hard question for an easy one. The same thing happens in end-of-life discussions all the time. The question “Do you want us to do everything to keep you alive if there is little chance of a good outcome?”...