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The Best of The Week

In clinic I have two jobs.

The first job is to diagnose. Chief complaint, history of present illness, past medical history, allergies, review of systems, medications (and vitamins and supplements and herbs and any pills or concentrated substances), social history including addictive substance use, family history, physical exam. What is my diagnosis? A clinical portrait of the patient.

The second job is to communicate and negotiate. I have to get a snapshot of the person's medical belief system, their past experience with MDs, their trust or lack of trust, whether they are willing to take a prescription medicine. I have to try to understand their world view at this visit, at this moment in time. And it's not static and may change before I see them again. If I can understand the person well enough to communicate with respect, with concern, with understanding, then we may be able to negotiate a treatment.

In clinic the other day I had a new patient…

This is a throw-away daylog, unless many of you think it should be renamed into a real write-up/node. I'd leave this hidden, but would like more input. I'm passing along information to a friend; but I earned my Master's so long ago, I know I need more current information. I'm not doing formal research for pay or play, I promise.

How many of you have pursued a graduate degree while working full time, and was it in a…

Used facetiously, the bozo bit is a notional semaphore flag that you can set alongside your mental model of a person or other entity. Like any other bit in the field of computer science, a bit is Boolean, meaning that it may have one of two states: ON or OFF. By default, we normally assume that any person we meet is not a bozo. This maps well to the common programming convention that new Boolean variables are initially set to zero, or off. Bozo, of course, was…