Glossary

Aphorism A pithy saying conveying a useful truth in a

memorable way. A classic medical aphorism (whose original

author is unknown) is as follows: The doctor who makes the

correct diagnosis will be the one who sees the patient last.

Here is another, this one an Oslerism: The doctor who treats

himself has a fool for a patient. See Chap. 1.

Argot In general, the word argot refers to an idiomatic

vocabulary. In medicine, it indicates words and phrases we

use that we think patients don’t understand, such as “high

serum porcelain level” (suggesting a “crock,” or hypochon-

driac) or “flick” (the pronunciation of the acronym FLK

for “funny looking kid”). For many reasons, medical argot

should not be used. See Chap. 3.

Bedside doctor A physician who avoids physical barriers

– such as footboards of hospital beds or exam room desks –

between doctor and patient. See Chap. 5.

Beneficence Ethical jargon referring to “doing good” for

the patient, and the opposite of malfeasance. See Chap. 12.

Closeted anarchism What Francis S. Collins describes as

the hope held by many scientists and practicing physicians

that someday they will turn up an unexpected fact that will

force a disruption of the framework of the day. See Chap. 8.

Collusion of anonymity A state described by Balint in which,

with many physicians and other providers, making decisions,

writing orders, and offering advice to patient and family, no

one is really in charge, resulting in a dilution of responsibility

that can compromise patient care. See Chap. 5.

347

348 Glossary

Consultation The act of sharing care with another physician,

generally resulting in improved outcomes and offering valuable

learning opportunities. See Chap. 5.

Declaration of Geneva An adaptation of the Oath of Hippo-

crates, intended to avoid some Hippocratic anachronisms,

currently recited by graduates of most American medical

schools. See Chap. 12.

Delusion of indispensability The erroneous belief that

your patients cannot get along without you, even for a short

while. See Chap. 2.

Designated requestor One whose job is to seek organ

donations from family members at the time of a death. See

Chap. 12

Disease denial and rationalization syndrome A medical

pas de deux in which both patient and physician enter into

an unspoken pact to ignore the need for action in a clinical

setting. See Chap. 2.

Distributive justice An ethical principle describing the

fair allocation of goods and services. See Chap. 14.

Doctor as the drug An allusion to the healing power of the

physician’s presence, often more potent than any medication

available. See Chap. 5.

Doctoring The art and science of providing healthcare to

patients – one person at a time. See Chap. 1.

Etiquette-based medicine The process of integrating good

manners into the clinical method. Examples include intro-

ducing yourself, shaking hands with the patient, sitting down

to talk, and explaining your role. See Chap. 3.

Evidence-based medicine (EBM) Highly valued by today’s

clinician, EBM is defined by Sackett as the conscientious,

explicit, and judicious use of current best evidence in making

clinical decisions about the care of an individual patient. See

Chap. 8.

Executive function The ability to plan, initiate, sequence,

monitor, and inhibit goal-directed activities. See Chap. 2.

Glossary 349

Experience What we acquire as we age, and what we

sometimes call our mistakes. See Chap. 8.

Furor therapeuticus A tongue-in-cheek, mock-Latin phrase

describing the frantic urge to prescribe something – anything

– to treat a disease. See Chap. 5.

GOBSAT An acronym for “good old boys sat around a

table,” usually used to describe a clinical guideline that is

short on evidence and long on opinion and “experience” (See

definition of Experience, noted earlier).

Health literacy The patient’s ability – or inability--to

comprehend printed handouts, instructions on prescrip-

tion labels, and all the other written material presented to

patients in the course of receiving healthcare. See Chap. 5.

Heartsink patient Someone whose name on the appoint-

ment schedule makes your heart sink just a little. See

Chap. 7.

Hidden curriculum What you might learn in medical

school along with diagnostic techniques, drugs and doses,

and technical skills. Examples are how to relate to other

physicians and how to nurture your inner self. See Chap. 9.

Hierarchy of natural systems A theoretical model of

systems ranging from sub-atomic particles to the biosphere,

based on the principle that any change (called a perturba-

tion) at any level in the hierarchy has an impact throughout

all systems. See Chap. 5.

Illness A concept that includes not only disease, but also

the patient’s experience in regard to the disease, including

pain or other type of suffering, the economic impact, and its

influence on his or her life and that of the family and close

friends. See Chap. 2.

Impact factor A measurement used by medical editors

and publishers to describe how often an article published in

a specific journal is cited in other journals. See Chap. 8.

350 Glossary

Improvisation In a clinical sense, and especially in the

setting of eliciting a medical history, improvisation refers to

the physician’s unscripted ability to respond to cues provided

during the dialogue with the patient, allowing the narrative

to meander in a meaningful way – analogous to the manner

in which some jazz musicians communicate while playing

music. See Chap. 3.

Information mastery The art of conquering the huge

amounts of scientific data the physician encounters each day

via journals, books, continuing educations programs and, of

course, the Internet. See Chap. 8.

Informed opinion imperative This is my term for what I

consider the physician’s duty, when a decision must be made

and after explaining all the choices, to give the patient guid-

ance as to the best option. See Chap. 12.

Malingering by animal proxy A term applied to situations

in which pet owners bring animals to veterinarians, describ-

ing non-existent ailments in an effort to obtain controlled

substances for their own (human) use. See Chap. 3.

Medical professional life Five more-or-less predictable

stages, beginning with medical education and training and

ending with winding down and retirement that most of us

experience during our years as physicians. See Chap. 13.

Narrative-based medicine The clinical act of helping the

patient tell a part of his or her life narrative, and helping that

person “fix the broken parts of the story.” See Chap. 3.

Narrative competence The ability to acknowledge, absorb,

interpret, and sometimes even act on the stories of others.

See Chap. 3.

Nighthawk A type of teleradiology in which a radiologist,

wide-awake in Spain or India, reads a diagnostic film taken

in, for example, Ketchum, Idaho, in the middle of the night.

See Chap. 13.

Non-malfeasance Ethical jargon roughly equivalent to

the maxim: “Do no harm.” The dictum especially applies to

eschewing intentional harm, such as assisting suicide. See

Chap. 12.

Glossary 351

Nutraceutical A neologism combining the words nutrient and pharmaceutical, indicating a food or food supplement

used for medicinal purposes. Examples include ginseng and

green tea. See Chap. 11.

Open-ended question A query that cannot be answered

“yes” or “no.” See Chap. 3.

Pareto principle Named for the Italian economist who

first advanced the concept, the Pareto 80/20 principle holds

that 20 percent of a set is responsible for 80 percent of a

related outcome. See Chap. 7.

Pathognomonic A pathognomonic clinical finding is a

symptom, physical sign, laboratory or imaging result that is

unique to a specific disease; its presence confirms a diagno-

sis. The finding of Koplik spots of measles is an example of a

pathognomonic sign. See Chap. 4.

Pathologic grief Describing a situation in which a person,

following a death of a loved one or some other type of loss,

becomes bogged down in one of the first four stages of grief:

denial, anger, bargaining or depression. See Chap. 6.

Pearl Also called a clinical pearl or diagnostic pearl (since

most have to do with diagnosis), a pearl is a little known,

clinically valid factoid stated in a way that is easy to remember.

For example: The patient with appendicitis is unlikely to be

hungry. See Chap. 4.

Personal legend According to the man who calls him-

self king, one’s Personal Legend is “what you have always

wanted to accomplish.” (Coelho, p. 21.) See Epilogue.

Pharmaceutical invincibility The notion, not altogether

rare among physicians, that just because we know about

drugs and their actions, we are immune to their addictive

effects. See Chap. 12.

Plastic pearl These are seemingly clever gems of wisdom

that have not turned out to be exactly true. An example is the

widespread misconception that administering narcotics to

a patient with acute abdominal pain makes it subsequently

difficult to determine the diagnosis. See Chap. 4.

352 Glossary

POEMs An acronym for “Problem Oriented Evidence that

Matters,” an effort to use EMB to answer key clinical ques-

tions. See Chap. 8.

Polypharmacy The pharmacologic Wild West of multiple

drug use, ruled by the dictum, “If one drug is good, then

three must be even better.” See Chap. 5.

Premature declaration of death The phenomenon of being

avoided that is sometimes reported by persons with cancer

or other potentially fatal diseases, leading to a sense of

isolation and abandonment. See Chap. 6.

Quiz-Doc A Doctor Seuss neologism, a Quiz-Doc is a

physician who is good at asking many questions, but not

necessarily good at listening. See Chap. 3.

Rational non-interventional paternalism A practice

described by Savulescu in which doctors form conclusions

as to what is best for their patients and argue rationally to

convince them to make what the physician sees as the best

choice. See Chap. 12.

Red flag Clinical “red flags” are danger signs indicating

the possible presence of “must-never-miss” diagnoses. An

example is painless gross hematuria, which may be the first

sign of a tumor of the urinary tract. See Chap. 4.

Rogue doctor The professional misconduct frequent flier,

who exhibits repeated evidence of unacceptable behavior.

See Chap. 12.

Second victim What happens when there is a medical

error harming a patient and then the physician suffers a

subsequent crisis of self-confidence that undermines future

practice decisions. See Chap. 12.

Systems-based medicine A healthcare concept that

embraces thinking of systems both “above” (such as the per-

son, family, and community) and “below” (such as tissues

and cells) a diseased organ such as the heart. See Chap. 5.

Telemedicine The rapidly evolving fusion of healthcare with

many applications of computerization, including electronic

medical records, telecommunications, and the World Wide

Web. See Chap. 13.

Glossary 353

Tenfold error A clinical misadventure involving medica-

tion use in which, for example, a recommended dose of 10

mgm may become administered as 100 mgm. See Chap. 12.

Testosterone storm A whimsically named condition,

describing what happens when an otherwise respectable

male physician acts on his sexual fantasies about a patient,

colleague, student, or a member of his staff. See Chap. 12.

Third ear An anatomical improbability usually stated as

“listing with the third ear,” the concept describes the ability,

when eliciting a medical history, to attend to how things are

expressed, body language and emotion, and what is carefully

not stated. See Chap. 3.

Ticket of admission A complaint offered by a one who

believes in it, rightly or wrongly, instead of what really

brings the patient to the physician. An example might be

a complaint of vague upper abdominal pain when the real

problem lies with the patient’s job, marriage, finances, or

family. See Chap. 3.

Virtual E-learning On-line learning based on a virtual

practice with virtual patients, peer-to-peer learning, and

“ask-the-experts” opportunities, customized to the needs of

the individual physician. See Chap. 8.

WHIM An acronym for “What have I missed?” Physicians

should ask themselves the WHIM question at the end of any

clinical encounter, especially if anything seems a little unset-

tled. See Chap. 4.

Wise physicians Doctors who provide excellent, up-to-date

care for their patients while taking good care of their own

families, their communities, and themselves. See Chap. 1.

Zebra A metaphor for the unusual diagnosis, especially

one that may pop up among a herd of ordinary “horses.”

Someday, among all the patients reporting fatigue, you will

find a person with myasthenia gravis. See Chap. 4.

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Index

Abdominal aortic aneurysm

(AAA), 95

Acetazolamide (Diamox), 115

Active listening skill, 61–62

A Doctor′s Work, 199

Aequanimitas with other

Addresses, 256

Alpha-1 blockers, 115

American Urological

Association, 190

Antidepressants, 116, 190

Antispasmodic drugs, 124–125

Applebee′s restaurant chain, 159

Apprenticeship model, 14

Aspirin, 115–116

Awakenings, 62

Beta-blockers, cardiovascular

disorders, 116

Bisphosphates, 116

Black box warning/amusing

absurdity, 112–114

Book writing, 260–261

British Medical Journal (BMJ),

181, 191

Broad-based journals, 181

Bullseye rash, 88

Carbamazepine (Tegretol), 116

Chronic obstructive pulmonary

disease (COPD), 31

Circadian biorhythms, 170

Clinical aphorisms

Hippocrates and abdominal

pain evaluation, 12

imperturbable self-possession, 13

new knowledge and creativity, 11

Clinical diagnosis

analysis, 78–79

Bell′s lecture, 73–74

carelessness, 92

casual observation, 76

diagnosis vs. incompatible

symptoms, 92

“diagnostic pearls,” 82–86

examination, 80

handshake, importance, 76–77

“missed diagnosis,”, 99

“must never miss” diagnosis,

93–95

objective evaluation, 91

over-analysis, 90–91

pathognomonic clinical

manifestations, 87–89

patient as “consultant,” 95–96

patient′s circumstances, 75–76

patient′s decision, 74–75

patient′s primary purpose, 77

“plastic pearls,” 86–87

practical methods, 80–82

rare disease, 100–101

“red flags,” 89–90

technical competence, 93

“vital signs,” 79–80

WHIM–exercise, 96–98

wise words, 101–102

Clinical Diagnostic Pearls, 84

Clinical dialogue and

communication

active listening skill, 61–62

believing the patient, 64–65

body language, 53

default opening question, 58

empathic expression, 66

359

360 Index

Clinical dialogue and

communication (Cont.)

eye to eye contact, 57–58

framing open-ended queries,

63–64

health professional′s role, 56–57

height-based exercise and

power implications, 58

“I don′t know,” 68

medical interview

improvisation, 59–60

medical slang usage, 68

medical word usage, 65–66

“narrative-based medicine,” 54

narrative competence, 54–55

open-ended questions and

Quiz-Docs, 59

patient′s contribution, 69

patient′s name, 55–56

physical examination and

medical history, 56

problem presentation and

clinical context, 69–70

relative eye level, 58

vague complaints, 60–61

values, language and culture,

66–67

wise words, 70–71

Clinical interview improvisation,

58–60

Clomipramine (Anafrani), 116

Collectivization of medicine, 16

Commercialization of medicine,

16–18

Community

The Adventures of Dr.

Huckleberry, 240–241

care of family members, 243

effective communication,

236–237

family involvement, 242

family time, 240

local committees and

commissions, 243–244

Make-A-Wish Foundation, 242

service activities, 244–246

work and family, 238–239

Complementary and alternative

medicine (CAM), 120

Computerization of medicine,

18–19

Continuing medical education

(CME), 177

Cutting out process, 322–323

Cyclophosphamide (Cytoxan), 116

Cyproheptadine (Periactin), 116

Daily Prayer of a Physician, 255

Data management systems,

162–163

Death, physician′s approach,

152–153

Death with Dignity Act

(DWDA), 141

Declaration of Geneva, 274

Democratization of medicine,

15–16

Digoxin (Lanoxin), 116–117

Disease denial and rationalization

syndrome, 46–47

Disease management

“bedside teaching,” 108

consultation, 126–128

counselling, 129

diethylstilbestrol and

thalidomide, 113

drug-herbal interactions, 120

hierarchy , natural systems,

111–112

ideal medication

characteristics, 122–123

limitations of medication,

124–125

polypharmacy, 123–124

prescriptions, 121–122

prevention and cure, 128–129

Rush′s methods, 112

Semmelweis′ observations, 107

therapy expectations, 109

treatment decisions,

108–109

wise words, 130–131

Dishonesty in Medicine

Revisited, 299

Index 361

“Doctor of first resort,”

community, 243

Doctors′ Marriages: A Look at

their Problems and

Solutions, 237

Dorland′s Illustrated Medical

Dictionary, 206

Dying patients and care

positive attitude, 145

death, physician′s approach,

152–153

family members′ relationship,

149–150

funeral ceremony, 139

Goldilocks approach, 142

Herodotus, 141

ideal average life span, 136

immediate remedy, problems

in, 145–146

informing family of death,

148–149

isolation, 144–145

leukemia, case illustration,

140–141

misinterpretation, 146

normative expectations, 138

Osler′s observation, 147

pathologic grief, 151

physicians′ emotional

responses, 152

prediction of death, 143–144

prognostication, 143

skill management, 136–137

suicide, 148

unexpected death, 147–148

wise words, 153–154

Edge of Medicine, 334

Electronic medical record (EMR),

162, 168, 172, 315

Emergency department (ED)

study, 171

Emergency medical technicians

(EMTs), 91

Encyclopedia of DNA elements

(ENCODE), 317–318

Enron: the Smartest Guys in the

Room, 223

Erythema migrans, 88

Ethical transgressions, 291–292

Etiquette-based medicine, 57

Evidence-based healer, 109–110

Evidence-based medicine (EBM),

109, 113, 183–185

Exchange traded funds (ETFs), 320

Familiar Medical Quotations, 329

Feeling Alive After 65, 190

Feminization, 19–20

“Gee-whiz facts,” 188–189

Geneva Declaration, 328

“GI cocktail,” 87

Goldilocks approach, 142

Gorging, 183

Graduate medical education

(GME) program, 229

Headache, 63–64. See also

Open-ended queries

Healer′s Art, 344

Health literacy level, 120–121

Healthy physician

active mind, 255

Asimov′s work, 267

carborundum, 251–252

health and exercise, 255

historical events, medicine,

261–263

humorous remarks, 266

indispensability, 252

journal and book writing,

260–261

knowledge and creation, 261

laws of probability, 267

learning skill, 256

life and work, 250–251

Murphy′s Laws of Medicine,

265–266

patienthood, 254

personal and professional life,

252–253

personal reflection, 263

physician–authors′ books,

258–260

professional successes, 263

362 Index

Healthy physician (Cont.)

reading non-medical books,

256–257

self-prescribed drugs, 253–254

wise words, 267–268

Heart failure (HF), 80

Herbal preparations, 120

Hippocratic oath, 272–275

Hunting/grazing. See Gorging

Hydroxychloroquine

(Plaquenil), 117

Hypnosedative drugs, 117

Ibuprofen (Advil), 117

I Married a Doctor, 236

Impaired registrants program,

326–327

Individualized normalized ratio

(INR), 120

Individual retirement accounts

(IRAs), 320

Individual retirement plan

(IRA), 319

Infectious Diseases Society of

America (IDSA), 20

Information technology

electronic medical record

(EMR), 315

telemedicine services, 317

video conferencing and

teleradiology, 315–316

Internal Revenue Service

(IRS), 320

International Virtual Medical

School (IVIMEDS), 187

Jenner, Edward, 6, 40

Journal of the American Medical

Association (JAMA), 25,

181, 182, 191, 312

Journal writing, 260–261

Koplik spots, 88

Language and ethnicity, clinical

communication, 67

Learning medical terms, 205–209

Learning style, 179–180

Life partnerships, 236–237

Literary models, 212–214

Lithium, bipolar disorder, 117

Make-A-Wish Foundation, 242

Medical Economics, 190

Medical Education in the United

States and Canada, 14

Medical errors

balancing probabilities, 286

Bavarian surgical team

incident, 289–290

clinical errors, 288–289

examples, 286–287

Medical ethics

autonomy, 276

beneficence, 275–276

clinical errors, 288–289

clinical misjudgments and

criticism, 290

confidentiality, 277, 284–285

credible physician, 290–291

ethical disagreements,

278–279

ethical transgressions, 291–292

Hippocratic oath, 272–275

informed opinion imperative,

283–284

issues, 279–281

justice, 278

medical errors, 286–288

non-malfeasance, 276

OPO and treatment, 282–283

patient autonomy, 283–284

political opinions, 285–286

principles

autonomy, 276

beneficence, 275–276

confidentiality, 277

justice, 278

non-malfeasance, 276

truth-telling, 277

professional misconduct

alcohol and drug misuse,

295–296

dishonesty and

dishonorable behavior,

298–300

Index 363

sexual abuse of patients,

296–298

violations, categorisation,

294–295

reverent devotion and trust, 302

training and expertise

botulinum toxin injections,

292–293

Roosevelt′s cardiovascular

disease, 292–293

trustworthiness and

commitment, 300–301

truth-telling, 277

wise words, 303–304

Medical heroes, 1–6

Medical knowledge updation

clinical skills, 177

Collins′ work, 192

consultation, educational

experience, 189–190

Creek′s work, 192

epidemiologic data, 188–189

experiential learning, 179

“information mastery” and

EBM, 183–185

information recording,

187–188

learning style, 179–180

medical literature, 182–183

medical writing, 190–191

Mukherjee′s and Shivakumar′s

case report, 192

personal reference library, 186

reading habit and broad-based

journals, 180–181

sharing and noting down

experiences, 190–191

Snow′s experience, 191–192

teaching and medical

education, 193–194

virtual E-learning, 187

wise words, 194–195

Medical literature, 182–183

Medical Marriages, 237

Medical Maxims, 85, 94

Medical paradigmatic change,

21st century

belief systems, 13

Flexner′s report, 14

Salk polio vaccine, 14–15

wound care, 13

X-ray discovery, 14

Medical Practice 2010: How We

Get There, 313

Medical profession

“applause cards,” 173

Applebee′s restaurant

chain, 159

“best doctors,” 4–5

clinical notes record, 168

“community spirit,” 159

customer service experts,

164–165

data management systems,

162–163

day′s planning, 169–170

electronic medical record, 162

emergency department (ED)

study, 171

financial destiny, 157

“great doctors,” 2–4

open access scheduling, 161

Pareto 80/20 principle,

168–169

patient feedback, 173

patient′s visiting schedule, 163

patient wait times, 171

practice management, 157

relative productivity, 168

respecting patients, 160

space and equipment, 161

staff achievements, 172–173

supporting office staff,

163–164

time management decisions,

165–166

time management problems,

167–168

“wise physician”

competence and

intelligence, 7

definitiom, 6

diligence and humility, 7

resourcefulness and

trustworthiness, 7–8

wise words, 173–174

364 Index

Medical professional life (MPL)

fundamental forces, 314

stages, 310–311

“systems thinking,” 313

Medical specialty selection

medical history, 209–211

personal values, 218

reasons, poor choices,

217–218

residency positions, 216

rotating internship, 216

Vesalius′ career choice, 215

Medicare Act , section1886(d)(5)

(B), 229

Medication side effects, 114–119

Mefloquine (Lariam), 117

Mentoring physicians

career options and

recertification, 219–221

early subspecialization,

218–219

Enron: the Smartest Guys in

the Room, 223

financial influence, 204–205

humanity and service, 204

investment and federal

funding, 228–229

Kipling′s work, 199

laws of probability, 227

learning medical terms,

205–209

literature and portrayals,

212–214

medical school and residency

training, 214

“most common things,” 228

personal health care, 221–222

physical examination skills,

222–223

privileges and powers,

physician, 202–203

“professional” and

“professionalism,”

229–230

professional inheritance and

legacy, 200–201

role model physician, 202

specialty selection

personal values, 218

reasons, poor choices,

217–218

residency positions, 216

rotating internship, 216

studying medical history,

209–211

Vesalius′ career

choice, 215

White Coat Tales, 224–227

wise words, 230–232

Microbe Hunters, 213

Minocycline (Minocin), 117

Mission statements and epilogue,

343–345

Multiple chemical sensitivity

(MCS) syndrome, 98

Murphy′s Laws of Medicine, 165,

265–266

“Must never miss” diagnosis,

89–90, 92–96

Narcotics Guidance

Council, 245

“Narrative-based medicine,” 54

National Basketball Association

(NBA), 202

National Institute for Health

and Clinical Excellence

(NICE), 335

New England Journal of Medicine

(NEJM), 181, 182

Note cards, 190

“Nutraceutical,” 261

Objective structured clinical

examinations (OSCEs),

107

Obstetrics and Gynecology, 283

On Doctoring, 257

Open access scheduling, 161, 166

Open-ended queries, 58, 59,

63–64

Organ Procurement Organization

(OPO), 282

Osler, Sir William, 6, 62

Over-analysis, patient′s medical

symptom, 90–91

Oxford Handbook of Clinical

Medicine, 26

Index 365

Parent-teacher association

(PTA), 245

Pareto 80/20 principle, 168–169

Pathognomonic clinical

manifestations, 87–89

Patient care

building confidence, 44

descriptive diagnosis, 41

“difficult” patient

dependent clinger, 35

emotive seducer and

somatizer, 36

entitled demander, 35–36

manipulative help-rejecter, 36

self-destructive denier, 36

disease vs. illness, 28–29

empathic comfort, 45

friendly patients, 37–39

Geddes, Auckland, 27

healer, 26–27

humor, therapeutic value,

41–43

illness

impact on family, 32–33

impact on patient, 30–32

“laying hands,” 34

patient′s experience, 29–30

understandiing clinical

symptoms, 33

National Institutes of Health

(NIH) funding, 28

new remedies, patient′s

research, 40–41

nonmedical chat, 43–44

patient–physician encounters, 43

patient′s criticism, 34

patient′s disillusionment, 44

patient′s judgment and

evaluation, 45–46

Peabody′s lecture, 25–27

professional lesson, 39–40

timely diagnosis and care, 41

timely medication and

presence, 47–48

wise words, 48–49

wrong caring, 46–47

Patient–physician

communication, 55

Patient wait times, 163, 171

Pensées, 144

Personal adventures, 43

Personal reference library, 186

Personal simplicity, 337–338

Phenytoin (Dilantin), 118

Phosphodiesterase type 5

inhibitors, 118

Physician–authors′ books,

258–260

“Plastic pearls,” 86–87

Politicization, medicine, 20–21

Polypharmacy, 123–124

Pramipexole (Mirapex), 118

Prescribed medication and herbal

preparations, 120

Prescriptions, 121–122

Privileged medical practice,

338–339

Professional misconduct

alcohol and drug misuse,

295–296

dishonesty and dishonorable

behavior, 298–300

sexual abuse, patients,

296–298

violations, categorization,

294–295

Professional productivity, 170

Prognostication, 143

Proton-pump inhibitors, 118

Pseudo-Latin aphorism, 251

Quinolones, 118

Quiz-Docs, 59

Quotes, medical wisdom, 21–22

Reading styles, 183

“Red flag,” 86

Relative seclusion, 32

Residency training, 107, 158,

214, 218, 219, 254, 256,

268

Retirement

age-related neurological

deterioration, case

study, 324–325

aging effect, 321–322

community-based and academic

physicians, 323–324

366 Index

Retirement (Cont.)

impaired registrants program,

326–327

physician contact and medical

interests, 328

plans and opportunities, 327

social contact and medical

interests, 328–329

survey, retired physicians,

325–326

Rifampin (Rifadin), 118

“Rooming” patients, 158

Rush, Benjamin′s methods, 112, 113

Salicylate poisoning, 116

“18-Second doctor,” 56

Self-prescribed drugs, 253–254

Sense of humor, 264

Service activities, community,

244–246

Service to humanity

Declaration of Geneva, 10

doctor, meaning, 9

Stead, Eugene A., 11

“Single-disease” protocols, 110

“Social thief,” 229

Specific reuptake inhibitors

(SSRI), 190

Spironolactone (Aldactone), 119

Surrogate family, 238

Technical competence, diagnosis, 93

Telemedical intensive care unit

(ICU), 334–335

Telemedicine, 316–317

Telepsychiatric services, 316

Teleradiology, 315–316

The Adventures of Dr. Huckleberry,

240–241

The Alchemist, 343

The House of God, 149, 152

The Invisible Wall, 322

The Knife Man, 213

The Lancet, 181, 182

The Language of God, 192

The medical marriage: sustaining

healthy relationships

for physicians and their

families, 237

The Physician: a Professional

under Stress, 237

The Practical Art of Medicine, 240

The Principles and Practice of

Medicine, 147

The Soul of Medicine, 288

The True Physician: the Modern

“Doctor of the Old

School, 318–319

“Ticket of admission,” 60–61

Time management

decisions, 165–166

problems, 167–168

Topiramate (Topamax) and

Trazodone (Desyrel), 119

United States Preventive

Services Task Force

(USPSTF), 95

Varenicline (Chantrix), 119

Video conferencing, 316

Virtual E-learning, 187

Wall Street Journal, 40

WHIM–exercise, 96–98

White Coat Tales, 211, 224–227,

261–266

Wise physicians

challenges in 21st century

practice

epiphanous moment

recognition, 336–337

financial considerations

and health care delivery,

335–336

ICU telemedicine, 334–335

personal simplicity,

337–338

privileged medical practice,

338–339

wise words, 339–341

comments, manuscript, 339

definition, 5

passion trait, 8

required qualities, 6

Withering, William, 39

Zebra aphorism, 100–101