Stephen James Ryan

Errors are inevitable in medicine When I think back, I would attribute most of the ones I've encountered to a lack of information This is usually in the form of some crucial piece of information That 'last known normal' time wasn't correct The patient with 'new right facial weakness' actually had a stroke with residual weakness 2 years ago The patient who is 'hearing voices' actually has very poor sleep quality and increased caregiver related stress who's hearing her husband's voice as she falls asleep. She also has a history of sleep walking/talking So much of what we need to know to care for our patients comes from talking with them and those who care for them I contrast that with some days at work where there will be a census of 30+ follow up patients to see and 10-25 new consults I have a team, it's not just me But it is a lot of info to juggle all the same As we see shortages of all physicians looming, not just neurologists, these longer conversations that lead us to the root cause of someone's problem are becoming more and more dear My suspicion is this will lead to more unnecessary tests, wasted money, and, ultimately, wasted time One of the things that drew me to neurology is that so much of the information needed to make the diagnosis is right there in the room with you and your patient Hearing their story Observing them, examining them One of my favorite, perhaps apocryphal, quotes of Osler is “Listen to the patient; he is telling you the diagnosis." While he may not have actually said it the sentiment resonates with me and I've found it has proven true time after time in my own practice I don't have any answers These are just musings that I have as I review my list and drink my coffee in the morning I do believe that education remains an essential part of addressing these issues And when something doesn't make sense, go back to your history Take the time now It will save you, and your patient, time in the future #medsocial30