My practice philosophy

February 20, 2013

By Sheldon Z. Goldberg

  1. Benefit the patient, that is the most important thing
    2. a. That means optimizing the outcome
    i. preserving the highest quality of life
    ii. For as long as possible
    iii. Optimizing the quality of life when prolongation is no longer possible
    iv. Sometimes it means a good death.
  2. There is no excuse for not using the most current information
    3. a. RSS feed
    b. Look it up forevery patient, no matter how familiar it feels
  3. Honesty
    4. a. With the patient
    i. Phrasing is important
    1. we all need hope
    b. With the family
    c. With myself
    i. Am I doing my best at all times?
  4. The patient is not a vessel of the disease.
    5. a. Sometimes shrinking a cancer is not a good investment for the patient.
    i. The treatment can lower quality of life
    ii. Sometimes, the treatment can shorten life.
    b. Research can emphasize the impact on the disease to the exclusion of impact on the patient
  5. It is at least as important to know what doesn’t work as what does.
    6. a. Sparing the patient side effects is sometimes the best thing the doctor can do.
  6. All assumptions should be questioned.
    7. a. More intensive, ineffective treatment is not good care
    b. The most dramatic therapy has the same burden of proof as any other therapy
    c. Sometimes a clinical trial is the most appropriate path
    i. But evaluate all of the alternatives