Richard Rathe, MD

Associate Professor of Family Medicine (ret.) and Medical Informatician

‘Medicine’ Articles

Thoughts on the Approaching COVID19 Pandemic

Posted: Mar 1st, 2020 •• Category: Medicine, Patient Care

I’ve annotated this NY Times graphic, rounding the estimates for COVID19 (aka the 2019 novel coronavirus) to 2% mortality and 2 people infected for every one who has the disease. What this suggests is the infection rate will be similar to a bad cold season, but unlike the common cold, a significant number of people […]

An Alternative Symptom Score to Replace the Overused 10 Point Pain Scale

Posted: Jun 22nd, 2019 •• Category: HPI, Medicine

If you take a 3pt functional symptom scale and couple it with a 3pt frequency scale you have a 3×3 grid that might work better than a one dimensional 10pt scale.

Patient Instructions Card with Advice on Common Problems

Posted: Aug 11th, 2015 •• Category: Medicine, Patient Care

Patients who are actively engaged with their health have better outcomes. Good communication is key. I made this Patient Instructions Card about six months ago and have been very pleased with it. I’ve turned it into a generic PDF with custom name, phone and tobacco resource fields. Fill in your particulars and have it printed at 50% on card […]

Atul Gawande “How do we heal medicine?”

Posted: Jul 30th, 2012 •• Category: Medicine

Cowboys vs Pit Crews Key facts from his recent TED talk… Modern doctors have 4000 procedures and 6000 medications at their disposal In 1970 it took 2 FTEs to care for a patient in the hospital In 2001 it took 15 FTEs to care for the same patient Checklists and mandatory pauses help decrease mistakes “We […]

The Supreme Court and Healthcare Reform – Careful What You Wish For!

Posted: Mar 23rd, 2012 •• Category: Medicine

The US Supreme Court is about to hear arguments for and against the recent healthcare insurance reform law enacted by Congress. (aka The Affordable Care Act, aka Obamacare) At issue is the constitutionality of the individual mandate to buy health insurance. It is unclear whether they will set new precedent or rule on a much […]

Approach to Cough Algorithm and Podcast

Posted: Oct 19th, 2011 •• Category: Medicine, Podcast

I recently updated my lecture on cough, given to third-year medical students and residents. It presents an algorithm I developed based on the omnibus supplement published in the journal Chest and other sources. Here is a quick summary of key points that are often missed  by primary care physicians… Acute cough is largely due to […]

A Guide to Medical History Taking

Posted: Sep 29th, 2011 •• Category: Medicine, Teaching

Always start with the standard questions applied to the patient’s Chief Concern(s): Location/Radiation; Quality/Severity; Duration (total/episode)/Frequency; Aggravating/Relieving Factors; Associated Symptoms/Effect on Function. It is useful to think of the secondary history as a Focused Review of Systems (ROS). These questions often bring out information that supports a certain diagnosis or helps gauge the severity of […]

Sick Around the World (PBS Frontline)

Posted: Jul 29th, 2011 •• Category: Medicine

This is a great documentary from 2008 that explores how other wealthy countries deal with healthcare. The corespondent T.R. Reid visits five capitalist countries that provide affordable, nearly universal coverage for their citizens. How do they do it? He observes that here in the US we have the British model for veterans, the Taiwanese model for seniors, […]

Responding to Emotions with BATHE

Posted: May 17th, 2011 •• Category: Medicine, Teaching

Being able to handle emotional situations is an important interviewing skill. It is safe to assume that every patient has some form of emotional response to significant illness. There is also growing evidence that an individual’s emotional state can effect or even cause physical disease. The patient will often give you several clues that should […]

Why Health Insurance is Different

Posted: Mar 27th, 2011 •• Category: Medicine

At the most basic level, insurance is about sharing risk. For example, a group of one thousand homeowners band together to create an insurance pool to protect against fire. If homes are worth $100,000 and there is one fire per year, they would have to chip in $100 each. Fortunately the risky event is rare, […]