Category Archives: James Channing Shaw

A Night in a Canadian Emergency Room

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by James Channing Shaw, MD* Key words: Single-payer, Canadian Healthcare, Medicare-for-All, U.S. Healthcare, Medicare, 2020 After practicing medicine in the United States for over twenty years, I moved to Toronto for professional reasons. One summer evening two years after our arrival in Canada, I developed chest pain, and being an experienced doctor, I ignored my own symptoms, thinking that certainly I was too young to be having heart disease. By 1:00 a.m. the pain had worsened and was travelling down my left arm so I figured it would be unwise to delay any longer. At 2:00 a.m. my wife and I arrived at a modern emergency department in the center … Continue reading →

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A Doctor’s Responsibility

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Doctors Helping Patients by James Channing Shaw, MD Keywords: Doctor’s Responsibility; Helping Patients; Hippocratic Oath; Physician Charter; Doctor-Patient relationship We diagnose, we treat. We try to do no harm. But what do we do when diagnoses evade us, or treatments fail? Do we physicians have an obligation to keep working with the patient after a diagnosis or cure eludes us? Some doctors might say no, that it’s perfectly acceptable to tell a patient “there’s nothing more I can do for you”; or discharge the patient without answers or directives, rationalizing that “I’ve done my part.” This especially applies to specialists. Patients, on the other hand, expect their doctors to keep … Continue reading →

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Can Doctors and Patients be Partners in Healthcare?

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By James Channing Shaw, M.D. Trust in doctors. It used to be absolute. If our sick patients improved, we were celebrated. When we failed, families praised us for trying. This arrangement was not right, but no doctor went to any great lengths to change the perception. About three decades ago, the pendulum swung. Now doctoring is frequently viewed as market share, self-promotion, unnecessary procedures and testing. It would seem that professionalism has become obsolete. Patients, too, have changed with the times. Many patients would like to have every test, expect their health problems to be cured, fixed painlessly, no disruption to social calendars, easy parking, and why can’t this cancer be … Continue reading →

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Corina’s Pride

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To cure sometimes, to relieve often, to comfort always by James Channing Shaw view PDF: CORINA’S PRIDE My resident, Rishaad, presented the case in the corridor: “This is Corina, a fifty year old woman with itching on her back, chest and abdomen. No other medical problems.” He presented his findings and working diagnosis. We entered the examination room. Corina appeared healthy. I agreed that the hundreds of tiny, rough bumps over her torso were probably benign keratoses. Being the third consultant, we performed a biopsy and prescribed short-term symptomatic treatment, asking her to return in a week or so. Outside the room, I explained that such an eruption of itchy … Continue reading →

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Doctors First, Specialists Second

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One morning, I pulled an empty chart from the rack on the examination room door: new patient, Ms. Judith Cornish, age forty-seven. I knocked twice and entered. “Good morning, I’m Dr. Shaw,” I flipped open the chart. “You are Ms. Cornish?” (I always used last names. It was formal, I know, but I preferred erring on the side of respect, not familiarity). I extended my hand. She sat, leaning forward in a chair, one very lean leg crossed over the other. “Good morning. Yes, I’m Judy,” she said in a husky voice. She shook my hand half-heartedly. In five seconds, I had processed a huge amount of diagnostic information: One, … Continue reading →

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