burnout2 Illustration by Jorge Muniz. We enter medicine with our hearts and souls on fire ready to serve humanity. By the time we complete medical training many of us have anxiety, PTSD, depression -- even suicidal thoughts. Why? Medicine is stressful. Many of us work 100-hour weeks surrounded by suffering and death. We may deliver a stillborn, try to save a teenager with a gunshot ...

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When I started medical school, I was most excited to start learning again. Having spent the last couple years as a teacher in a classroom, I sorely missed the experience of being the student. Reflecting on my college days, I missed the intellectual conversations generated in our seminars, hours poring over literature under dimly lit alcoves of the library; even the far-too-frequent all-nighters spent hashing through complex biochemical pathways with ...

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In the 2014 Forbes article “How A Nobel Economist Ruined The Residency Matching System For Newly Minted MD’s,” Amy Ho argues the way we place new medical school graduates into residency positions needs to be reassessed. She calculated the cost of applying to residency to be greater than $7,500 when taking into account loans and interest. If you have not participated in the U.S. medical educational industrial complex, ...

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As a pediatric resident, I have the joy of building relationships with families and watch their children grow while providing them with anticipatory guidance at every visit. From newborn visits to toddler visits to teenager visits, they come, and we all grow together. (They grow chronologically and as a family, I grow in my experience and knowledge.) The questions come in such a wide, but expected, variety: “When can I introduce ...

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I recently wrote an email to two Muslim colleagues apologizing for our nation’s political tenor. I shared with them my embarrassment over suggestions that our government bar Muslims from immigrating and monitor those who live here, my concern that a presidential candidate’s support congeals rather than erodes when he brays that “Islam hates us” and suggests that mosques be closed, and my dismay that so few ...

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“The road to success isn’t productivity, it’s differentiation.” – Tony Crabbe That statement is invaluably true -- especially for direct primary care (DPC) professionals. Your patients aren’t coming to you because you’re the same as everybody else. In fact, they’ve chosen you for the exact opposite reason. You’re gloriously different. The other guys force patients into the mold they’ve created: restrained by long waits, life-sucking insurance battles, and reduction to nothing more than a chart to be ...

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They were both named Mike. Both were superstar physicians and educators at MedStar Health. Both had a wife named Pam, a son, and a daughter. And both died untimely deaths within a year of 50 at the mid-point of their ascending careers, 18 months after being diagnosed with cancer. I don’t believe they knew each other, but having worked with each of them, they will be forever linked in my ...

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They said, "Do everything." She knew something was wrong. And by the time she was 85 she had forgotten the names of her children, the town she raised them in, even the name of her deceased husband. In her 70s she was diagnosed with Alzheimer's. Still coherent, she talked to her physician about becoming a DNR: do not resuscitate. She did not want to live on a machine that would breathe ...

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CMS announced that they will remove questions related to pain from the hospital consumer assessment of health care providers and systems (HCAHPS), commonly known as patient satisfaction survey.  This means that hospitals would continue to use the questions to survey patients about their inpatient pain management experience, but these questions would not affect the level of payment hospitals receive. This is a big victory for patients and the house of medicine. Here ...

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There’s no doubt physicians entering practice today leave their residency programs with a tremendous amount of medical education and training; what seems like a lifetime’s worth of knowledge crammed into just a few, intense years of instruction. Unfortunately, all the time residents spend on rotations, lecture, journal club, and myriad other obligations leaves little opportunity for getting oriented to the more mundane, yet absolutely critical components of practice. As a result, ...

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