Physician burnout has been previously described as heartbreaking, and this may be an understatement.  The growing complexities of health care delivery, intricacies of documentation practices as required by Meaningful Use, and difficulties inherent to billing and reimbursement are only a few of the issues faced by residents and attending clinicians these days. Unfortunately, these topics are still not formally taught in American medical schools. As students, we really do not know ...

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The non-medical reader may wonder what I am complaining about.  Of course, many of you have to be credentialed in your fields as well, whether law or accounting, law enforcement or public service, education, nursing or a trade.  But those of you in medicine know how difficult it can be to become credentialed as a physician, either by a state for purposes of a license, or by a hospital in order ...

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I was glad she never asked if I had done this before. My first nasogastric tube was placed on an elderly woman with chronic liver disease. As her illness worsened, it gradually turned her skin yellow, her abdomen swollen, and her mind foggy. One day, we realized that she was at too high a choking risk to swallow her medications herself. She would need a plastic tube to do it for ...

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Last week, my best friend took the recertification exam in anesthesia, the so-called MOCA exam.  Like a good doobie, she paid her $2,100, paid her nanny extra so she could study, took a day off in which she missed the funeral of a friend’s husband, and took the test.  Wow, she must be the most awesome, most well-read, most skilled, most enthusiastic anesthesiologist ever now!  Well, she always was, but ...

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Amid the many ongoing changes to health care, it's clear that better teamwork is needed in American medicine. Calls for stronger interdisciplinary collaboration have permeated position statements and policies, and organizations have begun redesigning care processes to include novel team-based approaches. Emerging data continue to affirm that strong teamwork and communication can increase the value of care. Of the many efforts to improve teamwork, however, one potential area for significant improvement ...

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At the outset of this process of becoming a doctor, a friend and mentor of mine, a professor emeritus of medicine known as a mentor who cares deeply about his students and for his New England style dinner parties, sat me down to explain the gist of medical school. The first two years, he explained -- bowtie notwithstanding -- are the equivalent of studying a language from textbooks. You must first ...

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It’s been a long day, and you just want to decompress. My boyfriend tells me about his day. I get to hear about the insane amount of reading he has to do for graduate school, or about the occasional annoying customer he’s had to deal with at his part-time job as a bank teller. When it’s my turn to decompress, I usually gripe about a patient or two from the ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. Some think that it should be repealed and replaced. Others support it but feel that it needs to be improved. A few believe that it’s OK as is. I’m not writing about Obamacare -- I’m describing maintenance of certification (MOC). I will not use up my word count ...

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During my residency training in plastic surgery, I remember spending time in the offices of some of our community faculty members. These were invaluable opportunities to gain exposure to the field outside of the academic university hospital, where things were quite different. The university was a large organization where several residency programs and hundreds of trainees were not just seamlessly integrated into the workings of the hospital, but actually required to ...

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eric garner On Thursday January 15, over one hundred Stanford Medical School graduate and medical students gathered to commemorate MLK day and remember the lives of Mike Brown and Eric Garner. On a white board that proclaimed "Black Lives Matter," attendees wrote their thoughts. On the board, I wrote "Keep the conversation going," and in that effort I'd like to examine one ...

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