Recently, our residency program had the excellent fortune of hosting Dr. Bob Wachter as a visiting speaker. Dr. Wachter is considered a pioneer in the hospitalist movement and has built his career around inpatient quality and safety. During lunch with Dr. Wachter, some of our residents, and hospitalist faculty, we discussed the topic of resident autonomy in the hospital. In the glory days of residency, I imagine that house officers experienced ...

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In the past 84 days, I have traveled to eleven different cities, been left stranded in two unfamiliar airports by cancelled flights, met approximately 124 new people and briefly recited the more interesting parts of my life story far too many times to count -- all for the purpose of matching to a residency program in March. Exhausting doesn't come close to summing it up. And yet, this process has also ...

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New journals are appearing almost every day. Does anyone read them? Journals keep popping up because of the need for faculty to publish. Another reason could be that publishers, particularly those who charge authors fees for publishing, are in the business of making money. Authoring journal articles is not only enhancing to one's CV (the old "publish or perish" cliché), it is required by residency review committees as evidence of "scholarly ...

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They say medicine is a hard science, based on heavily scrutinized theories and proven postulates.  Medicine is supposedly made up of differentials, diagnostic workups, and medications aimed to alleviate or cure.  Everything is based on evidence, everything. But, today, something happened that hasn’t been researched using IRBs; something intangible that restored my faith in humanity. I was on my way home from a long day of being intensely questioned by residents ...

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Remember your humanity, and forget the rest. -The Russell-Einstein Manifesto The American healthcare system is a paradox of triumph and failure.  We lead the world in medical innovation, yet we lag behind in cost, quality, and equity.  During my last month of medical school, I sat with a group of graduating students to discuss this challenge.  As students, we had directly confronted the shortcomings of modern healthcare.  As the next generation of ...

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During my internal medicine rotation, the medical students had the opportunity to attend intern morning report, an interactive teaching session where attending physicians walk the interns through a patient’s story, starting from the moment they hit the door of the emergency room to the final stages of diagnosis and treatment. After discussing the patient’s symptoms, complaints and past medical history, the attendings always ask the group to think carefully about the ...

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recent survey published in H&P, the Stanford medical school magazine, asked twenty graduating students to recommend books to read during the clinical rotation in internal medicine. Surprisingly, the top vote-getters weren’t books at all. The two most popular resources were both banks of practice questions, while the next two included a review book and a pocket handbook. “Is this how our students learn the subtleties of sickness and health? What happened to ...

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Recently, I had the fortune of hearing the tale of Bob and his bum knee.

It all started when Bob picked me up at the end of a busy clinic day in his neon orange Subaru.  Given that this particular shared car service promotes friendly conversation, Bob started up the gab by asking me what position I held in the medical center.  After describing my work as a ...

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During my year as a chief resident, I have the privilege to attend on the general medicine service for 8 weeks. I recently completed 4 weeks and, as expected, found myself in an entirely new realm of patient care and accountability. I would be remiss without recalling a few of the pivotal lessons and poignant moments that stand out. Transitioning from resident to attending inevitably results in greater scrutiny. Despite my best ...

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Placebos work. This isn't news. The term "placebo" was coined 60 years ago to describe how one-third of people respond to pills without any active drug in them. Twenty-five years later, we learned how they work: through endorphins produced by the body that work just like morphine. Today placebos are everywhere: from mothers kissing boo-boos to international drug trials. recent paper, though, shows that all placebos aren't created equal. As expected, ...

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