“I want to explore employment opportunities with you.” He is looking at me. Trying his hardest. Passion, yet anger, in his eyes. Everything I know about him and his tenure in the community helps me understand how difficult this conversation is. Everything I see in his eyes helps me understand how painful this is. Private practice is dying, on the vine, in America. The practices fold or reach a critical point, and they come ...

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"I'm just the night doc," you said. You said it with emphasis as if that explained everything and dismissed your incompetence, your lack of compassion, your failure to care. Unfortunately my sister was "just the patient," who lay suffering hours before her death and the RN was "just the nurse" withholding the morphine that the daytime doctor had ordered for air hunger and agitation. The nurse called you in to ...

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I just finished my first call weekend as an attending. It was a 96-hour bender. I had 4 vaginal deliveries, 1 cesarean, rounded on 20 patients on Saturday (mostly new), 14 on Sunday. I admitted 5, transferred 2 out --one for persistent ventricular tachycardia and one for a possible liver abscess, all while juggling full days of clinic on Friday and Monday. After the call, I felt tired, but still felt ...

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A few weeks ago, after feeding my face with rich, dense chocolate cake brought by a truly awesome nurse (for no particular reason other than a warm and generous spirit), I walked back into a room to check on a post-cardiac arrest patient. After surveying his vitals on the monitor, I turned my attention to two nurses and a pharmacist who were discussing the management of his six drips. He was ...

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shutterstock_124488283 As a relatively young physician, I always enjoy my conversations with the older members of our profession, who’ve seen so much change over the last few decades. I’m fascinated with their stories about how different the medical world was when they were residents, how treatments were so novel, and how they used solid clinical skills to get to the diagnosis. Those were the ...

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I have a long history with family medicine as my father was an early pioneer – heading up the family medicine program at Chicago’s Cook County Hospital in the 1970s. Even back then my dad was using physician assistants (PAs) -- many of them former military medics in the Vietnam War era -- who were part of what was at that time a brand new profession. Family medicine as a whole ...

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“A good surgeon has the eye of an eagle, the heart of a lion, and the hand of a woman …” – 15th century English proverb #ILookLikeASurgeon, a hashtag on Twitter and the movement it has inspired, has resonated deeply with me. I look like a surgeon. There is so much more behind this seemingly simple statement of fact. I am not just stating that I have excelled and I have achieved and ...

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The vast majority of physicians enter medicine with an inborn sense of compassion. Junior residents, however, are the logistical workhorses of teaching hospitals — their north star is efficiency and they are measured largely on their capacity to “get things done.” The consequence is often a slide towards unwitting apathy. I, like all residents, have witnessed this reality first-hand. By reflecting on my experiences, I hope to discover insights we ...

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The job of being a doctor can sometimes be like that of your favorite sidewalk juggler. It used to be that a good family doctor would have to show up in the clinic for a couple of hours, make a few house calls, and be available if anyone needed him while he played a round of golf in the afternoon. (Really, this is quite an exaggeration but it sets the ...

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About a year ago, I wrote a piece on my blog called “How to Welcome Incoming Residents.” It was about my struggle with getting the right messaging, messaging about the reality of stress during residency and the necessity of incorporating self-care and outreach to others. This year at orientation, in addition to adding the great suggestions posted by readers of the article, I took a different tack. It ...

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