Maybe 10 to 15 years ago, my medical center at the time invited a prominent former resident to give grand rounds. He had become the statistical director for what was a large regional insurer absorbed by a national insurer shortly after that. He spoke very little about the prevalence of disease among his company’s beneficiaries but extensively about how his company assessed the performance of physicians. He also related how ...

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"Annie, Annie, are you OK?" Many of us learned to resuscitate a person who has collapsed using Annie, the mannequin based on a death mask of a young woman who had drowned in the Seine in Paris in the 19th century. Bystander cardiopulmonary resuscitation (CPR) has become increasingly accepted and expected as the years have passed, and we have even begun to make affordable machines to deliver a life-saving shock (defibrillation) ...

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I recently attended the annual Society of Hospital Medicine conference in Las Vegas. As a proud hospital medicine doctor, this organization has grown exponentially over the last decade, and thousands of hospital physicians from across the nation descended on the city for a few days of great learning and networking opportunities. However, away from the conference, this being Vegas, there had to be some time for fun as well. On Saturday evening, ...

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I am nearing the end of my training at one of the top surgical fellowships in the country. I chose this fellowship not just for the name, but also because the surgeons all seemed like genuine and altruistically motivated individuals. It was two-thirds of the way through fellowship when I found myself in conversation with two male trainees. We were discussing the younger trainee and his girlfriend; he would be ...

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If you are a physician reading this, please pat yourself on the back. You made it through medical school and residency so, de facto, you have both resiliency and grit (serious buzzwords, y’all). But as anyone who has gone through these professional challenges, it often doesn’t seem so. I am 44 years old and am faculty at a major public university and cis-gendered, heterosexual, married, two kids and have a full-time ...

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Afterword from a story entitled “Litigation Lane,” excerpted from Beyond Bedlam’s Door: True Tales from the Couch and Courtroom (Thunder Lake Press).  Forensic psychiatry involves the interface of psychiatry and the law. Over the years, I was asked to psychiatrically evaluate people in the context of civil ...

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Recently, the Harvard Chan School of Public Health reported on the effect of surgical checklists in South Carolina. The press release was titled, “South Carolina hospitals see major drop in post-surgical deaths with nation’s first proven statewide Surgical Safety Checklist Program.” The Health News Review, for which I review, grades coverage of research in the media. Based on their objective criteria, the Harvard press release would ...

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December 2012, three days before Christmas. It started as an ordinary day, but soon it would become the turning point of my career. As I entered my office, I noticed a different energy in the room. The receptionist looked at me and said, “Doc, one of your patients died last night.” As a psychiatrist, I am not used to the feelings generated when someone you cared for, passes in the ...

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When my children were growing up, I advised them, “Don’t choose any profession in which your worth is determined by knowing a body of information or using algorithmic thinking. If you do that, you’re toast.” ”Toast” because monopolies on information have been supplanted by the internet, and algorithmic thinking replaced by computers and artificial intelligence. Incredibly, this seismic shift in what society values has occurred in just a single generation. And that’s ...

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I pause in front of the door. On the other side, you all wait. A spouse, sons and daughters, sometimes with their own small children in tow. Today, it’s your husband and father you have come for. Yesterday it was someone else’s mother. You have come from near and far, across the street and the country. Your weary eyes are unable to mask your sadness. Over the past week, you ...

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