shutterstock_141076960 As someone who has practiced hospital medicine up and down the East Coast for the last several years, I’ve had the fortune of working with some absolutely terrific colleagues. The hospital environment is by its very nature a busy and hectic one -- where we all put our heads down and work tirelessly at the coalface for hours on end. Doctors ...

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shutterstock_239583778 There was once a woman whom I met for the first time when she came to the ER, on death's door, metaphorically. I told her and her family just how seriously ill she was, and how slim the chances of survival. We all agreed on that day to take a shot at it -- at survival, that is -- despite lousy ...

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There is much to learn as a new physician, but some patients teach you things you never meant to learn. This happened to me a few months ago. I was taking care of a 26 year old who had an end-stage, inoperable brain tumor that was causing progressive seizure activity. He was admitted with a headache. He had just been discharged about one week ago with similar symptoms. We treated his ...

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shutterstock_50607919 Physician, heal thyself. That's the unwritten rule, sadly, for us. I am a physician. I am therefore invincible and inhuman and all the things my patients cannot be. To seek help is a sign of weakness, and our profession has no place for the weak of body, mind or spirit. We work through illness because our patients deserve that and disease and ...

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One of the core components in transforming a practice is team-based care, and this concept consistently is a focus of many conversations among physicians across the country. My employer, the Quillen College of Medicine at East Tennessee State University (ETSU), also has embraced this concept. And the outstanding group of interprofessional educators with whom I work are constantly looking for ways to enhance not only the way we provide team-based ...

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NoPRT-640x480 Here’s the latest medical fad: Physician resiliency training. Huh? Doctors are already the most resilient people on the planet. Doctors can go days on call without eating. I know. I have. Doctors can go 24 hours without a bathroom break. (Yes, we even have the most resilient bladders!) Doctors can work 168-hour shifts with little or no sleep as detailed in this whistleblower video. Doctors ...

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shutterstock_135157130 acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. Last month, I shared my take on the mess that we find ourselves in with our electronic health records (EHRs) and referred to the recently published ACP position paper on clinical documentation. The paper includes ...

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shutterstock_118491940 I used to be a surgical resident in the U.K. One day, I was a little dispirited during a brutal call, and my senior resident asked, “Do you love surgery?” “I like surgery,” I replied. “If you don’t love surgery, love it unconditionally I mean -- like loving your child -- you will be unhappy.” He warned. I really liked surgery. I like radiology. ...

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The whole thing was rather awkward. I have to admit that I was nervous. I perused the records before he walked through the exam room door. These conversations were always difficult and felt out of place in the office. But I had looked at the numbers over and over again. There was a glaring deficiency that had to be corrected. I planned to jump in right away, but we got sidetracked. He ...

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“A thousand times we die in one life. We crumble, break and tear apart until the layers of illusion are burned away, and all that is left, is the truth of who and what we really are.” The coronary care unit (CCU) rotation is a unique place. Postoperative cardiothoracic surgery patients among many other pathologies from heart failure to heart transplant fill the unit, and it is the job of the ...

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