The acronym "MI" has traditionally meant myocardial infarct, or heart attack. Recently it's taken on a new, more salubrious meaning: motivational interviewing. A growing number of docs are practicing this technique, which amounts to listening to patients to help them recognize their internal sources of behavior. Boston's NPR affiliate, WBUR, describes typical MI interventions in which doctors, instead of demanding that patients stop smoking or drinking or overeating, gently ...

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shutterstock_124029454 Jim almost convinced me.  The burning in his chest, after all, could have just been gastroesophageal reflux.  He assured me that the sensation was nothing new; that he got it from time to time after a large meal and took Tums.  I couldn't, however, ignore that it seemed to worsen with activity.  The pain was bothersome enough to drag him into my ...

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Let me be clear. I have spent a career, my adult life, 80 hours a week, 131,000 hours, fighting the dread disease: every method, every drug, every machine, every medical technique, every sinew of my being, to control or cure malignancy. A synopsis of my existence will say, “fought cancer.” Nonetheless, let us take a step back, if just for a moment, and reflect on the idea of saying, “no.” In ...

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When a doctor makes a mistake, it’s rarely out of ignorance.  We usually have the knowledge we need. Instead, most medical mistakes happen because we’re tired, distracted, hurried, or indifferent -- or maybe some combination of those things. Since physicians rarely publicize their personal frazzled-and-frenzied, pooped-out or burned-out quotients, health care consumers shopping for a doctor often consider Board certification as a kind of Good Housekeeping seal of approval. The “board” ...

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shutterstock_153912641 Recently, Marshall Allan and Olga Pierce, two journalists at ProPublica, published a surgeon report card detailing complication rates of 17,000 individual surgeons from across the nation. A product of many years of work, it benefitted from the input of a large number of experts (as well as folks like me). The report card has received a lot of attention … and a ...

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shutterstock_226271230 If you want to know who the best surgeon in the hospital is, ask the surgical nursing staff. If you want to know who does the best job opening up coronary arteries using catheters, balloons, and stents, ask the cardiac catheterization lab nurses and technicians. Unfortunately, these approaches to comparing physicians’ skills are only available to hospital personnel. They are the only people who are ...

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shutterstock_171708149 I attend pharmaceutical dinners every once in awhile because: 1) I like to stay up to date with all the new drugs (or just a slightly modified version of the generic, but with a much fancier name and packaging); 2) Though I’m several years out of medical school/residency, one thing I have maintained from those formative years is the mentality where I’d never pass ...

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shutterstock_182066816 It’s often said that we learn from our mistakes. Indeed, many a business course in leadership offers that premise as a given. I’ve glibly repeated this often in my classes, speeches, and advisory work. “You don’t learn from your successes,” I point out, “but rather from your errors.” But do we really learn from our mistakes as a matter of course? My friend and colleague ...

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shutterstock_239583778 A few months ago, the father of one of my best friends was diagnosed with cancer. He had to have surgery to remove the tumor. His father, being someone I’d known since childhood was like an uncle to me. After the surgery, I sat across from him in an otherwise empty hospital room on a sunny day in beautiful San Diego. It ...

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White coat in public place edited People can wear what they want in America. Whether you want to debut the latest vogue or your midriff rife with adiposity, you are free to do so. But just because you can, doesn’t mean you should. In the span of one week, I found two people -- on two separate occasions -- wearing white coats, each ...

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