We’re living in a world or ratings. Books get rated on Amazon, dry cleaners get rated on Yelp. Doctors are getting rated, too -- not only on web sites, but also in ways that end up dictating how much money we can make, or whether we can keep our ability to work in a hospital. Is this a good way to improve medical care or medical outcomes? Is it ...

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Prestige in medicine often follows research. Physician-scientists who do basic science research have often been considered among the giants of medicine. As the field of medicine advanced, the gap between what we knew from basic science and how we practiced grew. This created a need for more translational researchers: physicians who could bring what they knew from the laboratory bench to the bedside through large clinical trials. Now, the next great gap ...

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As I travel the country providing coverage for inpatient rehab units, I have been struck by the generally high quality of nursing care. Excellent nurses are the glue that holds a hospital unit together. They sound the first alarm when a patient’s health is at risk, they double-check orders and keep an eye out for medical errors. Nurses spend more time with patients than any other hospital staff, and ...

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When you tell people that your dad died of lung cancer, often the the follow up question is, "Did he smoke?" In my case, the answer is, sort of. I have fuzzy memories of my dad in our basement, smoking his pipe in his black leather chair and watching the original Doctor Who (I’m still processing the cultural implications of that last detail).  Rumor has it he smoked cigars in the ’60s, ...

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He was rather tall.  Or at least he appeared so with his long erect back jutting from the bicycle seat. The cringe worthiness of his helmet-less head was assuaged by the gigantic headphones covering his ears.  I figured they would provide minimal protection during a crash, but at least he would be listening to groovy tunes. He weaved in an out of traffic on a busy two lane road.  He peddled ...

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I’ve worked at a few VA medical centers, including four years at the Phoenix VA. I’d like to report something missed in the media storm. Before spilling secrets, though, I’ll dispense with the non-secrets. Everyone who has entered a VA hospital knows: 1. The system is overwhelmed. While we might have planned for the increasing needs of aging Vietnam-era vets, I doubt anyone predicted two long wars or the number of ...

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Apparently all doctors must practice medicine until the day the die.  Or so says Gordon Marino in a New York Times piece called “A Life Beyond Do What You Love.”  This article caught my eye, since I am currently trying to do “what I love,” having already lived a couple of lives doing “what I think I should love.”  I didn’t agree with everything the piece said about doing what ...

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Agnes was out shopping at her local corner store.  At age 82 her body was beginning to show typical signs of aging.  She had survived breast cancer surgery, a hip replacement, and cataract surgery.  Her doctors told her she had osteoporosis and low vitamin D.  She took medications for her hypertension, cholesterol, and osteoporosis.  Her spine had begun to curve and her gait was a few steps slower. Yet, with her ...

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Next in a series. The art of healing is very important in medicine. There is a difference between being a modern day physician and being a healer. All societies have healers -- wise men and women, shamans, medicine men and people of other names. The “old time practitioner” was almost always a healer but many physicians today are not. It is an issue of interest, training, time and prioritization. Most ...

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House call on a hundred foot cliff Johnny’s disabled. He can’t get to my office anymore. So I drive 100 miles up the Oregon coast to check in on him. I get lost, but finally discover his little white house on the edge of a cliff overlooking the Pacific Ocean. House call on a hundred foot cliff House call on a hundred foot cliff “Last ...

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