Her wary eyes, magnified from her thick-lensed spectacles, watched my every move as I pulled room 21's curtain to the side and entered her room. In her early eighties, it was apparent to me that my entrance into her life was more important than the abdominal pain that brought her to our emergency department. In the corner sat a slight man with wispy gray hair poking out from the border ...

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You may have already seen them -- medical scribes hunched over tablets in hospitals and doctors’ offices, working away like Kim Jong-Un’s omnipresent cadre of note takers (though in this case, they’re actually getting things done). Recently, this piece about the phenomenon was making the rounds in my corner of the Twitterverse. In a conversation with a reach so high that it at one point drew in Dr. Farzad Mostashari (former National Coordinator for ...

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One typically thinks of advances in medical science and technology as having unalloyed benefits. The ability to cure illness, the mitigation of pain and the possibility of making diagnoses that are more accurate are some of the uncontroversial results of medical progress. Yet as a new study of vegetative states demonstrates, such advances can raise ethical quandaries for physicians and the families of patients diagnosed as vegetative. The Read more...

I chose to leave clinical medicine in 1996 after just three years as a general internist. At the time, I was certain that it was the right decision and necessary for my overall health, but could not have articulated all the reasons why I needed to leave. I loved both the intellectual challenge and the art of medicine. I thoroughly enjoyed my connections with patients. I regarded my professional life ...

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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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shutterstock_81722251 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 ...

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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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