In 1994 I was thrilled to become certified by the American Board of Emergency Medicine. I had worked very hard. I studied and read, I practiced oral board scenarios and even took an oral board preparatory course. It was, I believed, the pinnacle of my medical education. Indeed, if you counted the ACT, the MCAT, the three part board exams along the way and the in-service exams, it was my ...

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I wish my patients could see what I see.  I see through a lens sharpened over 30 years of experience.  I see the present and often the future.  Yes, I’m a fortune teller!  Many times, the picture of the future I see is bleak. It’s my job to predict the future and then try to change it.  A friend once told me that he believed life was a movie playing on ...

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Imagine this scenario. You are a male health care provider and you complete an evaluation of a woman close to your age. You establish good rapport as you always do, she laughs at some of the same jokes you make with all patients, and she expresses delight that you are listening to her problems (unlike those other providers she says she has seen), feels you are helping her, and is ...

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An interview by MedCrunch with Ashley Wendel, MA, CMC, PDC, a Physician Executive Coach and Healthcare Organization Consultant dedicated to helping physicians create meaningful and sustainable change that positively impacts their professional lives. MC: Thank you so much Ashley for your time! Ashley: Thank you, I’m really happy to share anything I can. MC: You are a physician coach, what are the most common problems you encounter in your practice? Ashley: Well, for ...

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Two weeks ago I told a man that he was dying. We sat together in the mid afternoon haze. Puffs of snow meandered by the hospital window and wended their way down to the ground. The sun was lost behind winter's never ending clouds. The tempo of my voice was steady, lacking variation in tenor and pitch. I clung to my lab coat as if I was floating outside the window ...

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I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet, which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me about this in my training. What kind of shoes should you wear in the hospital? There’s a lot of walking in the hospital, but there’s even more standing.  Running shoes don’t provide ...

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As doctors, we have pills to treat infections and high cholesterol. We have scalpels to replace hips and open clogged arteries. But beyond pills and scalpels, what tools do we have? Walking out of the doctor’s office without a prescription is a rare occurrence these days. And the famous surgeon tagline has always been “a chance to cut is a chance to cure.” We see people when they’re sick and ...

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“I’ve been a fighter all my life,” said my new patient, a middle aged man with thinning hair, a worried wife, and a dismal prognosis. He had  worked all his life as a plumber with no health insurance.  When he was healthy, it was okay.  But now he was sick. I was meeting him for the first time in the community health center where I work as a family physician, tending ...

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One will find many examples of precaution and their corresponding examples of risk in how medical care is provided by physicians and accepted by patients. In fact, not only do these two elements correspond but at times the price, itself, of precaution becomes the risk. Risk is everywhere in medical practice. Risk is present when a patient is selecting a physician. The risk is becoming the patient of a doctor whose ...

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Incredible innovative and entrepreneurial skills have led to many new techniques and technologies in medicine. Some are both disruptive of the old way of doing things. Others are transformational. Over the next few weeks I will review some of those that I believe are among the most disruptive and transformational. Medical simulation is such an advance. It is dramatically transforming the way medicine, especially medical procedures, are taught and it ...

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