Once upon a time a doctor first attended 3 or 4 years of college, then finished 3 or 4 years of medical school, trudged through 1 to 8 years of residency training to hang out “a shingle,” and finally begin to practice medicine, usually in solo practice.  Those days are long gone.  Time has expanded—schooling and training are longer. Breaks are taken between and during this once but no longer traditional ...

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Even doctors must become patients eventually, and often challenging patients at that.  We know enough to be dangerous but not enough to be in charge.  We want to question everything but try not to.  We can tend to be catastrophic thinkers because that is how we are trained to be, but fear being alarmists.  We want our care providers to actually like us, when we know they inwardly cringe knowing ...

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shutterstock_94210177 “I’d really feel better if we got the MRI,” Ms. James said. “I understand you think it’s a migraine, but I want to know, just in case. Wouldn’t you?” Ms. James and I sat in her darkened hospital room—the light bothered her eyes and exacerbated her headache. She was a dialysis nurse with many years of experience in the healthcare field, and I ...

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The link to a recent article in Forbes magazine entitled, "Why Rating Your Doctor is Bad for Your Health" keeps showing up in my inbox with the subject, “thought you would find this interesting.” The reason is because I’m responsible for overseeing education and training related to physician communication and patient satisfaction for a large national hospitalist practice. The article isn’t so much interesting as it is unfortunate.  Its premise, ...

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"I did it," I mumbled to myself. The numbness overwhelmed my immediate sense of dread throughout my body.  I was trembling inside, full of anguish and at the same time, unable to contain my seething anger over an uncontrollable destiny.  Just a few minutes ago, I turned off her life support system.  The series of beeps had slowed down, pace by pace, like the ritardando in a finale movement of a concerto.  ...

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Have you ever gone to the doctor and felt like he wasn't listening to you? Have you tried to tell your story, only to have him interrupt with a checklist of questions: do you have chest pain, shortness of breath, fevers, cough, and so forth? Have you ever felt ignored, and left thinking that your doctor never understood why came to him in the first place? Studies show that
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shutterstock_120722284 acp-logo A guest column by the American College of Physicians, exclusive to KevinMD.com. Medicine is big business. If you don't believe me, the next time that you travel by plane, pick up the airline magazine in the seat pocket and read the ads. If the advertising is a reflection of the air traveling ...

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Christmas morning at 1:30 am the phone chimes away. What the … I’m not on call. “Please call Dr. Dred for patient Selma, perforated colon at local ER,” read the text message. Why are they calling me, I’m not on call. Dr. Young is. Maybe something’s happened and they can’t find him. So, I called. It was just as reported. There was a fifty year old female with abdominal pain for three days, ...

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I have the privilege to work in the medical profession where astonishment and revelation awaits me behind each exam room door. In a typical clinic day, I open that door 36 times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient.  I must peel through the layers of a person quickly to find the core of truth about who they are and why ...

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shutterstock_86514196 I know. I know.  Medicare is the insurance that all of us love to hate.  But being both an internist and geriatrician, I have learned to see the good side of the sometimes annoying government program for several reasons: 1. Medicare’s fee schedule. It’s bad, but not that bad. Sure, Medicare’s fee schedule has only increased 3.1% over the past 12 years, while ...

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