The healthcare workplace is undergoing profound changes.  Where once a letter and a handshake were enough to create a life-long working relationship between colleagues, now the multiple work settings and relationships create many possibilities.  Understanding not only how to get into the relationship, but also what might happen when you need to leave or are forced out of a relationship is critical. True case report:

A woman internist arrives at work one ...

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MiracleWhipMillion-e1371926810326 I happened to see this Miracle Whip advertisement in a magazine left open by a patient in our waiting room, and I really found it offensive.  Let’s dissect the ways in which this advertisement sullies the notion of food, and examine how far the concept of Miracle Whip strays from real food that should be enjoyed. At the top of the page it ...

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Monday afternoons are always the same.  I pick up the kids from their grandparents.  We drive home with their backpacks and a carton of home made food.  We park in the garage, and carry all the contents of the car into the house.  As the kids unload, I push the recycle container to the front for street pickup the next day. Occasionally, I stop and socialize.  Yesterday, I waited at the edge ...

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It occurs to me there are several keys to being an excellent physician.  One must love science, enjoy hard work, have the courage to make tough decisions, carry a modicum of intelligence and suffer angst at receiving 94% on an organic chemistry test.  In addition, the very best physicians, those we admire and to whom we flock, have a secret weapon.  They do not care. I do not mean that they ...

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I started seeing patients the moment we arrived at Apollo Hospital in the small rural town of Bilaspur. There was no time to rest. These patients had been waiting for us for weeks to arrive. It was during this clinic time, on this day, that I realized something that really struck me to the core. I have been to India to do these missions many times. Heck, I have been ...

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There is a stunning gap between what we know and what we need to do in health care to make it more affordable, accessible, and higher quality. In a recent piece by NPR, research shows that when it comes to treatment of low back pain, doctors are prescribing more powerful pain medications (narcotics) and ordering more imaging tests like MRI and CT scans when there is no evidence these are ...

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The price has been in lives.  The capture and killing of Osama bin Laden occurred without loss of any U.S. military lives.  It was hailed as a hugely successful special forces and intelligence operation. Still to believe that the operation was accomplished without the loss of life is both incorrect and naive. The lives lost have been those of polio vaccination workers murdered in the backlash against the use of ...

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These days they have navigators for everything.  When we got lost back in the day, we used to consult a map, or lacking a map, we would pull in to the nearest “filling station” (what we used to call gas pumps) and ask for directions from the friendly young man who would appear to wash our windshield, check the oil and the tire pressures, and of course, pump the gas.  ...

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Several years ago I wrote an article for physicians on the topic of balance, and one of the suggestions was to place family first.  There are two stories that I have learned since the publication of that article that I would like to pass along. Balance in a doctor’s life is best achieved if there is balance between family and work.  One of the best suggestions is to place family ...

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In recent months, AAFP President Reid Blackwelder has been editorializing and debating what they see as the encroachment of nurse practitioners (NPs) and other "mid-level providers" (physicians are, presumably, "upper-level") on the practice territory of family physicians (FPs). Dr. Blackwelder has repeatedly said that NP and physician roles are "not interchangeable." The AAFP's position on this issue seems to be resistance to the increasingly common decisions by state ...

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