In my work as an academic medicine education specialist, and, perhaps more importantly, in my experience as a patient, I have observed time and time again a common scenario.  I call it the grumpy  physician trickle down scenario. Here is how it plays out.  A physician, likely good-hearted, well-intentioned, competent, and compassionate, develops frustration with system operations (scheduling, inefficiencies, miscommunication, the list goes on).  The physician internalizes the frustration, perhaps believing ...

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As a Swede, I know all about socialized medicine. I grew up with it and I learned my trade in it. I worked under budget constraints, treatment protocols and formularies in the late 70′s and early 80′s while American doctors were essentially practicing the way they wanted here. I remember one of my surprises when I arrived in this country: I had learned in medical school that trimethoprim-sulfa was the drug ...

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soda I’m sad that a New York judge struck down the 16-ounce size limit for sodas and some other sweet drinks.  I think Mayor Bloomberg had the right idea. I get that whole personal freedom argument (although the court just said that it was arbitrary and out of Bloomberg’s purview), that this was a “nanny state” idea. But honestly, when it comes to obesity, ...

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We doctors who specialize in psychiatry have a sacred trust. We are given the opportunity to talk to people who are hurting every day, people who trust that we will listen to them, try to understand them, not laugh at them, and not think that they are stupid, crazy, or horrible. A tall order, granted, given that we hear stories that sometimes border on the unimaginable, bizarre and otherworldly. This ...

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Do you know anyone who has tried to find an internist recently? Good luck. Internists are either overflowing with patients, switching to retainer medicine, switching to hospital medicine or quitting. Internists are frustrated, burned out, and unhappy with the external transformation of our wonderful profession. We spend 20 years in school, and then 3 years of residency training. We learned to think and apply our cognitive expertise to the diagnosis and ...

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Everybody hates curbside consults – the informal, “Hey, Joe, how would you treat asymptomatic pyuria in my 80-year-old nursing home patient?”-type questions that dominate those Doctor’s Lounge conversations that aren’t about sports, Wall Street, or ObamaCare. Consultants hate being asked clinical questions out of context; they know that they may give incorrect advice if the underlying facts and assumptions aren’t right (the old garbage in, garbage out ...

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My interview series continues, this time with local litigation attorney Andrew Thompson, Esq. The topic this time is medical malpractice. I asked him a bunch of questions. He answered. See what you think. 1. In your opinion, is there a medical malpractice crisis in this country? No. This is not even a close issue. The concept of a “crisis” or dramatic increase in the number of medical malpractice cases is ...

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The cabdriver pulled up to take me to the community hospital where I work several weeks each year. Settling into the back seat, I made my request before he reached the intersection: "Could you please take 93 South?" He was quick to ask me why, and I hesitated. I had taken this route dozens of times and had usually found it to be faster than the alternative, I said, but ...

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One of my students told me about his experience at TEDMED, the future-oriented medical conference that bills itself as "a celebration of human achievement and the power of connecting the unconnected in creative ways to change our world in health and medicine." He recounted how one speaker showed off the Remote Presence Virtual + Independent Telemedicine Assistant, which news outlets quickly dubbed the "Robo-Doc." This high-priced gadget is designed ...

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shutterstock_114133564 Should doctors be able to write? At first glance, this might seem like a question with an easy answer. Yes, you might say, doctors receive a doctorate and are trusted with communicating to and about people at critical moments in their lives. Or you could reply, No, they are scientists and so need to be functional communicators able to write basic notes and prescriptions, and ...

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