Recently, way beneath all the press about Obamacare, there have been articles panning the president's pick as the next Surgeon General of the United States. Wait a minute. What happened to the last Surgeon General? Six months ago, family physician Dr. Regina Benjamin stepped down as the first Surgeon General under President Obama. Quick! Name one accomplishment under Dr. Benjamin. I can't either. What happened? Dr. Benjamin was a rising star in the ...

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I use my computer a lot, so I see a lot of advertisements. Many of them are for the latest two or three items I’ve priced online (which I find somewhat creepy but fairly easy to ignore). Many of them are generic, casting a wide net. These generic ads frequently talk about “one ridiculously easy trick” to halve your car insurance payments, lose 50 pounds, learn a foreign language, look ...

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Improving patient experience is all the rage these days. Hospital administrators across the land are talking about it. This can only be good for our patients and for the health care system at large. Satisfied customers are what every industry strives for. It is a bit sad however that it has taken the threat of looming financial penalties to make this happen. Now that hospital reimbursements are directly tied to HCAHPS ...

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When I graduated residency and started my first job, I walked around the ED confidently, chest slightly pumped up at all times. I knew I was well-trained. If there was a sick patient, I was going to resuscitate them. If there was an impossible central line that was needed – I was going to get it. Difficult intubation? No problem. There was no procedure that was too difficult for me. Many ...

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As a fourth year medical student I did my “sub-internship” in oncology. I hoped that this rotation would help me choose what specialty to pursue: internal medicine or psychiatry. One of “my” patients was a woman with breast cancer that had spread to her liver and lungs. Fluffy brown hair fell to her shoulders. Wrinkles surrounded her puffy eyes that held jade green irises. Though she was in pain, she was ...

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Suffering ceases to be suffering in some way at the moment it finds a meaning. -Viktor Frankl It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has. -William Osler Back in the 1990s when pain was the newest vital sign, physicians were mandated to treat it, often with powerful medications and without truly understanding the cause and significance of the ...

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How much weight do you think the average person gains over the holidays? I guessed about 5-10 pounds. I was wrong. According to a 2000 study in the New England Journal of Medicine, people overestimate how fattening the holidays are. We think we're likely to gain at least five pounds, while the actual gain is closer to one pound. Perhaps holiday weight gain has increased since 2000 -- it hasn't been formally studied ...

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image001 I was invited to give a talk about patient satisfaction at a recent grand rounds. I have written previously that satisfaction is a pretty low bar, and so I spoke instead about the patient experience. I opened my talk with the cartoon above. As I anticipated (and intended), it got a few chuckles from the audience, and I pointed out that it ...

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The field of medicine is one of the most rewarding occupations out there. Few occupations allow such an incredible opportunity to directly impact the life of a fellow human being and see the amazing results of something you did. Few occupations are allowed inside the most intimate and vulnerable moments of the human condition. In a word: amazing. But medicine for people has quickly given way to medicine for business. Business needs ...

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John and Eva had ongoing conversations about their home which was now far too big for their needs and lots of trouble and expense to repair and keep up.  John said, "It's the yard, the leaves, the painting, and general repair and replacement problems.  What's next to go?  The refrigerator or me?"  Eva was tired of shopping and cooking.  Her arthritis was slowing her down.  She told John, "Ok, you ...

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