About a year ago, there was a great commercial that depicted the slowing of time as a free-falling, but worry-free, James Franco uses his smartphone to chart a safe landing on the billowy awning of a restaurant dozens of stories below.  There probably isn’t a single person who hasn’t, at one point or another, wished she or he could control time in order to navigate a better outcome.  And doctors ...

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Delivering bad news is part of my job, an important part. It is fashionable nowadays to speak of the doctor-patient relationship as a partnership. In the sense that both doctor and patient have important roles to play for the patient to get good care, that’s very true. But even in the best of times, it’s a very asymmetric partnership. Even in a run-of-the-mill visit for a sinus infection the patient and ...

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Dear patients, First of all, thank you for calling for an appointment. Seriously. Ever since I’ve gone open access, if the phone doesn’t ring I’m toast. And thank you for your interest in preventive care. The fact that it’s now free (well, no cost to you at time of service: trust me, it’s not “free”) has probably motivated more of you to call. That’s OK. But sometimes it seems that your ...

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How many times do we start out our day with the best of intentions? It’s probably most days, if you’re at all like me. Even when we’re going through a spell of negativity, we all try to pull it together for the sake of our patients, our staff, our families. A couple weeks ago, I was tempted to throw in the towel. It was one of those days when the last straw was ...

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Forty is the new thirty. Orange is the new black. And failure is the new success. It seems these days that no success story is complete without a failure (or two) along the way: the bankruptcy that gave birth to a successful company; the entrepreneur who lost it all just before hitting the Fortune 500. Entire issues of the Harvard Business Review and the New York Times Magazine have been devoted ...

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shutterstock_162279323 Party Weekend - Joe “King” Carrasco Fight for Your Right (To Party)! - Beastie Boys We Just Wanna Dance - The Flirts My favorite radio station, WHFS, had a ritual every Friday afternoon to start off the weekend, back in the day. DJs Weasel and Bob Here would exchange pleasantries as they exchanged shifts, and would launch the same set of songs at the same ...

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shutterstock_70391227 The following article is satire. LAS VEGAS, Nevada -- As times have become harder for emergency departments around the country, one local hospital, Snooty Hospital and Casino (SHC), has come up with a solution to capture precious reimbursement from individuals with “enhanced diagnosis and treatment goals.” When checking into the ED either by ambulance or at the front desk, patients now have the ability ...

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shutterstock_192230474 The American Board of Internal Medicine is irrelevant.  It has always been.  I realized this when I first certified in internal medicine in 2002.  The test was largely fact-based and filled with information that I would never need to know in practice.  It did not measure my diagnostic acumen, or my physical exam skills, or my ability to listen and empathize ...

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My career is based on communication and empowerment within the medical world. I educate on the patient/family side and the medical professional side. It takes understanding and empathy from both sides of the stethoscope to optimize communication. It takes communication between both sides to bridge perceived power differentials. It takes work on both sides to change a culture of uneven power dynamics. I read two Facebook posts within the past few days dealing with a ...

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In my travels up and down the East coast, I’ve worked with a number of health care administrators (and even temporarily been one myself, although quickly discovered that it wasn’t quite my cup of tea). The experiences that I’ve had have been highly variable, and I’ve seen the full spectrum of administrators ranging from the brilliant to the quite dire. As someone who has read many autobiographies of famous leaders, ...

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