Atul Gawande posted a series of tweets, based on findings in the Senate CIA torture report, about the significant role physicians and psychologists played in torture. He comments, “But the worst for me is to see the details of how doctors, psychologists, and others sworn to aid human beings made the torture possible.” Agreed. Upon reading how these professionals used their knowledge to torture their fellow human beings I felt disappointed, ...

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shutterstock_97947788 As I watch the business world's fascination with the electronic medical record (EMR) and all of the big data that it accumulates, I see more and more processes codified and treatment pathways carefully honed. Only one small thing remains until the computer can tell doctors how to behave based on the developed algorithms: To turn free text in the patient chart ...

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shutterstock_114332227 I am a foreign born, foreign trained doctor, serving many patients from an ethnic minority, whose native language I never mastered. So, perhaps I am in a position to reflect a little on the modern notion that health care is a standardized service, which can be equally well provided by anyone, from anywhere, with any kind of medical degree and postgraduate training. 1. ...

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Information is everything, communication is the key. Recently, we were contacted by the medical director of a subspecialist fellow's practice at one of our affiliated hospitals. She wanted to discuss ways to improve communication between our practices, and expressed considerable frustration about the information received in consultation requests from the providers in our practice sending patients their way. She noted that they had "read-only" access to our electronic health record (through an information-sharing ...

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Improving patient engagement is a subject that’s being talked about in hospital boardrooms across the country. It’s become the in-fashion political buzz phrase. Certainly sounds very well and good, but what exactly does it mean? Likely different things to different people depending on what angle they approach it -- all the way from a care assistant up to the hospital CEO. In a nutshell, it’s all about allowing the patient to ...

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My earliest memories of medicine take me back to dinner table conversations with my mother, who is a physician. She would share with us her daily stories, telling us about patients she took care of in her clinics and in the hospital. As an internist, she often found herself traveling between many locations. I grew up knowing this to be medicine. As I have progressed in my career as a ...

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There are plenty of good reasons why thoughtful physicians are often unhappy with the current approach to measuring the quality of care they provide. Some, of course, object to the whole notion of quality measurement, but I believe they are in a shrinking minority clinging to an anachronistic mental model in which each physician defines for himself what constitutes high quality care. I have addressed this previously. But even those, ...

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shutterstock_1781218 Young doctors are often progressive thinkers who like to support small businesses, buy locally grown produce from food shares, shop from individual merchants on Etsy, and never be seen in any chain store larger than Trader Joe’s. It seems every industry is recognizing the benefits of the personal service of a small business. Decades ago, the majority of physicians owned their own ...

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shutterstock_182289464 I see it all the time at our practice. Parents come with kids who really don't need to go to the doctor; they are only mildly ill, or already getting better. When I ask them why they came, the answer is simple: daycare. They need a note saying the child is better in order for the child to go back. They need ...

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shutterstock_191076491 Traveling to another country can be daunting. So when a friend of mine hosted a Russian college-aged student named Anna for a year so she could take English classes, I agreed to help out if she ever needed to navigate the American medical system. Anna had insurance provided through her program, and she was in good health, so I wasn’t too ...

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