Doctors do not know everything. We make mistakes and mistakes in judgment. Sometimes we make the mistake of speaking when we should keep silent. At times, patients ask us questions that we can’t or shouldn’t answer; and yet we do. It shouldn’t be our objective to force certainly into an issue that is amorphous and murky. Here’s a response that I recommend in situations where certainty is elusive. “I don’t know.” I saw ...

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It occurred to me towards the end of our conversation that there was a large gaping hole.  We had talked about physician burnout, career choices, and his current plans.  He had drawn a map of his future.   It originally shot like a straight arrow towards clinical medicine, but now veered precipitously.  I took a moment to first clear my thoughts, and then my throat. Medicine, I explained, is still as ...

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Dear doctor: Attached please find the medical records of Mr. Ron C., who is transferring medical care to your office. Ron is a 63-year-old gentleman with recurrent lung cancer, which has spread to his opposite lung and bones. There are multiple treatment choices for his disease, which we have discussed in detail. However, Ron is leaving my care, because he does not trust me. As you are well aware, metastatic lung cancer ...

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Hospital cafeterias are important places. Great progress has been made over the last few years in raising the standard of the food served (to both patients and staff!), with much more emphasis too on making the options healthier and nutritious. Speaking as someone who has worked in several different hospitals, and with my own general interest in health care quality and improving the patient experience, it’s always very interesting to look ...

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Studies show over and over again that empathy is the key to physician-patient communication and is directly related to patient satisfaction, adherence to medical treatment, lawsuits, and clinical outcomes. Yet despite its importance, many doctors still struggle with showing empathy. The reality is that while most medical students start school with high levels of empathy, it doesn’t take long before that empathy is beaten out of us.  Studies show ...

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Medicine has undoubtedly come a long way. Paternalism has been ditched in favor of a shared decision making approach, diagnoses and treatments are (largely) based on scientific evidence, and information is not outright withheld from patients out of some misplaced belief that they are not capable of handling the truth. Some of the modern pain points that patients now face involve access to specialists, skyrocketing cost, misinformation and miseducation surrounding ...

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shutterstock_172354895 Compassion.  Once upon a time, I had a lot of it. I guess I still do, or I wouldn't be at this desk. I think most medical students start out that way. We want to help the sick, heal the wounded, decrease suffering. All that stuff we once wrote in the "personal statement" section of the universal med school application. And believed. A friend ...

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“There’s such an issue of privacy in health care, and yet they let all the patients walk around with their derrières sticking out.” This quote within an article by the National Post got me thinking about HIPAA. The Health Insurance Portability and Accountability Act of 1996 is a big flat hammer with excellent intentions. Like EMTALA, however, it too has its side effects. Along with many other ER docs ...

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I’ve been thinking about this over the last ten and a half years since my soul mate had a cardiac arrest and died. He was 38 and as fit as a fiddle. I am a rural general practitioner in South Australia (family practitioner in American parlance). He left behind four kids (from his previous relationship), and me with a broken heart. We had been together a little over two years. Western ...

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It is not uncommon for doctors to question the reasons why we do what we do.  The journey is long. The debts often seem insurmountable.  The harsh lessons learned from a mistake made with best of intentions are an unforgiving punishment for “life without forgiveness.” Memories may fade, but the scars always seem to linger. On the one hand, like a relief pitcher in major league baseball, we must forget ...

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