Before you can even form a thought, emotions are influencing your judgments. -Zimmerman and Lerner It’s 9am on a Monday, and our palliative care team circles a table to prepare for the workday. Before us is a list of names, each representing a patient and his or her needs, support system and care team. Many are referred to us because they are suffering -- be it pain, agitation, emotional distress, existential crisis ...

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shutterstock_94195759 This wasn’t just plain terrible, this was fancy terrible. This was terrible with raisins in it. -Dorothy Parker More and more of my clinic time is devoted to evaluation and treatment of depression and anxiety rather than sore throats, coughs, UTIs and sprains/strains.  An outbreak of overwhelming misery is climbing to epidemic proportions in our society. A majority of the patients who are coming in for ...

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I get it.  It’s not rocket science.  But sometimes everyone in the field of medicine needs a bit of a refresher when it comes to keeping our patients happy. After all, it’s a two-way street with medical providers and patients: we provide and support ways to improve and maintain the personal health of our patients while our patients provide and support the health of our careers and livelihood.  We depend on ...

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Do you have a medical, pharmacy or nursing license in several different states?  Do you have a license in more than one health profession?  Have you been notified that an investigation has been opened against you?  Are you thinking about resigning your professional license or voluntarily relinquishing such a license?  Then you must be aware of the following. First, you should never voluntarily relinquish or resign your license after you know ...

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Just as elite athletes are born with amazing skill, elite surgeons and doctors in other procedure-based specialties are also equipped with innate abilities that others do not possess.  Surgical skill is often difficult to quantify.  Certainly, outcomes data can be obtained and reputations are formed over time.  Years of training allow the truly gifted surgeons to develop their skills and perfect their craft. However, all surgeons are not created equal.  During ...

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I recently participated in a small conference devoted to “physician alignment in the academic medical center.” The meeting was sponsored by a health care consulting firm, and drew about a dozen participants from around the country. The title refers to ways in which academic centers figure out how to work with their traditionally autonomous if not completely independent physicians to advance the institutional mission. An informal format allowed us to ...

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Researchers at the American Academy of Family Physicians' Robert Graham Center have estimated that the U.S. will require 52,000 additional primary care physicians by 2025 due to the effects of population growth, aging, and insurance expansion. Since it takes at least eleven years of post-secondary education to train a family physician, even a renewed surge of student interest in primary care careers is unlikely to meet this anticipated need. Another recent 
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Recently, a family in my practice decided to move out of state, back to where they had lived before. When we said goodbye, the mother said that she was sad to change pediatricians. The pediatrician they would be returning to, she said, “only takes care of strictly medical things.” Clearly, she meant that I take care of more than the strictly medical things. I was flattered, especially since this was something ...

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“You are the worst doctor I have ever met.” This was the second patient in a row to explode at me when I explained that further back surgery for his back pain had a low chance of success. I spent a couple of minutes explaining the many successes of our hospital’s pain program. Then he exploded again: “You mean I drove five hours just to hear you tell me that you ...

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Recently, I received a phone call in the late afternoon from someone very close to me. Please note that this someone is also a doctor. “Uh, I need you for a minute. I’m kind of freaking out. Can I talk to you?” She had just gone to her local optometrist to get a new prescription for glasses. The optometrist looked in her eyes, told her that both of her optic nerves ...

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