shutterstock_77867152 Dr. Sandeep Jauhar, a cardiologist, believes with good reason that many physicians have become “like everybody else:  insecure, discontented and anxious about the future.”  In a recent, widely-circulated column in the Wall Street Journal, “Why Doctors Are Sick of Their Profession,” he explains how medicine has become simply a job, not a calling, for many physicians; how their pay has ...

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Actionable items. Today I decided to take a look at one of the dashboards that the information technology (IT) department built for our electronic health record, to help us a look at our patients enrolled in the multiple registries of diseases and conditions we are following for the patient-centered medical home. I booted up the program, and with just a couple of clicks of the mouse the program began running, checking with ...

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shutterstock_112553609 Dear NICU nurse, I couldn't have done what I do without you, and the time to thank you publicly for all the ways you have helped me is more than overdue. Thank you for teaching me how to handle 500 grammers when I was a medical student and had no clue.  This showed me your tolerance and good nature. Thank you for speaking up ...

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I opened my obligatory late-afternoon email to find my work schedule for the next morning: three general anesthetics for MRIs. My heart sank. A week before, I had been assigned to the new neurosciences MRI suite for a 6-hour interventional radiology procedure, followed by another intervention in the CT scanner. My first thought: Who is trying to punish me? It's well known in the anesthesiology field that these types of cases ...

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The hardest conviction to get into the mind of a beginner is that the education upon which he is engaged is not a college course, not a medical course, but a life course, for which the work of a few years under teachers is but a preparation. - Sir William Osler “You’re not gonna be happy with me, doc,” Richard said as he walked into the exam room at the Pine Street ...

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I live and work in the house medicine. You would think that those of us who have chosen this profession would actually know what dying looks like. Furthermore, one would hope that if the doctor could identify dying, he or she could share this with the patient and family (given that this is fairly significant medical information). I never cease to be amazed that most doctors cannot speak straightforwardly and compassionately about ...

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I became a physician in 2001, after originally having a career in business. I wanted to become a doctor to be able to do something important. I felt that if I needed to work, and to leave my children in day care, I at least wanted to be doing something that was meaningful to me. My job as a business manager didn’t fulfill me in that way. Over the years, I’ve ...

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The nasogastric tube was killing me. It had been in place for twelve hours now, threading its way up my nose and down my throat, past my esophagus, into my stomach. Try as I might, I couldn’t swallow away the nasty lump stuck to the back of my throat. And every time I tried, it hurt. Decades before, as a physician-in-training in upstate New York, I’d put in more nasogastric (NG) ...

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DECAFfinalresize-640x480 Pancakesresize-640x480 Health insurance is complex. Eating out is easy -- unless you were to involve your health insurance company. If you hired a third party to pay your restaurant bill, you’d pay twice as much, wait 2 weeks for a table, and have 7 minutes to eat. I shared my restaurant analogy on a LinkedIn ...

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A major debate taking place in the hospital medicine community over the last several years concerns the way in which we cohort patients on the medical floors. The traditional way is to have patients belonging to each doctor scattered across the hospital on several different floors. This is in contrast to designing a geographical system where all the patients for any one doctor are located on a single floor. On the ...

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