If you’re a 3rd- or 4th-year resident, chances are you’re no stranger to unsolicited job offers showing up in your email inbox. Maybe it’s a few a week, or maybe it’s a few a day, but they are always there. The emails find you. I’ve been out of residency for years and I’m still getting them. The macro reason for this flood of unsolicited job offers is obvious: You’re in high ...

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Risk-adjusted 30- to 90-day outcome data for selected types of operations done by specific surgeons and hospitals are now being publicly posted online by England's National Health Service. According to the site, "Any hospital or consultant [attending surgeon in the UK] identified as an outlier will be investigated and action taken to improve data quality and/or patient care." After cardiac surgery outcomes data were made public in New York, some interesting unexpected ...

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On the face of it, the phone call was relatively innocent.  A family member was confused about the test I scheduled.  Apparently the lab refused to draw the blood.  When I inquired why, I was informed that the patient hadn't been fasting.  I calmly explained to the daughter that fasting was not necessary.  Recent studies had shown little effect on lipid panel results and I was using the glycosylated hemoglobin ...

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Everyone involved in health care, and particularly hospital care, has witnessed a sea change over the last decade. Things that were never even thought about, let alone formally taught to frontline doctors and nurses, have now come to the forefront. Chief among these is the drive towards improving patient satisfaction and delivering a more optimal hospital experience. True, a large part of this is due to federal incentives and tying reimbursements ...

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Recently, the Los Angeles Times reported on California pediatrician Dr. Bob Sears’ role as a favorite among vaccine-fearing parents. What he tells them is absolute nonsense that he has freely admitted he made up in a Reddit interview. Now he’s let a little more honesty shine through. He told the reporter: “I do think the disease danger is low enough where I think you can safely raise an unvaccinated child in today’s society,” ...

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Joan Rivers: Pushing the limits of outpatient care There are minor operations and procedures, but there are no minor anesthetics.  This could turn out to be the one lesson learned from the ongoing investigation into the death of comedian Joan Rivers. Ms. Rivers’ funeral was held on September 7.  Like so many of her fans, I appreciated her quick wit as she entertained us for decades, poking fun at herself and ...

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One of the most important tricks of the trade that I learned in medical school was what some might have considered a little throwaway bit of advice. During my psychiatry clinical rotation the preceptor advised that, when applying the stethoscope to the patient’s back, one should rest the other hand gently on his or her shoulder. Human touch was important. It would relax the patient and convey subconsciously a sense of ...

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If a doctor doesn’t do excess testing, he isn’t going to be able to live An excerpt from Doctored: The Disillusionment of an American Physician. After the blowup with Rajiv, I committed myself to changing my standoffish ways. Rajiv had been urging me for some time to meet socially with his physician friends in a relaxed atmosphere away from the hospital, and so there I was a few weeks later at a doctors’ party in Manhasset, a tony ...

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When you feel yourself sinking deeper into a bad case of physician burnout, finding a way out can feel daunting, if not impossible. But it doesn’t have to. I believe recovering from burnout begins when you start taking small, purposeful steps in a new direction. I recommend you start by getting a handle on your work-life balance. Do you balance the time and energy you spend at work with the time and energy ...

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Taking lawsuits personally: A surgeons first malpractice case In all my years of practice, my dad called me at the office only twice. The second was to inform me of a horrible family tragedy. The first -- well, I guess in a small way you could say it was the same. "I hear you joined the club," he said. "What?" I had no idea what he was talking about. I'd recently moved ...

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