It’s been a fascinating week or so listening to everyone weigh in on which response they thought I sent to my patient. The general consensus, unsurprisingly, was that the first was far too cheeky -- not to mention insulting -- to effectively convey the necessary information.  The second, of course, was the one I send every day, day in and day out. Just this once, circumstances conspired to allow me to send the ...

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shutterstock_148604930 I was invited to a “networking party.” I went. I was horrified by what transpired there. And disgusted. And felt blindsided. And angry. And blown away by the prevalence of what I couldn’t decide was greed, ignorance, or an unseemly combination of the two. And what magnified the intensity of my repulsion was the fact that a large proportion of the people involved have the ...

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shutterstock_231296887 Each year as the holidays approach, countless medical families prepare for the dreaded release of the holiday schedule. Will the physician spouse be home this year? Will the non-physician spouse be packing up three kids under the age of five and traveling across the country alone to visit family they may only see once a year? It can be stressful. It ...

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shutterstock_192888809 The phone rang one evening and a pleasant voice was on the other end.  "Hi, my name is nurse so-and-so and I'm the educational coordinator for your upcoming knee surgery. Do you want to go to the patient orientation session?" she asked.  "It's very helpful to go over things before and after  your surgery and to answer any questions you might ...

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There are certain universal laws that appear to govern the broader workings of the world around us. For those of you unfamiliar with Pareto’s principle, it’s a concept that was first applied in economics and then found to be a governing rule in a whole host of different arenas. It’s no understatement to say that understanding and acting upon this concept can be transformative, not just in your work but ...

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The safety concerns that keep clinicians awake at night often aren't issues that you could fit onto a safety and quality dashboard. They aren't the kinds of things that feed metrics on the CMS Hospital Compare website or any of the other sources of publicly reported quality measures. They are intensely local, and no less important for being so. This reminder came to me recently during a quarterly meeting of Comprehensive Unit-based ...

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shutterstock_122907892 Is it just me, or is the world of medicine getting way more complicated? Sometimes I long for the good old days of practicing medicine. First, the hospital switched over to electronic medical records, which required us to to attend Saturday morning classes to learn how to tell the nurses our patients could go home after surgery. Next, our office got an insurance memo ...

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Two weeks ago, I went on an awesome vacation to Las Vegas. It was my first paid vacation of my medical career and by all accounts it went very well. I won $50 on the penny slots and got to see my old friend, the Hoover Dam. Many “Vegas vacation” lines were uttered as we walked across the dam bridge and asked all the dam questions we could think of. ...

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shutterstock_229011745People ran to the church for refuge in Medieval times. It was considered a place of safety, a sanctuary from civil punishment. In the church, one could claim a right to justice, food, water and shelter. That role was recognized by church and government authorities alike; doubtless sometimes grudgingly as the wanted escaped harsh punishments. These days, America's emergency rooms have filled ...

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shutterstock_145891352 Recently, allegations have been spread by women who claim that as teenagers, they were sexually assaulted by Bill Cosby. Some have not made any mention of these crimes until decades later; while others have said that they did report the allegations at the time of the assault, but were not believed. Due to Cosby’s notoriety as a celebrity, this has fueled ...

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