What is a pickup basketball game? It involves players of varying skill levels forming a team on the fly and hoping to win the game. Often the players have some or no familiarity with each other or their skill levels. What is the analogy to surgery? Often, surgeons walk into an operating room and have to form teams with unfamiliar or unknown personnel, and teams may not be consistent. However, ...

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When is it right to share our personal struggles with patients? I remember the day like it was yesterday. I was 10 years old, dressed in kid pajamas with sleep still in my eyes. I walked upstairs with a sense of purpose. “I can’t take it anymore,” I told my parents. At that point it had been a year since we found the surgeon who was finally able to offer the chance ...

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Oncologists have one of the lowest burnout rates. Why? The alarm clock’s blast brings hours of work, running from task to task, always pushing toward the next turn.  In moments of failure, the waves of complexity and anxiety batter and you question each stroke. Then you fly downhill, easy breeze in your face, as success urges you on.  After the finish, the parking lot empties, the lights go out, and ...

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At the national conference of the American Academy of Pediatrics (AAP), I got to hear Hillary Clinton talk about the AAP's partnership with her Too Small to Fail campaign. It made me happy -- and sad. The partnership is a great idea. It's all about improving early childhood literacy, which is way more crucial than most people realize. It's not just about an income gap when we talk about the ...

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Physician suicide 101: Secrets, lies and solutions This article adapted from a lecture presented by Pamela Wible, MD, at the 2014 American Academy of Family Physicians Scientific Assembly in Washington DC. Why did you go to medical school? I’m a family physician born into a family of physicians. My parents warned me not to pursue medicine. So I went to medical school. Ten years later, I’m unhappy with the direction ...

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Anesthesiology used to be a job that was attractive for people who don’t like patients very much.  The drill was: Meet patient 5 minutes before surgery, do case in OR without interruption, drop off in PACU, done.  Minimal need for personal interaction with patient, no need to listen to complaints about back pain and demands for antibiotics for a cold, no risk of getting called in the middle of the ...

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When patients seek a second opinion: Its not about you I remember when I first started in oncology; I had joined the faculty at Brown three years after fellowship and was seeing a patient* with newly diagnosed breast cancer. She was in her 40s, an advertising executive, married, with two small kids. The diagnosis was unexpected (as it usually is), with a lump found while showering. She had come ...

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In my administrative role, I have the great pleasure of signing thank you letters to patients and family members who have acknowledged the great care they have received by one of our physicians or other caregivers. It is a nice way to tell the patient “we got your note” and to simultaneously recognize the provider by copying her or him. The best part is that I get to read the ...

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When a doctor cries The calls came simultaneously.  One from the hospital and the other from a nursing home.  Two deaths separated by fractions of a second.  My heart swelled.  For a moment.  The pile of papers on the desk softly whispered.  My mobile howled jealously vying for my fragile attention.   I could feel the emotion drain as I turned back to the task ...

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Its time to tell fast medicine to slow down Americans tend to like fast things: instant coffee, sports cars, and speed dating. Many share a fascination with record holders, such as the world’s fastest runner or texter. And increasingly, the same goes for medicine. The number of minute clinics is exploding. Some emergency rooms now post their current wait times on roadside billboards. And increasingly, physicians and other health professionals ...

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