An excerpt from The Color of Atmosphere: One Doctor’s Journey In and Out of Medicine (Chelsea Green Publishing, 2011). We all make mistakes. To err is human—unless you are a doctor. This is a lesson that began in med school. If something went wrong, some­one else was to blame. Attending physicians blamed the residents, who blamed the interns, who blamed whomever else was within range—med student, nurse, patient. We gave ...

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I recently read a post from Jan Gurley, MD on here on KevinMD.com. Her opinion is that medical malpractice lawsuits are a “crap-shoot”; she notes that “malpractice lawsuits fail when it comes to medical errors-in both directions.  People who’ve suffered from errors both don’t sue, and lose suits, in the same percentages that people who sued have no suffered from errors.” Assuming that information is correct for purposes of this ...

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In 1911, George Bernard Shaw famously wrote "All professions are a conspiracy against the laity". One hundred years later, in 2011, I write "the MBA has done more to harm the public through bottom-line hospital administration than have many dread diseases." As an example, the continuing saga of this stent, that stent, the other stent placed into as many coronary and other arteries as often and as fast as possible does show ...

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Doctors vs. nurses (or doctors vs. nurse practitioners, or doctors vs. physician assistants, or what have you). The debate is old, tired, unimaginative, divisive, and wrong-headed--for reasons that are too obvious even to list. Does it get perpetuated because it garners comments (175 of them, to be exact)?  Snarkniess is not appreciated by this reader, at least. The New York Times recently ran a column by one of its editors, "
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In the very first episode of the TV series Marcus Welby, MD, our hero delivers an after dinner speech to a group of young interns. As he’s introduced, he hastily scribbles the title of his talk and hands it to the hospital director: “The future of the general practice of medicine, if any.” The year was 1969. In his introduction, the director somewhat tactlessly remarks that many “eminent specialists” have addressed ...

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Earlier this month, at the third annual American Medical Student Association Patient Safety and Quality Leadership Institute, I listened with sympathy -- and, frankly, a certain amount of discomfort -- to a fourth-year medical student's account of his grandmother's recent hospitalization at a well regarded inpatient facility in New York City. Admitted with an initial diagnosis of pneumonia, Cole Zanetti's grandmother languished in the hospital for almost four weeks. As the medically ...

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In a hospital setting, administrators love to work with physicians; they make sure whenever a new system is being formulated and implemented, this is discussed with a team of physicians, as they are also an integral part of success. All physicians work with each other in harmony and synchronicity. Cardiologists never step on each other's toes, radiologists call admitting doctors for any bizarre findings and hospitalists notify the primary about their ...

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I recently headed off to a reception for students from the new Pacific Northwest University of Health Sciences in Yakima, WA who are spending their third year of osteopathic medical school in Puyallup, WA doing rotations with the physicians in our community.  I’ve had a student with me recently, and it brings back memories of my third year in med school, and how things have changed.  It also leads me ...

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As I walked into the ED for my shift, the nursing supervisor was fumbling with a syringe attempting to get medication out of a small vial. “Ummmm. Looks like you need to adjust your bifocals,” I quipped. We have a running joke about who is older and bust on each other about our ages every chance we get. When she turned around, the look she gave me signaled that it was no ...

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The Institute of Medicine has been an advocate for clinical guidelines for many years. Although the value of guidelines has never really been established, both clinicians and medical malpractice attorneys often want to ascribe greater credibility to them than they deserve. The issue was raised again in the past few months and I review it briefly here. A few years ago Dr. Robert Ewart discussed the ethics of using guidelines to screen patients ...

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