It’s been more than a decade since the seminal report “To Err is Human” by the Institute of Medicine.  The report made waves when it estimated that 1.5 million people are affected by medical errors and that nearly 100,000 die annually as a result of medical errors. Some of those numbers have been debated, but there is no doubt that medical error is a significant issue in medicine that needs ...

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Mark Perry provides an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes.

Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail ...

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by 911Doc, MD I can't help but stand in awe of surgeons. I thought I was going to be one when I went to medical school, but my short attention span and my lack of true interest in the procedures spelled doom for that. Still, when I work in the ER and I have a surgical patient, I especially want to dot my i's and cross ...

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Every once in a while, there's a magazine piece that so encapsulates the key moral issues -- and irrationality -- of 21st Century medicine that it warrants designation as mandatory reading for anyone who interacts with patients. Atul Gawande has written some of these; so too has Slate medical columnist, Darshak Sangavi. The latest entry on the required reading list is Katy Butler's "My Father's Broken Heart," which appeared ...

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Several clients have endured the trauma of malpractice law suits, Medicare audits and stinging accusations or criticisms from patients or colleagues that leave them reeling. These clients have shared feelings of:

  • shame
  • despair
  • depression
  • loss of self-worth
  • disillusionment
  • confusion
  • hurt
  • defeat
Oddly enough, one of the least common feelings they're able to get in touch with is anger. Maybe it's because my clients are self-selected, and many tend to be goal-oriented strivers with a perfectionistic streak. They were, as was I, ...

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Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”.

More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title “The Fifteen Minute Hour” is from a book about addressing the emotional aspects of disease in primary care during brief appointments. The title and the concept seem relevant to much of ...

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How doctors can cope with stress

by Walter van den Broek, MD, PhD Often I ask my residents that if you can’t take care of yourself, how do you expect to take care of your patients? Or in another way: the only difference between God and a doctor is that God knows he’s not a doctor. These sound like cliches but there is some truth in them. In short, doctors are just ordinary people ...

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by an anonymous physician Recently, Danielle Ofri had a piece in the NEJM about medical report cards. You know, those computer generated reports that tell you how many of your patients have achieved normal blood pressures and normal cholesterols and so on. Dr. Ofri concluded her piece by shoving her most recent report card to the bottom of a stack of more important paper and heading ...

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Treat the patient, not the disease.

Care more particularly for the individual patient than for the especial features of the disease. — William Osler
We enter medical school eager to help the sick and the dying. Over the years this golden objective is transmuted into the base lead of disease-specific diagnostics and therapeutics. Our absorption in the strangeness of the manifestations of a remarkable pathophysiological process may distract us from its impact on ...

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How far will some women go to fit into high heels? The menu of services at Beverly Hills Aesthetic Foot Surgery in Studio City, Calif., provides a clue. There's the trademarked "Cinderella Procedure"—a preventive bunion correction that makes feet narrower. The clinic also offers the "Perfect 10! Aesthetic Toe Shortening" that invisibly trims toes that hang over the end of sandals or have to be crushed into tight shoes. There's also ...

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