Recently, I read an article about a new mother’s experience taking her toddler to the emergency room after a face-first fall onto an iron table, bleeding profusely. After her child was evaluated, it was determined that no serious injury was sustained, and no further intervention (i.e. stitches) was needed, and the toddler was discharged home with some wound care instructions and a popsicle. When the mother subsequently received ...

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An excerpt from Physician Suicide Letters -- Answered. When is a taboo topic no longer taboo? When is it OK to stop hiding behind euphemisms? When is it safe to tell the truth? The answer is now. This week I uploaded 53 chapters of physician suicide letters in a
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There’s no doubt that technology is changing the face of medicine. Today, surgeons can perform minimally-invasive procedures with the assistance of a robot or replace missing limbs with bionic ones. Radiologists can read imaging studies from halfway around the world. There are specialists providing remote services to patients with strokes, women with high-risk pregnancies, and critically ill neonates. Mental health professionals are now able to offer life-changing care to patients ...

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Every primary care physician has had this experience: We refer a patient to a cardiologist, pulmonologist or gastroenterologist and get a note back that says our patient’s symptoms are not cardiac, pulmonary or GI related. “Not my department,” in essence. Medical specialties are organized by organ or organ system, and not by symptom. This really leaves primary care doctors in the default role of being specialists in diagnostics. I often say ...

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It was never his intention that the name would stick.  A decade ago, when he first began working in the restaurant, some of his fellow employees knew that he was formerly a practicing physician and started to call him "Doc."  Although many of his coworkers had since moved on, taking the knowledge of his previous profession with them, his moniker persisted. Doc liked the simplicity and tedium of his bartending job. ...

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"She's ready to push, doc." It's 2 a.m. I've been up for the better part of the evening, doing my part in the process of labor. I groan; I have a full day of clinic patients six hours from now. But these are the wonderful times. These are the times, in the rural hospital that I work, where it's completely and totally about that laboring soon-to-be mom and her soon-to-be child. There are ...

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It’s been a long day in the psychiatry clinic. Seeing patients is never dull, and each interaction is meaningful in its own way. From the moment they walk into my office to the moment they leave, I try my best to be fully present with the patients sitting in front of me. That means listening to every word, watching every nuance of body language, hearing every concern -- both spoken and ...

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2015 was a hard year for my father.  He's a remarkably healthy 89 year old, with no diabetes, no hypertension, and (most importantly) he's got a sharper mind than I do on most days.  Perhaps that's a low bar to cross, but it's pretty good for him.  I think this is from all the crossword puzzles he's done over the years. Dad's troubles started around the middle of the year when ...

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Over the past year, I’ve read countless publications concerning the relationship of customer service and patient care. Many have alluded to the fact that customer service in health care is not only unfeasible, but also detrimental to patient care. As a huge proponent of customer service, it was quite natural to take a defensive stand, posturing against these “absurd accusations.” Over the years I’ve learned, quite often the hard way, ...

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I’m writing to you from the future -- approximately ten years from where you are now. You’re a few months into your medical oncology residency, just beginning to assimilate to the flow of your daily responsibilities as a doctor committed to the diagnosis and treatment of cancer. You hate living in upstate New York, and are dreading the upcoming winter and the associated endless piles of snow and sub-zero temperature nights ...

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