One day into our medical center’s newly announced colleague appearance policy, nobody has yet approached my office with a steel wool soap pad to make any of the docs or medical assistants shine. My active white coat went into the laundry bin the day before, having inserted my left sleeve into a puddle of spilled coffee. The other two lab coats with hospital logo remain in their plastic protective coating, ...

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This is a very controversial essay, but I am going to express how some women physicians, like myself, feel at the VA hospital. I came home one day after my clinic and was perturbed. I called my significant other and the emotion of the day unraveled. I was reporting an uncomfortable interaction I had with an older male patient. During this patient encounter, his tone and comments became sexually charged and ...

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If you stay in medicine long enough, you will encounter physicians who seem to care more about the paycheck than the patient in front of them: think Dr. Farid Fata.  You may find those colleagues revolting; I know I did.  I despised these physicians and felt nauseated even to be in the same room as them.  But as time went on, I realized that almost nobody starts a career ...

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21 minutes on the phone for a pre-authorization? Watch Dr. Ryan Neuhofel try to get a CT scan "approved." Take a deep breath, and press play. Want to escape pre-auth hell? Consider attending the Direct Primary Care Summit.

Ever since the U.S. government decided to link Medicare reimbursement dollars to patient satisfaction scores, hospital administrators have been obsessed with improving the quality of care for patients visiting their emergency departments. While the motivation may be partly financial, the goal of improving the patient experience during emergency department and hospital visits is an admirable one. Unfortunately, many of the tactics used by administrators have done little to achieve that goal. ...

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Residency is a time of immense learning. You learn from your attendings, your patients, and your colleagues. Of all the teaching moments during my residency, one that frequently stands out in my mind now is the day when one of my co-residents told me about the “post-training phenomenon.” He had previously completed a different residency and practiced in that field for a decade prior to switching to our specialty. “Once you ...

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“Someone else will lend a helping hand,” a physician told me once, when asked to help with an emergency in public.  As a PALS instructor for more than a decade, I have always responded when possible.  In the last decade, there have been three in-flight emergencies, two elderly individuals who passed out in church, and a host of other less serious maladies.  A week ago, I discovered the best reason I ...

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As a member of the general population, we see physicians as those who were born with a calling. Though society acknowledges that becoming a doctor is difficult, it is near impossible to fathom exactly what that title entails. I was raised in a small rural community in which resources were quite limited. The nearest grocery store was a 35-minute drive away, there were no coffee shops or traffic lights, and we ...

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Diagnostic tests such as CT scans are not perfect. A test can make two errors. It can call a diseased person healthy: a false negative. This is like acquitting a person guilty of a crime. Or a test can falsely call a healthy person diseased: a false positive. This is like convicting an innocent person of a crime that she did not commit. There is a trade-off between false negatives and false positives. To ...

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Most primary care physicians (PCPs) who admit patients to a hospital are family practitioners or internists. Since medicine becomes more complex each day, PCPs must remain up-to-date on the latest treatment related to drugs, surgery, procedures, risks, complications, and costs. This might require your PCP to be a quarterback bringing together a team of consulting specialists to guide you through your hospital stay. The economics of hospitalization are changing, and since ...

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