I took a long walk with my dog today, and then I took a shower. I like showers. I’ve always found them soothing and comforting. I can think in there. I can relax. I can’t hear the phone ring. I can’t see a television. Generally, no one bugs me while I’m in there.  I come out clean, refreshed, and smelling and feeling good. A shower can relieve aching muscles while removing the ...

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Yesterday I woke up to a startling realization: Like the dozens of women I treat, I will soon be entering “the change” as they call it, and I instantly was catapulted on to the other side of the exam table.  While all the symptoms are not present, I’ve been noticing the signs, and when I reviewed the blood work that was done last week, it was clear. The “M” word ...

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I started November 8th so hopeful. The polls were a comfortable 78. I wore my new berry colored pantsuit purchased especially for the election. I even wore my suffragette sash to work. The last face I saw before stepping into my office was a young woman in her 20s who gave me a thumbs up and that knowing smile that said, I’m with her too! Every woman I met had ...

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Performance in the practice of medicine has always drawn scrutiny and evaluation. Lives are at stake and years of education, practice and certification are required, simply to have the chance to be a physician or nurse. But today we’re witnessing an unprecedented rise of ranking, rating, and scorekeeping of performance in our hospitals. And there’s growing evidence that more patients are making their hospital choices based on these ratings and ...

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A letter from a physician to her former employer. This may seem to come out of the blue for you, but for me, it is something I have thought about often. You will likely not remember the details like I do, so let me spark your memory. It was a Thursday, and my husband, who I have known since I was 19 -- not unlike you and your wife -- was diagnosed ...

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The day after the 2016 election I went to work, and from medicine, I better understood the outcome of the election and the next goal of America. Driving into the hospital, I called the ICU of an acute rehabilitation hospital to check on a patient. He had sepsis from a very complex urinary tract infection which exacerbated his chronic hypotension. He already had renal failure on dialysis and was on chronic ...

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Cleveland took a major economic hit a few years back when United Airlines cut most of its flights from our city. An airport is the heart of a metropolis. Lack of direct flights means that business meetings, leisure travel, conventions and trade shows will likely opt for more convenient locales. This was a business decision for United which I am sure was rational. Nevertheless, their gain was our loss. As a ...

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I dreaded Mr. L’s office visits. His mouth half vacant of teeth and his clothes reeking of hand-rolled cigarettes, he regularly demanded medicines he didn’t need. He was pushy and thankless. I frequently declined his requests. He stuck with me anyway. Over the years he grew in orneriness. Divorced, childless, and unemployed, he declared one day that he was tired of living. He was reasonably healthy. He disavowed depression. Would I ...

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Spend time talking with non-medical friends and acquaintances. Ask them about their medical experiences. Imagine what they want, or ask them what they want. People want to feel that their physician has spent adequate time talking, examining and explaining. They want to look into the physician’s eyes. They want the best possible care, but caring matters. Our “system” discourages such care implicitly. Physicians do not get paid to spend time with patients. ...

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In a recent PBS interview, Mayo Clinic CEO Dr. John Noseworthy suggested patients should “change physicians” when faced with non-empathetic doctors suffering from burnout.  His cavalier resolution to our occupational struggle feels like a betrayal, to both his esteemed colleagues across the country and our profession.  In my opinion, firing your physician is a risky proposition in light of the looming physician shortage. Burnout is an overwhelming sense of ...

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