Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following the publication of that post, I heard from several hospital executives and was pleasantly surprised that they all responded positively to my ...

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The frenetic pace and chaos of working in an urban trauma center are addicting -- at least for a while. Interesting, unusual, and tragic patients test the mettle of even seasoned physicians. For some, the lure is too strong to step away. For others, the attraction of a quieter life and promise of a more sane existence is too powerful to resist. My story After training in one of the busiest level 1 ...

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I swear by Epic, by eClinicalWorks, by Allscripts, by AthenaHealth, and by all the coders and accountants, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. To hold my mouse in this art equal to my own hand; to make it right-click as well as left-click; when my ACO is in need of money to share an “at-risk” portion of ...

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To be clear, this is about one person.  It warms my heart to know that people want to come and start new lives as Americans.  Some of the best doctors got their education and training overseas.  Not only have I worked with many of them, I’m related to three by marriage.  Most people have heard of Mr. Andrew Wakefield.   He used to be a British doctor before being stripped of ...

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“I attribute my success to this-I never gave or took any excuse.” -Florence Nightingale I was publically thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit. Over the past Christmas holiday a couple of patients, being human as we all are, forgot to get their medications squared away before the clinic was going to close for a total of ...

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Wellness. It’s all the rage these days as we try to manage our crazy work schedules while still maintaining balance in life. We have wellness committees, wellness workshops, wellness coaches, and wellness apps for our smartphones. So, then, what does it mean to be well? To the average person, and to the dictionary, to be well is to be “in good health” or “in a good or satisfactory way.” However, to those suffering ...

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Just after I started at Stanford’s Graduate School of Business, I wrote an article on why I’m doing an MD/MBA. I argued that business school can help clinicians develop a new perspective, acquire important skills and build bridges between doctors, policymakers, and administrators. I heard from dozens of students, faculty, and physicians who supported the idea of an MD/MBA. However, a question repeatedly came up about as to ...

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So, how do you do it all? It’s a Monday morning.  After a flurry of activities, I am walking into the office at 8:00 a.m.  I think back to the past 2  to 3 hours.  I was up at 5:30 a.m., and in my workout clothes soon after.  I managed to squeeze in a 20-minute workout, thanks to a video on YouTube.  I then reviewed my schedule and patient charts for ...

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As the immediate past-president of the Society of General Internal Medicine (SGIM), the major professional association of academic general internists, I participated in SGIM’s Hill Day on March 8, 2017.  Hill Day is when an organization mobilizes its members to visit the offices of Senators and Congresspersons on Capitol Hill in Washington, DC to discuss key issues.  Coincidentally, March 8 was also the day two House Committees began deliberations on ...

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As a medical student, I had nightmares about my first day in the OR: scrubbing incorrectly, contaminating a sterile field, forgetting the anatomy I had so carefully studied the night before. It seemed like the only thing I could do in that artificially lit room was mess up. After a few cases I came to love the routine and ceremony of each surgery: the timeout; the rhythmic pattern of suture, ...

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I am a member of the American Medical Association and chair the Delegation from the Florida Medical Association. As an advocate for the medical profession, I am very proud of the work that we do, but I also realize that much more is needed. In particular, we desperately need to address the growing disconnect between the AMA and the broader physician community. This disconnect is one of the key reasons ...

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I knew the moment when my career in pediatrics was over.  I was in the fourth year of my med-peds residency, taking overnight call in the pediatric ICU.  Nights were busy, stressful and I was alone.  A young boy came in as an unrestrained MVA after his father hit another car. Dad was OK (although severely distraught), but the five-year-old towhead boy in front of me was not, with his head immobilized in ...

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"Too many times I feel We are losing time once shared And only when you're in ecstasy You seem to really care" I recognize the song immediately — Chuckii Booker's "Turned Away." Not the regular version, but the extended one. As the words rush over me, caressing my nostalgia, a memory, a moment comes back. I was standing behind the counter at Homer's Ice Cream on a brilliant summer morning before the doors opened. We ...

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The federal government has declared, through its major health policy agencies, that the number of pain patients on opioids and the dosages they are on should be severely restricted.  The Center for Disease Control (CDC), Veteran’s Administration (VA) and Centers for Medicare and Medicaid Services (CMS) have all issued new guidelines within the past year to that effect.  Private insurers are following suit, in many cases refusing to pay for ...

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The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She'd come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she'd come by taxi. The veins in her arms were small, threadlike and collapsed, like those of ...

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How do you describe the feeling when you are at a restaurant, and the waiter sees your coffee cup at less than half full (never half empty) and without asking they refill the cup or better yet, bring you a fresh cup of coffee?  If you are like most customers, you have a nice feeling about the restaurant and the waiter as they have anticipated your needs.  Usually, this anticipatory ...

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Recently, one of the biggest mistakes ever observed on live television occurred when Warren Beatty and Faye Dunaway, presenters of the award, announced the wrong film as winner of the Academy Award for best picture.  Not since Janet Jackson's costume malfunction has, live television caused such uproar. How could this have happened?  How could it have been prevented?  Moreover, what can this error teach us about how we care for patients? A ...

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Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we're wrong. Perhaps, we dread providing unwanted news. Perhaps, we don't want to face reality or extinguish our patients' hope. As a daughter, I felt that sense of sadness and dread, waiting to hear the news that would not be told. It was September ...

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Here’s a quote that readers will not readily recognize: "It is a pity that a doctor is precluded by his profession from being able sometimes to say what he really thinks." I’ll share the origin of the quote at the post’s conclusion. How’s that for a teaser? I'll give you a hint below. Physicians, by training and experience, are guarded with our words. To begin, we are never entirely sure of anything, ...

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The surgeon told me: "No offense, but girls really aren’t cut out for this work. They’re too fragile. They get too emotional. It’s not your fault; it’s biological." Yes -- health care is sexist. And it is racist. And just like our country, it is divided. Brilliant people face an uphill battle against prejudice as they work to become healers. Abuse within the system is rarely punished or even noticed. This has to ...

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