“Customer service” is the new buzzword in health care. (Yes, I know it’s two words. Stay with me here.) Health care has become a service industry, like a restaurant or a company that comes to your home to replace a broken windshield. The shrimp is too salty, or the tech left footprints on your floor mat? You complain, and you send the shrimp back, and the tech apologizes and says ...

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I was really anxious.  My father's legs were getting weaker and his pain was worsening.  He had been having pain for quite a while, and that pain was often disabling in its severity, but the weakness was alarming. Dad went to the neurosurgeon, who was also alarmed at the weakness, but didn't feel that the problem was surgical in nature.  When I heard this I broke one of my most tightly-held ...

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Shhh. I think this is supposed to be a secret, but this Wednesday at the super-elite AMA House of Delegates meeting in Chicago, where only the mostly highly connected and AMA devoted doctors get to attend, they actually stood up for us.  It is now AMA policy that the AMA opposes mandatory ABMS recertification exams. Crazy, right?  News of this random act of fortitude trickled out to us on Twitter by the small ...

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PamelaWiblePostcard283-copy Dear Dr. Wible, Thank you for the work that you do. I have been following your push for humane medical education for several months now. I finally decided to contact you after reading your article about how “burnout” is actually abuse. I am a med student entering my third year. I have been consistently hearing horror stories from other students about the ...

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One of the episodes of the Walking Dead was titled “JSS.” In this brutal episode, one learned by the end of the show that one of the characters, then others after her, had learned that all they could expect to do for the moment was JSS, or just survive somehow. I met a patient recently who embodied that mantra. Small, petite, with stringy hair and sun-browned skin, she did not look the ...

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The street was glistening with Christmas lights, and tiny flurries were falling onto our hats as we walked down a picturesque Philadelphia street. It was the end of one of the first “real” dates that I have ever had in my young thirty years of life. We started the night with dinner at a fancy restaurant followed by attending the musical White Christmas. As we walked down the street, my date ...

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When I was in high school, I remember being fascinated by the television series House the medical mystery show whose title character was the doctor version of Sherlock Holmes (only with non-existent ethics and a drug problem). Back then, of course, I didn’t have much understanding of the medicine behind the show, but I was impressed by the show’s apparently realistic use of medical terminology and the way it made the ...

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Every day on my way to work, I walk through one of the most famous and historic LGBT-friendly neighborhoods in the U.S.  This past Saturday, my walk back home from the hospital was a particularly entertaining one.  It was Pride weekend.  People were celebrating, the sun was shining, the rainbows painted on the street seemed brighter.  Even though I had worked a long day, my walk back home left me ...

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Move over, placenta eating -- there’s a new player on the newborn scene, and its name is vaginal seeding. In case this practice hasn’t crossed your radar yet, it’s a practice involving transferring bacteria from a mother’s vagina to a newborn who was delivered by C-section. Before you stop reading because you think that sounds gross, remember that the majority of babies pass through the vagina on their way into ...

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The stethoscope is dying.” That’s the word on the wards. Clunky and less precise than what modern technological advances allow, many say it will soon find itself useful as only a historical artifact of 19th and 20th-century medicine. While it may pain many clinicians,  it’s tough to argue the stethoscope’s immunity to Moore’s law. As technology allows us to make better, more accurate tools, we embrace them as ...

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A new research study recently published in the BMJ claims that medical error is the third leading cause of death in America. It is third only to heart disease and cancer. Most of the major news outlets are sensationalizing this report. A few headlines are even slowly starting to replace the phrase “medical error” with “doctor error.” Some comments I noted on social media include, “Medical errors kill eight ...

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She drew the life-saving medication into the syringe, just 10 cc of colorless fluid for the everyday low price of, gulp, several hundred dollars. Was that a new chemotherapy, specially designed for her tumor? Was it a “specialty drug,” to treat her multiple sclerosis? Nope. It was insulin, a drug that has been around for decades. The price of many drugs has been on the rise of late, not just new ...

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One weekend about nine-and-a-half years ago, I flew from Minneapolis, where I live, to Atlanta for a publishing conference. A colleague and I were to make a presentation to the vice-president of one of our major customers. For a couple of weeks, I'd been plagued by a sore throat, but I'd written it off as allergies or a virus. When I tried to begin the presentation, though, all that came out ...

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Start with one excellent childhood experience -- a loved one who is cured. Add a generous helping of baseline optimism, a cup at least.  More is better. Mix in well a half cup of ability to suspend disbelief.  And then, maybe a pinch more. Add a teaspoon or two or even three of denial.  Pollyanna had it right. Remember to include an ounce of prevention -- Worth a pound of cure, so they say.  Suspend ...

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Recently, a patient of mine died of cancer, whom I loved very much.  She had a special way of enjoying life; a half, wise smile that after our many years together did not take me too seriously and reflected her deep inner strength.  She taught me about joy; I will miss her always.  Her husband, understanding my loss, said that it was alright, that I had done my best, that he ...

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asco-logo As an oncologist who also specializes in sexual health, I have realized just how essential it can be. I have seen many grapple with the consequences of cancer and its treatment on their own sexual view of themselves (their sexual self-schema) and how it can impact the relationship between partners. For some, the experience draws them closer; for ...

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As many who are pediatricians or know pediatricians are aware, the quest to end gun violence is a passion for our profession and an advocacy issue of utmost importance for our professional organization, the American Academy of Pediatrics (AAP). Having practiced in areas with a high incidence of gun violence for most of my career until recently moving to California, I have seen first-hand how this tragic issue affects the ...

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“I should be home well before nine o’clock,” I said to my wife on the phone as I steered my eight-cylinder SUV quietly down the highway at 75 mph with more than 100 miles left to go. “More like eight fifty-five,” I added. “That’s well before nine?” She sounded both weary and incredulous. I knew what she meant. I am not as obsessive about time as I used to be, but even ...

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At our last visit, she asked me "not to forget us" and gave me a photograph of her family. She included a picture of her daughter, whom I had never met. I had missed her by four years almost to the day because she was shot and killed driving through her neighborhood in the middle of the afternoon. I first met Mrs. P early in my training as a physician in ...

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A couple of weeks ago I visited the island of Cyprus with family. Having seen a lot of mainland Europe over the last several years, I was keen for something a bit off the beaten track and away from a major city. We thought about a few possible destinations, but opted in the end for Cyprus (partly because of the desperate need for some warmer weather). Booking the trip quite rapidly, ...

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