Two hours of administrative tasks for every hour with patients. A proliferation of non-physician administrators deciding how the day is going to run. Little in our training about how to cope with uncertainty and change. It’s no surprise that burnout rates are approaching 60 percent. Despite being so common, when we see a colleague struggling with physician burnout, we may not know what to say. Responding appropriately can bring someone ...

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Your brain is a three-pound hunk of biological tissue. And though it’s nothing more than a conglomeration of specialized cells, it generates the taste of cheesecake, the ecstasy of enchantment, and the misery of suffering. Amazing, right? I certainly think so, though I find myself among a shrinking minority. Whereas the eyes of our medical forefathers were turned toward the heavens in search of answers to seemingly unknowable questions -- ...

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Once during my TV news days, I was feeling pretty good about myself during a three-hour drive to the Mayo Clinic. “I am so glad I don’t practice!” I crowed to my photographer. “Practicing physicians are so sad. They’ve lost their income, their autonomy, and the public’s respect.” My photographer didn’t miss a beat. “Yeah,” he replied. “They sound just like you.” By which he meant that as a journalist, I’d lost ...

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I see them every time I wait in the inescapably long lines at the grocery store. They’re offering me so much. Fat-melting foods that “work like gastric bypass.” Sleep masks that prevent breast cancer. One day diets. And, of course, the perennial “medical miracles.” All these revelations can be mine with a simple magazine purchase. It’s easy to dismiss the medical advice being propagated through the supermarket checkout aisle. Who would ...

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President Trump told a group of Republican Senators that the House-based American Health Care Act is “mean” -- and on this he surely called it right! How else would one describe a bill that would take health insurance away from 23 million people, allow states to waive rules requiring insurers to cover people with preexisting conditions at no extra charge, and raise premiums and deductibles to the oldest and ...

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In my last year of training, I came to realize the difference between doctors who felt successful and those who didn’t. From the beginning, I had always been hard on myself. I always thought about the decisions I made for every patient in detail, played them over and over in my head, and wondered what I could have done differently for each one. Whether or not their outcome was satisfactory, ...

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Dear Senators, I know that the plan is to meet soon to pass the latest GOP health plan. The Affordable Care Act (ACA), also known as Obamacare, failed with a price tag of over a trillion dollars. Yes, this faulty plan is not sustainable as is. Yet, your proposed plan is just a rehashing of the failed elements. While you look at the economics and short-fallings, I look patients in the eye ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old pregnant woman is evaluated for a cardiac murmur identified on examination by her obstetrician. She is asymptomatic. She is in her 24th week of pregnancy. Medical history is unremarkable, and there is no family history of heart disease. She takes prenatal vitamins and no other ...

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Any physician who firmly believes in the ethical principles of beneficence and justice will recognize the legislation recently passed by the United States Congress known as the American Healthcare Act (AHCA) as a moral travesty. The bill’s provisions to shift costs from the wealthy to the impoverished, diminish protections for individuals with pre-existing conditions, and strip away essential health benefits for patients are cruel measures that run directly counter to ...

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Pain is not a vital sign. It cannot be measured objectively, nor does an extreme value portend crisis as in the case of pulse or blood pressure. The myopic focus on pain in recent decades has been misguided and deleterious, and the opioid crisis is the result. Now, like ostriches with our heads in the sand, we are again playing victims instead of wielding power when we allow customer satisfaction ...

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As a pediatric allergist, I treat several conditions that commonly affect children, including asthma, food allergies, eczema and allergic rhinitis. Almost everyone knows someone affected by some form of allergic condition, which makes for frequent questions from families, referring providers, and the public at large. Early in my career, I noticed that many patients (and even colleagues in other specialties) were asking me questions that were either outdated or born entirely ...

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My hospitalist medical group consists of as great collection of atheists, agnostics, and skeptics as you will ever find.  But we all agree that quality is our religion.  We believe to our last breath that patient care is sacred and an invaluable gift.  And so, as with all faith, there is no halfway.  You believe, or you stand around scratching your head asking what those other fools are worshipping.  Just ...

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I read an article by Dr. Jarret Patton that reminded us that “Cops and doctors have the same problem: People don’t trust them.” I remember thinking to myself that I had to do something to help clarify the source of this age-old problem and also to help improve the situation. It is important for us to remember that our past life experiences, diverse cultures, goals and ...

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"Management's overall aim should be to create a system in which everybody may take joy in his/her work." - W. Edwards Deming "Your skin is not thick enough to hear me yell for even ten minutes!" a 92-year-old patient's family member shouted at me while attending a care plan meeting. I was soon asked to leave the room left with case manager, social workers and mid-level managers. Later that evening, as I claimed ...

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“Transparency” is the name of the game in the 21st century. Transparency is now required in any service-oriented profession, whether plumbing, law or real estate. Now, transparency has made its way into the field of medicine. I say this because medicine has historically been an opaque profession. Many physicians leveraged the fact that they were put on a pedestal to deliver a paternalistic style of medical care. With the advent of ...

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My grandmother's room is silent, save for the plucks of sitar strings and Pixar movie soundtracks I try to stimulate her with. Instead of books, we fill the shelves around her bed with mouth swabs, drab hospital gowns and vials of baby powder. My grandmother — who walked an hour every day, who thrashed me in gin rummy, who rose before sunrise every morning to read — now lies bedridden ...

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I was approaching 24 hours in the hospital and waiting for my partner to come into my operating room so we could do “hand-off." That's when I spend 15 minutes going over all of the events of the surgical case and explain my patient’s health history, his current status, my current treatment strategies, the heart ultrasound findings, and our plan for the rest of the case. As I was awaiting ...

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There has been a lot of talk lately about maternal mortality. A recent story published in ProPublica and NPR has been circulating social media, highlighting the problems with our labor and delivery system. The story is heartbreaking, describing a preventable postpartum death in a young, healthy mother. While the article makes many good points, I do believe it is misleading when it comes to ...

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Physician-comedian Brad Nieder, MD riffs on healthy eating in one of his stand-up concerts. See more at the Healthy Humorist.

I remember one sunny day in Chicago, in June 2011, when my husband and I packed up our two young children, aged 2 and 5 months.  Professional movers had collected our belongings and had driven off a day prior.  We were headed out of state, to my first job at an academic hospital.  It had been a rather hectic few months for me, having just had a baby 5 months ...

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