I used to think that there was a communication gulf between doctors and patients.  Somewhere in the hubbub of the harried office visit some secret sauce was missing.  A divide that was so fundamental that both parties often left the room feeling disjointed and uneasy.  Patients wondered if doctors truly heard them.  Physicians wondered if anyone was listening to what they were saying.  The tension ebbed and flowed but never ...

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Our specialty of hospital medicine has grown exponentially over the last decade and now finds itself at the forefront of American medicine. I’m proud to be part of such a growing movement and must say that I find the job just as rewarding as when I first became an attending physician when the specialty was still in its fledgling stage. As the number of us soars towards the 50,000 mark, the ...

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“You have the nurse hand you the equipment, that way she doesn’t just stand and stare like a chaperone,” my doctoring mentor explained to me before we entered the room to do a pap smear on a young, 35-year-old woman. My doctoring mentor is a middle-aged, 6-foot-5, exceptionally hairy, broad-shouldered man that carries a warm, jovial presence. Yet the reality of the fallen world is that no matter how sweet, happily ...

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Like most of my age cohort, I was brought up to believe that the great Satan threatening to undermine the bloated American health care system was our broken-down, antiquated, self-interested model of reimbursement for care provided called "fee-for-service."  Being a professional who, to the best of my ability, tries to maximize the value of the care I provide to my patients, I subscribed wholly to the notion that the cause ...

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Recently, I had the opportunity to sit at the table with some of the nation’s top thought leaders. We convened at the Newseum in Washington, DC, for the Healthcare Leadership Council’s National Dialogue for Healthcare Innovation; it was like a health policy nerd red carpet. Center for Medicare Director Sean Cavanaugh was there. Leapfrog Group CEO Leah Binder was there. America’s favorite bioethicist–oncologist–provocateur Zeke Emanuel was there. The chief executives ...

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It’s hard enough to sustain a good relationship when neither partner is facing a health challenge. Illness ranks high on the list of life’s stressful events, so it’s no surprise that it can have a negative impact on a close relationship. Couples may benefit from counseling, one of the principal reasons being that the presence of a neutral party in the room can facilitate more calm and constructive communication. What follows ...

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medpagetodayFrom MedPage Today:

  1. Nephrologists Iffy About Dialysis in Expectant Moms. A third of nephrologists reported being somewhat to very uncomfortable caring for a pregnant patient on hemodialysis despite a growing number having to do so.
  2. What Makes an Opioid Stronger or Weaker Than Morphine? A February 2015 report from the Centers for ...

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3-D printing has been documented as an innovation that’s being rapidly deployed in the medical field.  Doctors and researchers have been creating intrinsically realistic models of organs, bones, appendages and sometimes, implanting them into patients.  In 2012, University of Michigan doctors implanted a splint to hold open a 3-month-old child’s airway tube.  They published their results in the New England Journal of Medicine and opened the gates for others to ...

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Perhaps we thought we could get away with ignoring the relationship between doctors and patients. The Kaiser Health News article, "Efforts to Instill Empathy Among Doctors is Paying Dividends," explains why we can’t. Patient satisfaction scores and reimbursements aside, this relationship was once considered the cornerstone of quality care. Doctors are healers but in recent years many have been reduced to diagnosticians, electronic medical records (EMR) data entry clerks, and health ...

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shutterstock_158329577 1. Be yourself and learn to be flexible. Don’t ever change who you are as a person. It’s OK to have a personality of your own. If you secretly listen to Taylor Swift’s Shake it Off on the way to work, it’s OK. As a junior member of the team it’s very unlikely your iPhone playlist will make the cut for the operating room ...

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Experiment 1. Stop five random people on your way to work and ask them to name the top public advocates of health and wellness that come to mind. Do I dare speculate that more than a few would mention Dr. Oz. Or Jenny McCarthy? Experiment 2. Stop five medical colleagues and ask them to list their top physician writers and journalists. Do I dare speculate that more than a few would only have ...

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If it weren’t for the coming together of people from all over the globe, the influenza pandemic of 1918, also known as the Spanish Flu, would not have had the devastating effect that it did. It is estimated that at one point this deadly strain infected one out of every five people on earth and ended up claiming the lives of approximately fifty million people (in comparison, nine million combatants ...

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March30-copy-640x480 I’m in a room full of doctors at my mom’s 50th medical school reunion when I announce, “It’s almost March 30th!” I pause. “Doesn’t anyone know what March 30th is?” Nobody has a clue. March 30th is National Doctors’ Day! Who knew? I never heard of it -- until a friend told me last week. Veterans know about Veterans Day. Mothers know about ...

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EverythingIsAwesome Recently, I was asked to fill a questionnaire during check-out at a hotel in India. I was very pleased with my stay, so I agreed to provide feedback. It is worth pointing out that if I was only mildly satisfied I would not have agreed. If I was disappointed with my stay, I would have filled the form more enthusiastically. When I ...

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medpagetodayFrom MedPage Today:

  1. EHRs Take Center Stage in Battle to Control Hypertension. How did a group of community health clinics with a low-income and uninsured population and frequent no-shows achieve a hypertension control rate among the best in the country? Electronic health records.
  2. How Do You Bill For Teaching Parents? "When you ...

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At age 37, after a nearly 2-year battle with stage IV lung cancer, a talented neurosurgeon lost his battle. My oncology-related newsfeed is filled with stories this week about this brave and clever man’s recent passing. In a field where the recent tweets tout results of the latest clinical trials (overall survival prolonged from 2 months to 4 months!), it is sobering to be reminded of what truly matters to ...

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A big challenge facing academic medical centers is how to maintain a focus on patient care in an artificially divided environment.  Most academic medical centers developed in a system with abundant resources, cost-based reimbursement and a traditional academic departmental structure.  This led to individual departments growing as microsystems formed around particular specialties. The untoward effect of this is that the different silos within the system tend to operate with their own ...

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41NmPFjOxXL._SL250_ An excerpt from The Real Doctor Will See You Shortly.  Warning: Contains explicit language. It started with a banana peel. After years of quiet study in the libraries, laboratories, and lecture halls of Harvard Medical School, I finally made the tectonic shift to hospital life in the summer of 2006. The third year of medical school marks a ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated for a 6-year history of typical gastroesophageal reflux symptoms treated on an as-needed basis with a proton pump inhibitor. However, the frequency of his reflux symptoms has recently increased and his episodes do not respond to treatment as completely as in the past. An upper endoscopy is ...

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The July Effect is a relatively well-known reference to the influx of new trainees entering hospital systems annually on the first of the month. Researchers have attempted to investigate the impact of the new trainees on patient outcomes with divergent conclusions. Despite the ongoing debate, educators in medicine recognized the need to prepare medical students for day 1 of residency training, by establishing core competencies to evaluate the preparedness of students. One such example ...

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