This past month has been a particularly difficult one for me because I’ve been on our float rotation. I have worked only night and swing shifts throughout our hospitals; this means my work hours are primarily from 8 p.m. to 10 a.m. There are certainly other rotations during which I worked longer hours and had more emotionally draining conversations, but I have never felt as burned out as I have this ...

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I spent the past month working on an inpatient medicine team at our tertiary care hospital. As a referral center, we often care for incredibly complex patients who require multiple consulting services. One of the most vexing parts of caring for our patients is attempting to track their care through many previous hospital systems. Unless a patient is both extremely vigilant about his or her medical care and highly health literate, ...

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“I’d like an MRI for my leg pain. I haven’t had an MRI for many years, and I’m worried.” These were some of the first words I heard from a patient I was seeing for a new patient visit. Based on this patient’s story and physical exam, her pain was most consistent with a muscle strain. My preferred approach to manage this complaint was to ask the patient to rest her ...

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We have all seen the statistics; America is an aging country. The baby boomer generation is retiring, and families are having fewer and fewer children. In health care, we often hear about this issue in the context of an inadequate health care workforce. An aging population in conjunction with the ACA has created a quickly growing pool of patients that outpaces the slow growth in the supply of health care providers. But ...

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They say that the path to hell is paved with good intentions. Few things in medicine illustrate that as well as how we've approached chronic pain management in the past 10 to 20 years. The advances that we have made in medicine in the past few decades have been truly remarkable. But, unfortunately, pain is one of the ailments we still do not treat well. One of the difficult aspects of ...

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Despite the changes around us, the training of physicians has stayed much the same. Sure, there are new work hour limitations and a push to move towards competency-based assessments, but the overall structure of our training remains largely untouched. We spend the vast majority of our time training in hospitals, with the remaining time spent practicing in traditional outpatient clinics. However, health care is being increasingly delivered outside these two arenas. ...

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shutterstock_185853248 Recently, I wrote about the importance (and difficulty) of maintaining a healthy lifestyle as a resident. Now, I’d like focus more specifically on the toll that residency -- and in general, a career in medicine -- takes on a health care provider’s mind and soul. As you may have heard, in August two young physicians decided to end their lives. No one can ...

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There is much talk about cynicism in medicine, and I remember being confronted by it almost from the beginning. In fact, I still remember how shocked I was the first time I heard a provider describe a patient in a disparaging matter. We were responding to a 911 call regarding a woman in her 30s who was feeling short of breath. I remember being worried; she seemed too young to be ...

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As a fourth-year medical student, it was fairly easy to maintain a healthy lifestyle. When you have much leisure time and are relatively stress free, you can eat healthy, stay physically active and maintain quality mental health. However, as I begin the journey called residency, it is clear that the task of maintaining my own health will be much more difficult. But the importance of this task should not be overlooked. ...

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Patient noncompliance. I wasn’t very familiar with this term until I started my clinical rotations. But after just the first week, I started noticing that health care providers throw this phrase around all time. We particularly like using it as an excuse. Why did this diabetic patient require a foot amputation? Why does this patient come in monthly with congestive heart failure exacerbation? Why did this patient suffer a stroke? It’s often ...

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