I'm no economist.  In fact I have never taken any business or accounting classes in my life.  But it doesn't take a formal education to get this.  We are speeding down the wrong path. The call at three in the morning woke me from a deep sleep.  I fumbled and strained to hear the whispered voice of the apologetic nurse.  Apparently Mrs. Thompson had scraped her arm against the wheel chair, ...

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Barron Lerner thinks he understands doctor's motives.  In his recent article in the Atlantic he laments that physicians act on tradition and emotion over adopting new science.  In defense of his position, he sites the example of how cardiologists use angioplasty and coronary artery bypass to treat coronary disease. He states,

... cardiologists have been remarkably slow to abandon the old hypothesis, continuing to perform hundreds of thousands of bypass operations and ...

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It was a particularly challenging case.  On the car ride into the hospital, I found myself doing something that I rarely do.  I called a local allergist for an inpatient consult.  Most allergy issues are not an emergency.  So it is odd indeed to summon this particular kind of physician into the medical wards.  His nurse took the message and promised that she would plug my mobile number into his ...

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Malcolm Gladwell thinks we should tell people whats it's really like to be a doctor.  And by God I have invested the last seven years in doing just that.  I have written countless blogs, given lectures, and traveled to Ireland.  I have coined the term Caring 2.0 to describe the bidirectional flow of empathy.  Patients will tell us what it is like to suffer with disease, and we ...

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1. Process vs. product. Computers are just machines.  I repeat, they are just tools.  Health information technology is a shell which houses knowledge and human ability.  It is nothing more .  Electronic medical records may either streamline our thought processes or make them more cluttered.  They will not, however, lead to better or more perfect care.  They haven't yet, and they won't in the future. And they are prone to be ...

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Movements come and movements go.  To be memorable, to last, depends on continuously refining the message.  The brand, by necessity blindingly clear in the beginning, must be anything but static.  Ideas mature, knowledge grows, and movements pivot.  They must pivot. The meteoric rise of hospice and palliative care has had untoward affects.  Specifically, the treatment of pain and suffering has dislodged itself from the moors of clinical medicine.  A new generation ...

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Home visits are hard, there is no doubt about it. I felt like I had been driving for hours.  The thirty minute travel time showing on my GPS was woefully understated due to the arctic temperatures and colossal snowfall.  My jacket and clothes felt caked with dried salt rubbed off from the car or somehow accumulated from the ether.  I pulled the key out of the ignition and braced for the ...

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When I was seventeen, I developed a medical problem due to no fault of my own. It was painful, it was embarrassing, and when it became uncomfortable enough to disrupt my life, I went to see a well known surgeon downtown. The specialist, tucked away in the hallow halls of academia, stared down at me past a pair of spectacles perched at the end of his ever-protruding nose. When he examined ...

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I immediately noticed upon awakening that the intense jaw pain was gone.  I guess the TMJ was on hiatus.  Than I reached my hand down to my waist to make sure that the pager hadn't fallen off during sleep (as I do every morning): it wasn't there!  It took a few moments for me to remember that I had dispensed of it the day before.  For the first time in ...

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I guess it shouldn't have been a surprise. Her house was exactly as I expected it to be.  The door couldn't have been more fitting; red wood with a green holiday wreath attached perfectly in the center.  The carpet was so white that I almost took off my shoes on the front porch before entering through the threshold.  The room was warm.  The ambient temperature was accentuated by a plethora of ...

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