I just left the most unusual conference I have ever attended. First, it was small: 25 invited participants. Second, it was all women. Third, it was all women who have done amazing things ...make that “trailblazing things.” They were journalists at major news outlets, retired military officers from the highest ranks, senior leaders (in some cases, the most senior leader) at major federal and state health care agencies, Fortune 500 companies, large ...

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While everyone has heard the old adage about not getting sick in July because of new interns, the truth is that new interns nationwide have started already. Yet, you don’t hear much about the “late June effect?” So is the July effect overblown or true?  Well, there have been many studies – so many so there was a recent systematic review co-authored by one of my own co-interns a long time ago.    ...

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Recently, I was having a discussion with a colleague about being a doctor. She confided in me that if someone asked her about becoming a doctor, she would tell him or her to become a nurse practitioner.   After reading the emotional open letter to our policymakers in Washington DC, it may sound like a reasonable suggestion.  After all, why go into this much debt and spend so much ...

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I recently had the opportunity to read Daniel Pink’s Drive.  I read it partly to understand why pay-for-performance often fails to accomplish its goals for complex tasks, such as patient care.  However, the thing I found most interesting about this book was the way in which creativity is deliberately inspired and cultivated by industry. I could not help but think about why we don’t deliberately nurture creativity in medical trainees.  Why ...

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Using the iPad Mini in the hospital: One doctors experience On my birthday several weeks ago, I was lucky to get an iPad Mini from my husband. I already have an iPad and have shared my experience. In fact, we gave all of our residents iPads (one of them contacted Steve Jobs and got a response), and documented an improvement in efficiency on the wards. ...

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Last week, I tried something new with our residents. We tried to talk about why physicians overuse tests.   This is the topic of the moment, as the American College of Physicians (ACP) just dropped their long-awaited new High Value Cost Conscious Curriculum for what has now been dubbed the “7th competency” for physicians-in-training. In addition to the ACP curriculum, which I served as one of the reviewers for, I ...

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I recently watched Dr. Atul Gawande on video describe how what American healthcare needs is pit crews and not cowboys.  This sentiment is also memorialized in his thought-provoking writings for the New Yorker. Interestingly, Dr. Gawande is not the first person I have heard to suggest such a thing.  A colleague named Dr. Ken Catchpole actually studied Formula 1 pit crews and used the information to guide ...

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Amid the buzz about whether medical students should be sued and the bill currently debated in Arizona (a state which finds itself in the spotlight more than usual these days), I noticed some commentary from several people who do not think they would like a medical student on their case.  Sometimes patients do refuse to be cared for by medical students, often due to overestimating the involvement they will ...

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I recently saw a post in Yahoo questions entitled, "Is it illegal for a medical student to introduce themselves as 'Doctor' before they have received their MD?" One of the answers that was rated highly was "I think it is more unethical than illegal." Clearly, if a student is deliberately misrepresenting themselves as a ‘doctor’, it is grounds for disciplinary action.  More often than not, this misrepresentation is not ...

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I just finished another 2 weeks on service.  This time, I had also had a shadower, but one of a different kind.  As part of our Institute for Healthcare Improvement (IHI) Open School, we are making an effort to have collaborative learning opportunities for our medicine and health administration program students.   Achieving true interprofessional learning is challenging for schools like ours without a pharmacy ...

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