As more doctors work for hospitals and large conglomerates, patient satisfaction rules.  And these physicians are saying, "My boss is CEO!"

“Blessed. I’m so blessed.” She kept repeating this, from her seat on the examining table. “I’m so blessed.” I unwrapped the bandage holding on the splint that had covered her arm for the three weeks since the bullet went in above her elbow and came out through her forearm, hitting no bone, touching no major artery. “Blessed.” Homeless. With diabetes that needed insulin, which needed a refrigerator, that she didn’t have. Vulnerable. A few years earlier, ...

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shutterstock_223911598 I have issues with the customer satisfaction paradigm, but it’s not generally hard to make patients happy. Sometimes, though, it can be nearly impossible. It all depends on our own inner life as physicians and human beings. The key to medicine, to being a beloved physician, is to love our patients. This can be a tall order. Human beings are remarkably difficult ...

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shutterstock_154990457 The truth is, I know it's easy to go to the Minute Clinic.  I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the end of your appointment.  Who doesn't like convenience and a friendly smile to add?  Who doesn't like the customer service offered ...

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shutterstock_181449266 I truly love my job as an emergency physician. I think it's the best job there is in the house of medicine, melding the most ancient of medical traditions (abandoned by many modern practitioners) with the most cutting edge tools of medical technology. And really I never love it more so than at this time of year. I went into this field ...

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One of the things that I love about my job as a hospitalist is the ease with which we can develop friendships with colleagues from other disciplines. Since I am an inpatient physician, it’s not surprising that some of my good friends are cardiologists, nurses, endocrinologists, physical therapists and, of course, other hospitalists. In fact, I met my neurosurgeon husband while co-managing his patients at the hospital. While thinking about ...

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shutterstock_208236568 I tried to order an echocardiogram yesterday at work.  But it turns out, they only do them on Monday, Wednesday and Friday.  Fair enough.  It’s not an unknown phenomenon.  Some places, surgeons are only available on Tuesdays and Thursdays, cardiologists on the second Wednesday of months with an R. After hours, most hospitals now struggle to have ultrasound at all, unless, of ...

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I was on call over a holiday weekend and Friday night at 10 o'clock I was paged by the emergency department about a nosebleed. A man in his 30s had a bloody nose Friday morning and over the course of the day had developed red spots all over his legs. The ED checked his blood and his platelet count was near zero. Blood looks red because of the oxygen-carrying red blood cells, ...

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A few years ago, the United States Navy launched a new recruiting and marketing campaign using the slogan: “America’s Navy: A global force for good.” The line was apparently a flop, and the Navy threw it overboard for “protecting America the world over,” but I liked it. I thought it captured a deep truth about the Navy, which is that it is undoubtedly a global force and that the force exists for ...

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As part of the second-year clinical skills course, each member of my class is required to complete two 8-hour emergency department (ED) shifts. I had my first ED shift last week, and when I walked in, I introduced myself as a second-year medical student who needed to practice IV placements, EKGs, and any other procedures that happened to come my way. Three hours later, when I walked out of the ...

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