Why would a well-respected, venerable health care organization adopt a soft and squishy approach -- tracking disrespect and other forms of emotional harm -- to monitor its performance? In 2007, Beth Israel Deaconess Medical Center (BIDMC), a 672-bed health system affiliated with Harvard Medical School, adopted the audacious aim of eliminating all preventable harm by January 1, 2012. According to Kenneth Sands, MD, chief quality officer of BIDMC, the organization has ...

Read more...

When I was a third-year medical student, I was a victim of sexual harassment. I had a patient (I no longer remember his name, so let's call him Mr. X) who was in his eighties and I had to do a rectal exam on him. I had been on the team taking care of Mr. X for a while, and I was fine doing the rectal exam and checking for blood ...

Read more...

A pediatrician decides a struggling teen with mental illness needs hospitalization to neutralize psychologic demons impacting their personal and social life. A workers’ compensation doctor requests a neck MRI in a powerline worker with growing right arm numbness and weakness to search for potential paralyzing nerve impingement. An orthopedist orders special testing to determine if an elder patient with right hip pain which limits walking and driving might need surgery to improve ...

Read more...

I burned out, big and bad.  I can see that now.  My practice environment had become gradually untenable and every attempt I made to change it was blocked.  My call schedule was inflexible and a lot more frequent than when I started my job.  The hospitalists and ED kept sending me cases I didn’t feel qualified to manage, but as it was usually the middle of the night and I ...

Read more...

STAT_LogoAmerica’s resident physicians have strict limits on how many hours they can work in the hospital. Many break that limit and keep quiet about it. Others lie. Resident physicians are the doctors-in-training that millions of Americans come into contact with at teaching hospitals across the country. We work for three to seven years (it depends on the medical specialty) under ...

Read more...

Reducing the essence of a human being to a single sentence is impossible, but in taking care of patients, we doctors do it all the time The one-liner attempts to summarize an individual and an illness into a single, typically run-on, sentence to expedite communication.  It is a thesis statement for your diagnosis. Word choice and omission are critical.  By the end of this thesis statement, your audience, in spite of ...

Read more...

Danny rarely came to the clinic. He paid a sliding scale fee for the visit but this, in addition to the money he paid for his medicines, was already too much for him to afford. Now, in early November 2013, he had become concerned. Danny had previously owned a jewelry boutique with his wife, Jacky. She made her own pieces and sold them in the store. Over time, the economy had ...

Read more...

William Osler once said, “Listen to your patient; he is telling you the diagnosis.”  Anybody who practices medicine knows that is easier said than done. The ability to take a skillful history takes years to develop. There are many nuances in a medical history and physicians must know the right questions to ask. The next step is to avoid asking the wrong questions and the wrong wording of the right ...

Read more...

Startled out of sleep, I reflexively reach for my beeping pager. For a split second, I lie poised between wakefulness and terror in the pitch-dark resident call room, not sure where I am or what happened. I resolve to sleep with the lights on from now on. I dial the call-back number. "Pod A," a caffeinated voice chirps. It's Candice, one of the nurses. "Hi. Amy here, returning a page," I murmur. "Oh hi, ...

Read more...

Hospitals have lots of codes. The most famous one is Code Blue (medical emergency), but it turns out there are lots of color-based codes. This can be confusing, as the connection between the code colors and the situations they represent are usually tenuous at best. Today we explore all of the types of codes, and shed some light these arcane medical euphemisms. Code Blue What it sounds like it means: Aggressively-scented cologne from Armani. What it actually means: ...

Read more...

368 Pages

Most Popular