There have been recent discussions in the lay media about a growing trend of litigation cases focused not on the “right to live,” but rather on the “right to die.” These cases have involved patients who received aggressive treatment, despite having documentation of their wishes not to receive such aggressive treatment. Although unsettling, it is not surprising that this issue has arisen, given the national conversations about the exorbitant cost ...

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There are many different theories out there about the direction that health care should go, and what we need to be doing in the future. Passions run high, and peoples’ opinions vary wildly. It’s frequently difficult to find agreement on anything. There is, however, one universal truth I’ve found about the everyday practice of medicine, and what constitutes great medical care for any individual in any health care system. Having worked ...

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The data tells us when physicians run hospitals or clinics, those institutions have better health outcomes and higher employee satisfaction scores. So now, what do we do with that information? Watch and discuss. Jamie Katuna is a medical student.  She can be reached on Facebook.

Dear intern, It will be the best of times, and it will be the worst of times. But what a special time this will be. It will be a time of learning the details and nuances of clinical medicine — the diagnostic features of sarcoidosis and the second, third and fourth line treatments for community-acquired pneumonia. You will learn how to learn, and you will forget what you learned, only to learn ...

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In a recently published JAMA meta-analysis, medical students were found to have a higher prevalence of suicidal ideation and depressive symptoms than the general population.   From the mental exhaustion that begins in medical school to the physical fatigue that peaks with residency, it is not shocking that medical trainees are suffering.  Current discussions have ignored one of the biggest hindrances for the ...

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Thinking outside the box is a somewhat cliché way to illustrate thinking beyond the norm and imagining what “could be” with an innovative mindset. This imagery of being stuck in a box rings true for many physicians, given how many of us are quite literally surrounded by the four white walls of an exam room most of our lives. Physicians work hard to treat each patient individually, but this feeling of ...

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The patient in front of me is trying to die. Elderly and frail, he is lying in bed. His ribs outlined under the skin that should be smooth. His temples are concave where they should be flat. Both are an outward display of internal damage from his lung cancer. More striking than his cachexia are the strained muscles in his neck and his pursed-lip breathing. He is working hard for ...

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“Mr. Jones, how are you this morning?” I ask. A muffled, incoherent reply. “Are you in pain?” “No.” I perform a brief, perfunctory exam — it's unchanged from yesterday. I then glance at his breakfast tray on the bedside table — still untouched. The plastic mug is still full of watery, lukewarm coffee, the rubbery pancakes on the plate are still intact. This is at least the third morning that my patient — who ...

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The first thing I remember as I regained consciousness, lying in a hospital emergency room, was hearing a nurse ask my mom if I was allergic to any foods. With my eyes still closed, I said, “asparagus,” thinking this might reduce the chances of anyone serving me what was then a dreaded vegetable. “Asparagus,” repeated the nurse, making a note on my admission form. And then, with a chuckle and what must ...

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How many people does it take to change a lightbulb? Five. One to hold the lightbulb, four to hold and turn the table the first guy is standing on. This was a mean joke towards people from a certain town in an area of the world I happened to live in for a few years. In some countries, a certain town or city takes ...

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