BEEEP BEEEP BEEEP BEEEP ... I pressed a button to silence my pager and rose groggily from the bed in the on-call room.  I hadn’t truly been asleep, just catching a quick rest between pages.  It was 2 a.m.  I was 19 hours into my shift and, from the looks of the page, there was a new patient ready for admission to our family medicine inpatient service.  I picked up the ...

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“I’d like an MRI for my leg pain. I haven’t had an MRI for many years, and I’m worried.” These were some of the first words I heard from a patient I was seeing for a new patient visit. Based on this patient’s story and physical exam, her pain was most consistent with a muscle strain. My preferred approach to manage this complaint was to ask the patient to rest her ...

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In psychology, the Lake Wobegon effect refers to a mythical town where “all the women are strong, all the men are good-looking, and all the children are above average.” In other words, humans have a tendency to overestimate their capabilities, particularly in relation to others. As a physician, I have yet to meet a fellow doc who didn’t think that their patients loved them or that they weren’t great clinicians. And ...

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I’m not going to be a doctor. It feels more like a confession than a statement -- like I’m disappointing someone. Each time I say, or even think, those words, I feel as if I need to atone for it. Survey a hundred scribes.  Ask them of their goal in becoming a scribe, and all of them will tell you about higher aspirations. They want to be surgeons, cardiologists, intensivists, ...

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Dear attending, I’m a third-year medical student fresh out of the classroom.  I’ve studied from books for years, and now I finally get to see what it is like to be a doctor. It’s exciting but also a daunting experience. I look to you as a guide: what you wear, how you speak, what tools you use, and how you treat others.  This is the year I will be socialized ...

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Hospital cafeterias are important places. Great progress has been made over the last few years in raising the standard of the food served (to both patients and staff!), with much more emphasis too on making the options healthier and nutritious. Speaking as someone who has worked in several different hospitals, and with my own general interest in health care quality and improving the patient experience, it’s always very interesting to look ...

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Medicine has undoubtedly come a long way. Paternalism has been ditched in favor of a shared decision making approach, diagnoses and treatments are (largely) based on scientific evidence, and information is not outright withheld from patients out of some misplaced belief that they are not capable of handling the truth. Some of the modern pain points that patients now face involve access to specialists, skyrocketing cost, misinformation and miseducation surrounding ...

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It is not uncommon for doctors to question the reasons why we do what we do.  The journey is long. The debts often seem insurmountable.  The harsh lessons learned from a mistake made with best of intentions are an unforgiving punishment for “life without forgiveness.” Memories may fade, but the scars always seem to linger. On the one hand, like a relief pitcher in major league baseball, we must forget ...

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Earlier this month I read a Wall Street Journal article about Zeynep Ton’s Good Jobs Index. Who is Zeynep Ton? She is a professor at the Massachusetts Institute of Technology’s Sloan School of Management who has ranked retailers on employee happiness. This was so positive. It was good to hear about businesses concerned about employee happiness and not just about profits and shareholders. Two weeks later I was dismayed to ...

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It was a week into my elderly patient's hospital admission when he began to have fever and profuse diarrhea, some 10 to 12 bowel movement a day. The diagnosis was not hard to make: a stool test showed he had C. difficile. Another patient, a thin women in her late 40s who had become paraplegic after a gunshot wound decades ago, came in from a nursing home when her urinary catheter ...

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