Would my white lab coat be better put to use when I carve the Christmas roast than when seeing patients? After all, we know that these coats can be covered with pathogens, including drug-resistant ones, which may be transmitted to patients. They are cleaned infrequently: In a survey of physicians, nearly 58 percent said they laundered their white coats monthly or never. Less than 3 percent washed them daily ...

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I was recently invited to visit an academic anesthesiology department to speak to the residents about becoming a leader.  In addition to recognizing the honor and privilege of addressing this important topic with the next generation of physician anesthesiologists, I had two other initial thoughts:  1) I must be getting old; and, 2) This isn’t going to be easy. I came up with the following list of lessons that I’ve learned ...

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Her nails were painted. She probably had them done just a couple of days ago. The bright red polish glistened on her perfectly filed fingernails. She had her toes done too. Was she preparing for the holiday season? Had she begun her Christmas shopping yet? Was she making a list of new year's resolutions? It didn't matter anymore. She was lying there. The cold metal table provided the platform for her lifeless, still body. ...

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Dear Fizzy, MD: Your article on part-time physicians “ruining” medicine really struck a chord with me.  That you, as a mother and a wife, chose to prioritize your wholeness and family above career is commendable. I applaud your courage to chart your own course in the face of a work culture that undermines your wellbeing while at the same time, expects you to deliver health and healing to others ...

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Two decades ago, I admitted a patient to the intensive care unit for a heart attack. His children were grown, and he looked forward to retirement purchasing an RV to relax and travel the country with his wife. Invasive cardiac technology had not evolved, so he remained in the ICU on intravenous medication to control his symptoms. On the fifth hospital day, his wife brought a letter from the insurance company ...

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Physician cure thyself. After 30 years of participation in multiple medical staffs, including small regional hospitals and large academic settings, there is one constant that continually undermines how content physicians are with their medical practice and the health care system. Many challenges in patient care seem insurmountable. From declining reimbursements to intensified quagmire of bureaucracy, the practicing physician, whether employed or not is berated by administrative authorities with no experience in ...

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“Help me stop doing this.” Mr. G was a 55-year-old homeless man who uttered these words to us during his fifth hospitalization for problems related to his alcohol use:  intoxication, falls and alcohol withdrawal. He was on a downward spiral through the hospital’s revolving door and felt helpless. As a medical team, we felt helpless too. We did not know how to address his real problem -- his cycle of addiction. Hospitalized ...

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With the depths of winter just around the corner, doctors and nurses everywhere know what’s about to hit them over the next few months. The inevitable surge in hospital admissions during colder weather is almost as predictable as knowing the leaves will be falling off the trees in the fall. As someone who has worked in several different hospitals over the last few years, ranging from small rural institutions to large ...

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There was a time within my professional lifetime when old records would arrive on the medical ward in a wheeled wire basket, multiple volumes with shabby pages. And in the VA of the 1980s, which still had veterans of World War I who never lived anywhere else the previous half century, the forklift could deliver not only the charts but the x-ray films that had not yet been sent to ...

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Incident reports are frequently submitted by hospital personnel. Did you ever wonder what happens to them? I have. Over the years, I estimate that I’ve heard of hundreds of such reports being filed, but rarely have I heard of a problem being solved or for that matter, any action being taken at all. In fact, I don’t even know where they went or who dealt with them. When I was a department ...

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