My brother-in-law, Ron, was a curmudgeon; grumpy, sullen, even downright mean at times. By blood, he and my husband Bill were cousins. In the 1950s, when Bill was just a child, his mother died unexpectedly, and Ron's mother took Bill in to live with her and her four children. They were an African-American family living in the midst of a middle-class, predominantly white Connecticut township. Their home, located on a wealthy ...

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Bashing the Veterans Administration (VA) health care system has become a familiar pursuit following the 2014 expose regarding concealed wait times and concerns for substandard care.  In the aftermath of the ensuing national scandal, Congress passed reformative legislation, and President Obama appointed Robert McDonald Secretary of the VA. A 2016 report from the Harvard Business School indicates that the Secretary has “made impressive progress over the past year.” Numerous veterans ...

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Our recent paper on differences in outcomes for Medicare patients cared for by male and female physicians created a stir. While the paper received broad coverage and mostly positive responses, there have also been quite a few critiques. There is no doubt that the study raises questions that need to be aired and discussed openly and honestly. Its limitations — which the paper highlights — are important. Given the temptation ...

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Dear hospital executive, If you are like many of the hospital leaders with whom I regularly talk, you’re probably concerned that your hospitalist program isn’t delivering the value you need in this metrics-driven and cost-constrained environment. You may see your hospitalists as disengaged free agents who either don’t know or care too little about contributing to the success of your organization beyond seeing the patients on their list. They may repeatedly ...

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Making health care more patient-centered is rightly on the agenda for all hospital administrations across the United States. The need to give our patients the best "service" possible has also been pushed to the forefront as a result of reimbursement models which place more of an emphasis on patient satisfaction. Unfortunately, this has led to some in the hospital industry making comparisons with hotels, and how hospitals can take lessons from ...

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“Who’s in charge of the case?” the doctor asked a bit impatiently. My husband was in the hospital, and his care seemed disjointed and fragmented. I was concerned and called his primary care physician (PCP) to ask advice. He hadn’t known my husband was in the hospital again and seemed frustrated. I thought about his question for a minute and answered, “I guess I am. I am the one who talks to ...

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As an intern, I once cared for an elderly gentleman who came in with heart failure. In no time, we grew fond of each other. It was almost like he looked forward to my visits. He sometimes called me “sunshine.” I am not sure if he meant it in a way that meant that I woke him up every morning.  He was almost ready to go back home when he ...

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About three years ago, our hospital was abuzz about patient satisfaction. Our HCAHPS scores were lower than expected, and there was a push by the administration to improve them. As a hospitalist, I wondered to myself, what could I possibly do to improve them?  I already believed I was doing a very good job communicating effectively with patients. Many years ago, I developed the habit at the end of each encounter ...

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While having coffee the other day, I came across a video called The Thank You Project. Watch it. I assure you, it’s worth 5 minutes of your time. In 2004, Kellie Haddock, her husband, and their 14-week-old son were involved in a horrible car accident. Her husband was killed on impact, and their son was severely injured.  In her heartbreaking tale, she recounts the roller coaster ride she endured ...

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Halfway through the “Bell Curve,” which is an analysis of differences in intelligence between races, I realized what had been bothering me about Charles Murray’s thesis. It wasn’t the accuracy of his analysis, which concerned me too. It was what he analyzed. The truth, I used to believe, was always beautiful, whether it was what happened in the multiverse at T equals zero or the historical counterfactual if ...

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