It was my turn to be on call during Christmas. I held the long list of patients signed out to me, and began my rounds early that morning in the hopes that I could be home in time to open presents with my family that evening. I went from room to room on the surgical floor, talking to patients. I knocked on one door and pushed it open. A white male ...

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“We must not allow a mineshaft gap!” famously spoken by George C. Scott as General Turgidson in Dr. Strangelove as the post-nuclear holocaust planning begins in earnest. For some reason, this quote goes through my mind as I sit through meetings, assemblages and retreats that talk about the future state of medicine in a large gobble-gobble network that has aspirations to provide population health as an Accountable Care Organization to ...

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An excerpt from Attending: Medicine, Mindfulness and Humanity. Sometimes a simple gesture and a few well-placed words can signal presence. One day on rounds in the hospital, as we walked into the room, Laura Hogan, a nurse-practitioner on our palliative care team, said three words to the patient: “What beautiful flowers.” ...

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A hospital stay is a right of passage for any patient, but the road to health is often a marathon and not a sprint. Discharge is an essential step in the patient journey, but it can be as exciting for a family as it is daunting. Families can prepare ahead and put all the right pieces in place in order for a “soft landing” home. Here are some of our ...

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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 ...

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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 ...

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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 ...

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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 ...

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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 ...

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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 ...

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