shutterstock_141783304 As an Air Force family physician and faculty at a family medicine residency, it was my job periodically to lead an inpatient team of young family medicine residents and medical students.  That particular morning seemed like any other -- half a dozen new admissions, total census of a dozen or so, and a few new consults.  And it was my habit to ...

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shutterstock_151579694 During my third-year internal medicine rotation, I was introduced to and helped care for a patient named Casey (name changed to protect privacy). I identified with Casey because we were the same age, and I felt empathetic toward her situation. Casey was very sick, a direct result of her risky behavior. She was admitted for infective endocarditis secondary to intravenous opioid abuse. She ...

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shutterstock_182066816 It’s often said that we learn from our mistakes. Indeed, many a business course in leadership offers that premise as a given. I’ve glibly repeated this often in my classes, speeches, and advisory work. “You don’t learn from your successes,” I point out, “but rather from your errors.” But do we really learn from our mistakes as a matter of course? My friend and colleague ...

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White coat in public place edited People can wear what they want in America. Whether you want to debut the latest vogue or your midriff rife with adiposity, you are free to do so. But just because you can, doesn’t mean you should. In the span of one week, I found two people -- on two separate occasions -- wearing white coats, each ...

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shutterstock_100173191 Consider, for a moment, that you are a new physician. A patient, who is a lifelong smoker, comes to your clinic complaining of shortness of breath, and after conducting several tests you diagnose him with chronic obstructive pulmonary disease (COPD). Relying on your training, you prescribe medications, arrange for follow-up visits and describe activities that can help him better manage his breathing ...

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shutterstock_277885379 Doctors and nurses said patients and their families created the largest obstacles to end-of-life decision making in the ICU, in a large survey published in JAMA Internal Medicine. About 1,300 staff at 13 academic hospitals in Canada rated barriers to end-of-life goals of care on a 1 to 7 scale. Doctors and nurses considered the largest barriers to end-of-life decision ...

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Terminator-Salvation_0 In the past, physicians were responsible for both the business and practice of medicine.  While administrative personnel played an important and complementary role in practice and hospital management, physicians were the cornerstone.  In comparison, today the leadership structure in medicine is now an entirely foreign landscape.  Administrators dominate medical practices today and, according to the New York Times, their ...

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shutterstock_143533171 I take a deep breath as I get ready to go see Mrs. H. I can predict after sign-out from the ER doc where this is likely to go. Mrs. H. is an 87-year-old woman who comes to the emergency room with weakness. She stumbled and fell to the floor but could not get up to reach the phone to call ...

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shutterstock_182066816 Imagine an institution where the occupants are routinely left immobile, deprived of sleep and fed a diet that is tasteless and nutritionally marginal. Imagine further that they experience the indignity of losing any semblance of privacy and get stuck multiple times a day with needles. Sounds like a brutal prison, right? Yet the same description could apply to a typical U.S. hospital. As ...

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shutterstock_271375967 California is in the middle of an historic drought, with the government setting limits on how long people can sing in the shower. Farmers in the state may soon need to cut back on planting or production, as ground water dries up. But California is still fruitful ground for testing promising ways to improve how health care consumers, otherwise known as ...

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