William Osler once said, “Listen to your patient; he is telling you the diagnosis.”  Anybody who practices medicine knows that is easier said than done. The ability to take a skillful history takes years to develop. There are many nuances in a medical history and physicians must know the right questions to ask. The next step is to avoid asking the wrong questions and the wrong wording of the right ...

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Startled out of sleep, I reflexively reach for my beeping pager. For a split second, I lie poised between wakefulness and terror in the pitch-dark resident call room, not sure where I am or what happened. I resolve to sleep with the lights on from now on. I dial the call-back number. "Pod A," a caffeinated voice chirps. It's Candice, one of the nurses. "Hi. Amy here, returning a page," I murmur. "Oh hi, ...

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Hospitals have lots of codes. The most famous one is Code Blue (medical emergency), but it turns out there are lots of color-based codes. This can be confusing, as the connection between the code colors and the situations they represent are usually tenuous at best. Today we explore all of the types of codes, and shed some light these arcane medical euphemisms. Code Blue What it sounds like it means: Aggressively-scented cologne from Armani. What it actually means: ...

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For those who are not avid followers of President Trump or his decisions, often his decisions have far-reaching consequences that affect lives and people.  As a health care provider, I understand quick decision making, but also the importance of risk versus benefit and consequences of your decisions.  I would like to tell you my story and how his actions have affected my life, the lives of my patients and their ...

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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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