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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  Since finishing my residency several years ago, I’ve worked in almost every type of hospital up and down the East Coast, from big urban academic medical centers to more rural community outposts. Although I primarily practice hospital medicine, working with both smaller private groups and being a hospital employee, I empathize a lot with my independent practice colleagues and brethren. I almost certainly would have gone down the route of ...

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How can a doctor resist an essay entitled, "The Sickness Unto Death?" Kierkegaard, the darkest of the bleak existentialists, begins by asking, “Is despair an excellence or a defect?” Can despair be an excellence? It is December in Oregon, the rain comes down in sheets, with only a few hours daily of half-light. Kierkegaard’s winters in 1840 Denmark must have felt a lot like this, so I press on. “In despairing over ...

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Are physicians unruly children? That’s the attitude I see at hospital C-suite meetings. (As in, “Our doctors are protesting our new unproven proton beam therapy center. How cute! They think they know how hospitals work: Even cuter, they think their opinion matters.") Chuckles all around. That smiling dismissiveness doesn’t surprise me. Call me cynical, but when people have power over other people, they become contemptuous. And in today’s world hospital executives have that power ...

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Do women make better doctors than men? A recent study in JAMA Internal Medicine claims that they do. According to the authors, there is a 4 percent risk reduction in mortality for elderly patients treated by women. There is also a small but clinically significant reduction in readmission rates. By their analysis, this difference could translate to approximately 32,000 lives saved “if male physicians could achieve the same outcomes ...

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“Orange is his favorite color.  It’s all orange, all of the time in there.” And, indeed it was.  Like the deceptively soft glow from a garish, neon storefront light, passing his room, it was impossible for one’s eyes not to be drawn inside.  Hunter blaze bedspread, pumpkin spice robe, marigold slippers, and even a persimmon beanie -- wavelengths of orange permeated the otherwise drab, muted colors of the space. It became a ...

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I want to share a cool idea used at Mission Health in North Carolina. I recently interviewed Dr. Ron Paulus, CEO of the health system. Three years ago the organization launched “Immersion Day,” when board members leave their corporate meeting rooms to shadow the doctors and nurses in their hospitals. Journalists and legislators are also invited to join. They don scrubs, go through an orientation, sign privacy forms, and spend 9 ...

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