Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we're wrong. Perhaps, we dread providing unwanted news. Perhaps, we don't want to face reality or extinguish our patients' hope. As a daughter, I felt that sense of sadness and dread, waiting to hear the news that would not be told. It was September ...

Read more...

Recently, the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decision to increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect confidentiality): “I did my internship in internal medicine and residency in neurology before laws existed to regulate resident ...

Read more...

It would never have gone down this way ten years ago when length of stay was all the buzz. The CT scan would have been done in the emergency department, and the patient would either have been discharged or admitted for a quick observation stay. Bing, bang, boom. One, two, three. Instead, the CT was pushed until morning. A resident saw the patient at midnight and then not a single practitioner ...

Read more...

A few years ago, I was in a position where I was quickly going down the route of hospital administration. I thought it was interesting at first, but realized it wasn’t quite my cup of tea, at least in the circumstances that I was exposed to. What I didn’t like about it was the feeling that I was losing touch with the front lines. And wherever my career takes me, ...

Read more...

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 ...

Read more...

“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 ...

Read more...

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.” ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

Most Popular