In my former life as a hospital-based, shift-working physician with young children at home, this time of the year inevitably brought the same question from at least a handful of individuals:  “Isn’t it hard on your kids not to have you home on Christmas?”  Thankfully, I was always able to answer truthfully, “no.”  With consistent effort and a no-nonsense attitude, my kiddos either didn’t know the difference because they were ...

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For any health care professional, a typical day in the hospital brings about its unique challenges. Depending on the patients that we see, one second the situation can be routine, and the next second, it can become complex. In the midst of this flux, there is an expectation for us to make important decisions, with the speed of these decisions dependent on how a patient is doing at a given ...

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With the recent election, there has been a new recognition of the various “bubbles” we all seem to be living in. It reminds me of the parable I like to often mention, popularized by the late great writer David Foster Wallace:

Two fish were swimming along when an older fish swam by, nodded his head at them and said, “Mornin’ boys, how’s the water?” The two young fish nod back ...

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Nothing compares to the apprehension of starting residency. OK, that’s not true, but it’s really high up there on nerve-wracking firsts. I remember my first day as a resident. In a matter of a few hours, I went from being human furniture to being asked to make life-altering decisions. I was overwhelmed, to say the least. Here are some pieces of advice that I wish senior residents would have emphasized before I started this ...

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In November of my intern year, I had trouble finding the sun. It was dark when I woke up for work, and it was dark when I headed back home. I'd picked up the service on the cancer ward from an intern named Bob, and he left me six handwritten pages on the subject of Jim Franklin. This was the deal: Jim Franklin, thirty-seven years old, was in the cancer ward ...

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A recent story in U.S. News & World Report described how a Seattle hospital is taking a systems approach in improving health care quality and cutting costs. It said, "Virginia Mason Health System ... has looked to adopt many of the much-admired and often-emulated business philosophies from Toyota." The best-known of those philosophies is the so-called lean methodology which is based on eliminating waste and focusing on things that add value. Attempts ...

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As a family practice resident, I've found that a premium is placed not only on my clinical acumen but also on how well I respond to my patients' mental and emotional experience of illness. Yet the work of learning to be a doctor is just that — work. (And in overwhelming amounts.) Time management becomes ever more vital: As I take the time needed to gently break bad news and to ...

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In a time when the deep divisions in our country have become increasingly apparent, I, perhaps like you, have been seeking hope. I supposed hope would come in the form of an enlightened article or a profound speech, but it did not. Hope came to me in the form of my patients. The division you have been seeing in our country is barely visible in the hospital. Here, patients are assigned ...

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OSH, or "outside hospital," is one of those abbreviations that has crept into the lexicon of hospital jargon that merits additional scrutiny. What are the implications of calling another health care facility “outside”; does that make your hospital the “inside” hospital? I suspect that it is, as many patient-related conditions are described, multifactorial. Or, if you like the band Fort Minor, “Remember the Name” (apologies to the band):

This is ten percent ...

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"If you do not cooperate, doctor, we will have no choice but to label you as being 'disruptive' and take whatever steps are necessary to remedy the situation." What physician does not dread hearing these words? Over the past several years, the term "disruptive" has been increasingly used to characterize and intimidate a physician who is perceived as not being a "team player." With hospitals increasing the difficulty in navigating a ...

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