My earliest memories of medicine take me back to dinner table conversations with my mother, who is a physician. She would share with us her daily stories, telling us about patients she took care of in her clinics and in the hospital. As an internist, she often found herself traveling between many locations. I grew up knowing this to be medicine. As I have progressed in my career as a ...

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My department had a problem that harmed patients on at least a weekly basis. It was well-known, but it seemed there was no viable solution.

My supervising attending was in his seventies and highly regarded at my hospital, having held powerful administrative positions for decades. About ten or so years ago, he stepped down from running the hospital, and ...

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shutterstock_158365127 I can recall, though it seems quite long ago, my first basic life support (BLS) course as a first-year medical student. The instructor dutifully demonstrated on a mannequin to eager young medical students what to do if someone is found unresponsive. Shaking the unmoving mannequin she said loudly,  “Sir, are you OK?” Then hearing no response she showed us how to ...

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shutterstock_231634663 I am a young hospitalist who is 16 months into my role at an urban academic medical center. Unlike many of my more senior colleagues who found their way to hospital medicine by circumstance, luck, or as a second career path, I have been planning my career in hospital medicine since the beginning of my residency training. The things that drew me ...

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shutterstock_168551594 Everyone wants to be sure their physician is competent and appropriately trained. The way this is done is through credentialing. A new applicant for privileges to practice at a hospital or other health care facility fills out an application and submits a curriculum vitae that details when and where a physician trained and the certifications obtained, such as specialty boards, and a work ...

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Last year, hospitals and health systems underwent 98 consolidations, a 51 percent increase from 2010.  Many of these mergers and acquisitions arose in response to declining government reimbursement and the Affordable Care Act.  Smaller hospitals are having increasing difficulties maintaining a margin and many face high debt burdens, bankruptcy or even closure. But is consolidation the clear-cut answer? Here are 4 reasons bigger actually may not be better for all hospitals: 1. Disparate ...

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shutterstock_221545084 There’s been a lot of talk recently about low morale and disgruntlement among doctors. A recent article on focused on a list of reasons when doctors know it’s time to quit. I found the article a bit sad and unfortunate, but I’m sure the feelings behind it were sincere. Another excellent article in the Wall Street Journal last week extensively discussed the factors behind ...

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shutterstock_157424303 I think I will become a neurosurgeon. Tomorrow. It shouldn’t be too hard, right? I’m a breast cancer surgeon, and that is kind of like being a neurosurgeon, isn’t it? I wear scrubs and know how to tie knots really well. OK, maybe I don’t know much about the brain, and the last time I was on a neurosurgical team was during ...

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No one wants a hospital-acquired infection -- a wound infection, a central line infection, or any other kind.  But today, the level of concern in American hospitals about infection rates has reached a new peak -- better termed paranoia than legitimate concern. The fear of infection is leading to the arbitrary institution of brand new rules. These aren’t based on scientific research involving controlled studies.  As far as I can tell, ...

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shutterstock_119657461 "If doctors do no other good, they at least prepare their patients early for death, undermining little by little and cutting off their enjoyment of life." These words from Montaigne are 350 years old, but, sadly, too often they describe the results of modern medicine, particularly when it is mindlessly applied in a needlessly heroic way to the end of life. I spend ...

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