We have all heard the grumblings regarding the 80-hour resident workweek.  This is due to the opinion that jobs after residency typically require hours that surpass 80 hours a week. But, why?  Why does medicine have to be this way? I have worked 100 plus hour weeks for over 20 years, and I am exhausted.  I am burned out and I can not catch up because of the sleep deprivation. This ...

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Dear Dr. Wible, I am writing to you with great sadness, but with relentless determination to ignite change. I am a doctor with a disability. Two years ago I began residency training in pediatrics. The privilege was overwhelming as I stood a doctor in the very halls where I had been wheeled in as a patient with a brain tumor. I couldn’t believe that I had actually made it, that I ...

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On the way to work the other day, I heard a radio commercial advertising a local hospital network’s cardiac care services. In it, a patient’s daughter related her overwhelmingly positive experience with the hospital team that treated her 90-year-old father with a transcatheter aortic valve replacement (TAVR), a minimally-invasive alternative to open heart surgery. It was a good commercial. It had all the elements: “I was worried at first, the doctors ...

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She squeezes her eyes tightly shut and holds her breath. Her head is bald. Her belly round and taut. Her daughter stands over her, clasping both hands in hers, her own eyes tightly shut, softly singing a song of hope and redemption. Her husband sits quietly, barely present, in the far corner of the room. She tenses when I slide the needle into her skin, gasps at the sting of ...

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Cleveland Clinic published an article that cited the work of Cynthia Kubu, PhD, a neuropsychologist in Cleveland Clinic’s department of psychiatry and psychology. She examined the potential of focusing on relationship center care to help provide good care and long-term care giving for physicians. Cleveland Clinic uses the REDESM (relationship, establishment, development, and engagement) which focuses on the provider-patient relationship as the premise for care. The idea is a physician ...

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“Doctor, why can’t my mother breathe?” he asked, eyes full of concern as he watched his mother’s chest heave like someone who has spent too long underwater. I turned up her oxygen as we discussed the possibilities we were testing for: infection, a reaction to chemotherapy, blood clots. Her breathing eased as we spoke, and in turn, I saw some of her son’s anxiety dissipate. As our conversation came to a ...

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“If physicians aren't happy, they can't heal others” - Vivek Murthy Last year, nearly 400 physicians committed suicide, a rate higher than other professions. Our nation is facing an epidemic of overwhelmed physicians subjected to increasing external stressors. Modern medical practice has evolved into a system driven by incentives to meet care quality measure benchmarks, implement incomplete electronic systems, provide care that is satisfying to patients and more. To keep up, physicians ...

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Dr. Kaveh Shojania, a prominent patient safety expert who scoffs at the numbers and laughs at the tragedy inflicted on countless victims of medical error, should step down as editor of a leading hospital safety journal. About three years ago, a scientist named John James published a study proclaiming that -- at minimum -- 210,000 people die every year from hospital errors, making it the third leading cause of death in ...

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During my first rotation of intern year, we took care of a woman who walked into the hospital with a kidney stone and never walked out. 52 years old, diabetic but otherwise healthy, she had been vacationing in Vermont with her son and extended family when she became sick with high fevers. When her symptoms didn’t improve, her son rushed her to our emergency room where an imaging scan revealed ...

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2:15 a.m., July 2, 1981. Its 83 degrees outside in a loud, humid Chicago night, but here the scrubbed air is chilled, dry, while white tiles reflect the occasional nurse, who appear and vanish, and the rhythmic sighs of the machines, gasping somewhere down empty halls, are occasionally interrupted by a frantic chime. My first night in the unit and my first patient’s chart.  Papers spill from the accidentally opened binder ...

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