Dear health care industry: I think we have a serious problem, and I think we both deserve some of the blame.  Over the last couple of decades, I the patient have been demanding many things of you: reduced wait times, increased access to medications and procedures, more luxurious and colorful accommodations, and numerous scheduling conveniences among other things. Meanwhile, I have watched as an industry long-based on the revered call of service ...

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“Don't ever land in a teaching hospital on a holiday weekend, they always staff up with residents," noted a close friend who was all too familiar with the inner workings of hospitals. That statement sticks in my head heavily today as I prepare to visit my father’s year-old grave.  My father, a man that was involved in the Department of Health & Human Services (HHS) and private sector research societies for decades, ...

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This story is a great one. It’s about a female dog with only three legs. Her fourth leg was amputated following a traumatic accident as a puppy. Now, when she walks, she has a hitch in her step. And, when she hitches, she kicks the stump of her injured leg outward. Step, step, hitch. Step, step, hitch. One day, the female dog has puppies. And, her puppies do what all puppies do. They nurse. They watch. ...

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I remember the day like it was yesterday. I was a medical student, rounding with my team, and we had just talked to a diabetic patient who was recovering from a myocardial infarction. The attending looked over at the side and saw some chocolate donuts and cakes lying on the tray table, which had been brought in by the patient’s relatives. The attending shook his head disapprovingly and said, “I don’t think those are going to ...

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I learned a valuable lesson recently about how difficult it can be to make the correct diagnosis when you see a patient for a very short period of time. In the acute rehab setting, I admit patients who are recovering from severe, life-altering brain events such as strokes, head injuries, and complex medical illnesses. It is challenging to know what these patients’ usual mental function was prior to their injuries, ...

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BEEEP BEEEP BEEEP BEEEP ... I pressed a button to silence my pager and rose groggily from the bed in the on-call room.  I hadn’t truly been asleep, just catching a quick rest between pages.  It was 2 a.m.  I was 19 hours into my shift and, from the looks of the page, there was a new patient ready for admission to our family medicine inpatient service.  I picked up the ...

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“I’d like an MRI for my leg pain. I haven’t had an MRI for many years, and I’m worried.” These were some of the first words I heard from a patient I was seeing for a new patient visit. Based on this patient’s story and physical exam, her pain was most consistent with a muscle strain. My preferred approach to manage this complaint was to ask the patient to rest her ...

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In psychology, the Lake Wobegon effect refers to a mythical town where “all the women are strong, all the men are good-looking, and all the children are above average.” In other words, humans have a tendency to overestimate their capabilities, particularly in relation to others. As a physician, I have yet to meet a fellow doc who didn’t think that their patients loved them or that they weren’t great clinicians. And ...

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I’m not going to be a doctor. It feels more like a confession than a statement -- like I’m disappointing someone. Each time I say, or even think, those words, I feel as if I need to atone for it. Survey a hundred scribes.  Ask them of their goal in becoming a scribe, and all of them will tell you about higher aspirations. They want to be surgeons, cardiologists, intensivists, ...

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Dear attending, I’m a third-year medical student fresh out of the classroom.  I’ve studied from books for years, and now I finally get to see what it is like to be a doctor. It’s exciting but also a daunting experience. I look to you as a guide: what you wear, how you speak, what tools you use, and how you treat others.  This is the year I will be socialized ...

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