Significant snow in New England every winter is about as certain as sun in Florida every summer. When I moved to the USA from the south of (old) England to do my medical residency in Maryland, my first few years living in the United States were relatively snow-free. But when I started my first job as an attending physician in central Massachusetts, I was in for a big shock. I had ...

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She is always a difficult admission. The long chart review. The vague complaints. The entitled attitude. The misdirection. These are expected. As is the cake at her bedside after a diabetic crisis. The two-liter soda after an emergent fluid dialysis. The urine toxicology was positive for cocaine. The staff knows her well. I know her well. I give her the attention, kindness and empathy that I give to every patient. ...

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Amid the many ongoing changes to health care, it's clear that better teamwork is needed in American medicine. Calls for stronger interdisciplinary collaboration have permeated position statements and policies, and organizations have begun redesigning care processes to include novel team-based approaches. Emerging data continue to affirm that strong teamwork and communication can increase the value of care. Of the many efforts to improve teamwork, however, one potential area for significant improvement ...

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Neither of the two most important people in Aaron's life could stand to be in the same room with each other.  There was a long colorful history between his ex-wife and his brother, and as his disease began to accelerate, the feuding became quite intense.  They argued over Aaron's advance directives.  They both tried to coerce and manipulate themselves into commanding positions.  The shouting became louder, the fury more fierce.  ...

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shutterstock_258407336 With the endless appearance of medical malpractice solutions in the press, any reader would think we have the answers to the logjam -- but no will to implement them.  If you follow the topic, you know every proposal has flaws and limited applications as they relate to individual states or delivery systems. The worst offender seems to be safe harbor protections (i.e., “follow the ...

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shutterstock_138966065 There isn’t any such thing as an ordinary life.  - Lucy Maud Montgomery Heroes are ordinary people who make themselves extraordinary. - Gerard Way My colleague, Dr. Jesse Ehrenfeld, is currently on leave from his academic anesthesia practice as well as from his post as speaker of the house of delegates for the Massachusetts Medical Society to serve as Lt. Commander Jesse Ehrenfeld, combat anesthesiologist in Kandahar, ...

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Michael Davidson’s death was the result of a senseless act, and it has shaken our community to its core. We physicians are part of a profession that prides itself on healing and restoring lives, and it is difficult to accept an untimely and unjust death in any context. It is all the more incomprehensible that such tragic circumstances could exist as to result in such an irrevocable end to one ...

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shutterstock_114973210 As clinicians, we often forget or become desensitized to the image that society has of medicine and doctors. Alongside teachers and scientists, we are seen to be among the most trustworthy of professionals, yet our morale is low, with almost 50 percent describing it as “low” or “very low.” You can imagine, then, why I often describe medicine as ...

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In medicine, the seemingly simple questions become the complex ones. “How’s it going?” It is a question that is frequently asked whenever we encounter friends and acquaintances. In a given day, we ask this question many times out of courtesy and we expect to hear short, affirmative answers, such as “Things are good,” or “It’s OK” as we continue to walk to where we need to go since we are pressed for ...

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Rural hospitals are fighting for their lives. Over the past five years, more than 40 rural facilities have closed their doors due to lack of funding. And because the majority of their funds come fromMedicare and Medicaid -- two government programs facing potential cutbacks in 2015 -- many rural hospitals may be fighting a losing battle.   Understandably, small-town residents fear hospital closures or downsizing may leave them vulnerable when serious ...

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