How can a doctor resist an essay entitled, "The Sickness Unto Death?" Kierkegaard, the darkest of the bleak existentialists, begins by asking, “Is despair an excellence or a defect?” Can despair be an excellence? It is December in Oregon, the rain comes down in sheets, with only a few hours daily of half-light. Kierkegaard’s winters in 1840 Denmark must have felt a lot like this, so I press on. “In despairing over ...

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Are physicians unruly children? That’s the attitude I see at hospital C-suite meetings. (As in, “Our doctors are protesting our new unproven proton beam therapy center. How cute! They think they know how hospitals work: Even cuter, they think their opinion matters.") Chuckles all around. That smiling dismissiveness doesn’t surprise me. Call me cynical, but when people have power over other people, they become contemptuous. And in today’s world hospital executives have that power ...

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Do women make better doctors than men? A recent study in JAMA Internal Medicine claims that they do. According to the authors, there is a 4 percent risk reduction in mortality for elderly patients treated by women. There is also a small but clinically significant reduction in readmission rates. By their analysis, this difference could translate to approximately 32,000 lives saved “if male physicians could achieve the same outcomes ...

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“Orange is his favorite color.  It’s all orange, all of the time in there.” And, indeed it was.  Like the deceptively soft glow from a garish, neon storefront light, passing his room, it was impossible for one’s eyes not to be drawn inside.  Hunter blaze bedspread, pumpkin spice robe, marigold slippers, and even a persimmon beanie -- wavelengths of orange permeated the otherwise drab, muted colors of the space. It became a ...

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I want to share a cool idea used at Mission Health in North Carolina. I recently interviewed Dr. Ron Paulus, CEO of the health system. Three years ago the organization launched “Immersion Day,” when board members leave their corporate meeting rooms to shadow the doctors and nurses in their hospitals. Journalists and legislators are also invited to join. They don scrubs, go through an orientation, sign privacy forms, and spend 9 ...

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If you understand statistics and possess the intestinal fortitude to examine a ranking methodology, you will recognize that it involves ingredients that have to be recombined, repackaged and renamed. It's messy, like sausage-making. This is not to say that the end product — hospital rankings — are distasteful. Patients deserve valid, transparent and timely information about quality of care so they can make informed decisions about whether and where to receive ...

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The mantra of striving for excellent customer service is a very American concept. I’m reminded whenever I travel around the world and experience general service expectations elsewhere — even in some very advanced nations in Europe — how far ahead we are in the United States. We totally take it for granted that we can expect high levels of customer care almost everywhere we go, and any complaints and feedback ...

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About a year ago, Yusuke Tsugawa -- then a doctoral student in the Harvard health policy PhD program -- and I were discussing the evidence around the quality of care delivered by female and male doctors. The data suggested that women practice medicine a little differently than men do. It appeared that practice patterns of female physicians were a little more evidence-based, sticking more closely to
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Once upon a time, I worked for a large hospital in the surgical-trauma ICU. It was just a six-month gig, and I had to travel from home further than I wanted. But my son would be starting college soon, and the $10,000 bonus was too irresistible. Diane was the manager. The most kind, skilled, and helpful person I have ever met as an ICU manager. She had every possible attribute as a ...

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Even though I am over 40 — by a long shot — I am familiar with the abbreviation TMI. Today, we are inundated with so much noise, chatter and static. I feel that we are bombarded with information that we must sift through and ultimately delete. The news cycle is 24 hours and hits us from so many electronic sources simultaneously. I am deluged each day with so many unwanted ...

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