The first time I cried as a doctor was in residency. I was taking care of a patient who had terminal lung cancer. The first time I met him, his wife was at his bedside. The couple displayed such a positive outlook on life and seemed to have accepted the poor prognosis. He was one of the first cancer patients I took care of. Being a cancer survivor myself, I felt a ...

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My name is Dr. Neha Sharma, and I have a confession. Recently, a patient was transferred to me from New Mexico. He was found in his house, unresponsive. By the time I admitted him, he was connected to a breathing machine, and had a serious lung infection. Over a course of a few days, his condition improved. We were able to remove his breathing tube and successfully treat his infection. However, ...

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A road trip from Georgia to New York was going splendid, dare I say, wonderful -- catching up with old friends and family -- when it took an unforeseen and slightly less desirable turn: I got admitted with a small bowel obstruction.  Thanks to truly excellent care from a community hospital, I am home and now subjected to endless computer questions from my father that has me briefly contemplating readmission ...

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Part of a series. Among Medicare recipients, those discharged from the hospital incur about a 20 percent risk of an unplanned readmission within 30 days. The number is higher for some conditions such as heart failure. This is the result of a terribly dysfunctional health care delivery system. Of course some patients will need readmission; the number can never be pushed down to zero, but 20 percent is appalling. Why ...

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San Diego, Tucson, Orlando, and Dallas. Those are a few of the modest destinations to which I have traveled, as a hospitalist, to attend CME conferences, using the pre-tax CME benefit from my employer, including paid days off. As a young professional, my yearly CME trips gave me a mildly magical sense of privilege: “Really? They’re going to pay for all of this?” Browsing through various CME conference options and dreaming ...

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I was talking with a colleague in another section today, and she was noting the difference between our hospitalist group and her section.  She has somewhat intimate knowledge of our section because she did a year with us before moving on to her specialty fellowship.  She is a bit frustrated with her new home and its team members because she feels like there are a lot of “B's.”  You know ...

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“Doctor, I am ready to die.” I knew her from a few years back. This patient of mine. I am a hospitalist and the patients in my care come and go, making it difficult to really form relationships like the ones primary care physicians have with their panel of patients. But this patient was different.  I saw her once many years ago when she was gravely ill, and we managed to pull 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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Medicine has undoubtedly come a long way. Paternalism has been ditched in favor of a shared decision making approach, diagnoses and treatments are (largely) based on scientific evidence, and information is not outright withheld from patients out of some misplaced belief that they are not capable of handling the truth. Some of the modern pain points that patients now face involve access to specialists, skyrocketing cost, misinformation and miseducation surrounding ...

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Recently, I spent two days in Greenville, SC as a guest lecturer. During that trip, I had time to chat with some hospitalists. During our conversations, I explored a classic problem: the inpatient-outpatient handoff. Talk with hospitalists and you will discover their angst about getting outpatient information on their admitted patients. Talk with primary care physicians and they echo the angst when seeing recently discharged patients. Personally, I have experienced both sides of ...

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