One theme has gripped the collective conscience of the nation for the last year. One theme has connected Ferguson, Missouri, to Staten Island, New York, to Charleston, South Carolina. One theme has destroyed neighborhoods, incited riots, and terrorized churches. That theme is racism. Unfortunately, it’s also found a way into our health care system. Black and white In 2003, the Institute of Medicine (IOM) released a groundbreaking report stating African-American individuals ...

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Have you ever been a patient? Yeah, me too. Many newly insured Americans will visit doctors’ offices this year. The average time you -- or anyone -- has with a primary care provider is 15 minutes. What’s a sick person to do? Happier patients make happier doctors. Here’s a helpful list that I’ve developed to help patient visits go smoother: 1. Pick three questions or concerns that you have for your doctor and write ...

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Part of a series. Patients need doctors that take time to listen which means a limited number of patients under care. Employers need programs that reduce costs and ideally improve the health of their staff. These apparently disparate needs can come together in a new model for effective company-sponsored primary care programs. Those of you who have followed this series know that I am an advocate for PCPs finding ways to ...

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Throughout the course of a physician’s career, many patients come across the path with numerous complaints and medical conditions requiring interpretations and actions, respectively. In a field with little time to see everybody at length, pattern recognition becomes important to make efficient decisions with regards to patient care. Usually, it involves focusing on the patient’s condition exclusively, but at times, the social aspects of a patient come into play with ...

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maxresdefault Sir William Osler (1849-1919) is universally considered the father of modern medicine. “He belongs to medical students of all time, as Lincoln belongs to the common man everywhere.” - Wilder Penfield, eminent Canadian neurosurgeon, who met Osler while at Oxford “His energy, productivity, and humanity blossomed out of a deep vulnerability. Between the pages of his books, we can still encounter an Osler who is … ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old man is evaluated during a routine examination. He is asymptomatic but is concerned about his weight. Medical history is significant for prediabetes and elevated cholesterol levels. He smokes one or two cigars a week. He drinks one or two alcoholic beverages a few nights each week. He does not get ...

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Burnout-640x400 Physician burnout is the latest trend among doctors. There are books, workshops, even special breathing exercises for physician burnout. Suddenly every other doctor I meet has burnout. And half of all med students have burnout before they graduate. WTF. We enter medicine as inspired, intelligent, compassionate humanitarians. Soon we’re cynical and exhausted. How did all these amazing people get so screwed up ...

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It was two years ago.  It was a rough morning and I felt defeated.  I stood by the next patient’s doorway.  I couldn’t see myself, but I knew my own appearance: head down, a look of resignation, shoulders slumped.  I knocked on the patient’s door and entered.  “Good morning!” I said to the patient.  I felt my energy levels depleting in the effort to remain upbeat and enthused.  The tank ...

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shutterstock_110328875 Time was baffling. It seemed like just yesterday; I sat in a posh auditorium in Chicago as an enthusiastic young adult during my first day of medical school orientation at Northwestern in 1995. Eighteen years later I was a forty-three-year-old burned out physician, practicing in Boise, Idaho, doing Google searches on the most effective way to end my life. During my time ...

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The history of American medicine is the story of the rise and fall of a professional guild.  In the 19th and early 20th centuries, physicians distinguished themselves from other healers by banding together to form professional associations dedicated to science-based practice.  Even more important, medical ethics put the patient first, above considerations of personal gain or even collective social goods.  The medical guild may have been insular, self-protectively territorial and ...

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