One year ago (read: before intern year), pretty much the most exciting part of my fourth-year emergency medicine rotation was having my pager go off. BZZZZ! I leapt into action, excitingly reading the text page: “Leg lac in E9.” I was on it. Suture kit in hand, I burst through E9’s thin emergency department curtains with abandon; I was going to fix this. The “leg lac” turned out to be a ...

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No, customer service in the U.S. is terrible when it comes to health care.  No, the customer service in the U.S. health care system is horrendous.  No, health care has the worst customer service of any industry in the U.S. There.  That seems about right. What makes me utter such a bold statement?  Experience.  I regularly hear the following from people when they come to my practice:

Back in my first year of blogging, I wrote a post, titled "A Day Without a Diagnosis," about the way we now spend most of our time “managing” chronic diseases, some of which weren’t even considered diseases when I went to medical school. That’s not how all my days go nowadays: A week ago I had a day of some very real doctoring. My first patient of the day was ...

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Dear doctor, I need you to be healthy. When I come to you for help, I need your "A" game. I need you sleep enough. Eat healthy food. Not too much. Mostly vegetables. I need you to exercise regularly and take time to take care of your own physical, emotional and spiritual needs. I need to you use the bathroom when you need to. I need you to stop and take ...

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There has been a significant amount of outrage over the past few months of the maintenance of certification process. The anger has not only been targeted towards the ABIM, but also towards the other specialty boards. Pediatrics, for example, now requires ABP approved quality improvement (QI) projects that have been widely criticized. While these MOC requirements are a major nuisance for most, the implications may actually run much deeper. A number ...

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It’s Tuesday around 9 a.m., and I, a pediatric ear, nose, and throat surgeon on my third or fourth patient at a satellite clinic an hour away from home when the abdominal pain started. It feels as if someone is repeatedly stabbing a knife, and twisting it around, right below my breastbone. I barely got through that encounter, then moved to the next patient. It will stop, it has to. There were 14 ...

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(Because sometimes my brain processes information in the form of a radiology report.) EXAMINATION: Analysis of physician burnout CLINICAL INDICATION: Increasing use of term physician burnout, particularly via social media, and need to address associated connotations/perceptions TECHNIQUE: Non-scientific retrospective review of popular published pieces on the topic and comments platforms on these articles COMPARISON: Innumerable articles on the topic and experiences of professional and personal contacts FINDINGS: The number of articles about physician burnout have ...

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With the upcoming presidential nominations on the horizon, one of the go-to topics for candidates has been health care. What’s wrong with it. How we can fix it. Is it Obama’s fault? But there is actually one key piece of the puzzle missing which actually can create a win-win situation. It’s a very simple strategy: Pay doctors more. When the idea of paying doctors more money for their work is proposed, ...

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Part of a series. Here is a model for the delivery of primary care which offers certain rights balanced by responsibilities for patient, provider and insurer alike. First the rights of each party. As a patient, you deserve a high level of care in a satisfying manner without frustrations. The insurer and your employer want to see the total cost of health care come down. The physician wants the satisfaction ...

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Three (and a half) years ago, when I left my old practice, I was near burnout.  I was exhausted, not because of the amount of time I was spending -- it was actually about the same, if not less than I had worked before -- but because of an ever-increasing gulf between me and my patients.  I have always tried to give care that focused on the person with me ...

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