My new patient looked around dodging my eye contact, scanning the ceiling, the room, and me. I felt that she was hiding something. In my clinic, I often find it one of the most difficult challenges to get new patients to open up, and one of the most beautiful moments when they finally do. I stopped interviewing midsentence and took a step back. “Let’s just get to know each other. I’m ...

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Early in my career, I learned that keeping my focus on patients would help me define the physician I wanted to be. One of my first offices was in a cell of a repurposed juvenile detention unit with cinder block walls painted pasty white. Occasionally, I had to apologize to my patients as I explained that the smell was sewage from the toilets backing up. In that cold, harsh room, ...

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Beyonce wasn’t kidding when she wrote the song “Girls Run the World.”  We as women wear as many hats as some of us have shoes.  However, the cost of that can be grave if we never learn to create balance in our lives.  When I say balance I don’t mean the balancing act, I mean the act of giving back to ourselves.   Imagine that you have an energy bank account.  ...

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In the middle of a five-way thoroughfare intersection, with the early-morning sun's glare on my windshield, I hit the curb of the median and blew out my left front tire. Amid stopped traffic, I ran to collect my escaped hubcap, whose silver eye stared helplessly from among the automotive debris of previous accidents. A policeman blocked the lanes until I could pilot my car into the gas station on the other ...

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  It’s Wednesday, the day after the election. I spent the previous night clicking from one website to another, trying to find someone who was refuting what the others said was true. And when it became inevitable, I held my infant twin boys and cried. Now I’m in front of my exam room, walking in to see Mr. Bundy. I open the door to find him wearing a red hat embroidered with ...

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In my previous post, "Have physicians finally joined the working class," I discussed the changes in the health care system regarding physicians roles in these systems. In this post, I propose two strategies that could help physicians regain some influence over their work and to participate fully not just in the execution of strategy from management but also have an input in creating it. Building unions There has been a ...

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Over the past two days, listening to separate podcasts, I have heard the same story and now have a better understanding of artificial intelligence. A Freakonomics podcast — The Future (Probably) Isn’t as Scary as You Think:

And in general, what’s happened in the past couple of years is the best chess player on this planet is not an AI. And it’s not a human. It’s the team that ...

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In the technology-thick landscape of modern health care, the physical exam remains in a backwoods. Sure, there have been advances — blood-pressure cuffs, for example, now inflate themselves — but on the whole, the exam has barely changed in the past century. Patients still open up and say "ah," take deep breaths and gaze at a tiny light peering into the back of their eyes. A well-done exam can still determine whether ...

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In my home, we have two conversations: politics and medicine. The most vociferous discussions are around their product, health care.  We know doctors on the right and left, Democrat and Republican, boisterous blues, rebellious reds and garrulous grays. Respecting opinions and debate, we love ‘em all.  However, no matter on what side of the aisle they stand, which lever they pull, they share one trait.  All physicians are deeply conservative.  ...

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As soon as the microphone opened for Q&A at a conference I recently attended in New York City, a physician in the audience began his question with, “as a front-line physician.” Another asked from the perspective of someone “in the trenches.” And a third wondered how to provide medical care when we are getting “bombarded by mandates.” As I speak to physicians across the country, I am increasingly jarred by these ...

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