Part of a series. You know the serenity prayer, written by Reinhold Niebuhr in about 1940:

God, grant me the serenity to accept the things I cannot change, The courage to change the things I can, And the wisdom to know the difference.
I saw an elderly woman in the hallway recently with the prayer framed and done in needlepoint by her daughter. It was very beautiful, and it got me to thinking ...

Read more...

How do we know what to believe about anything? In times past we read books, we took classes, we spoke to experts. These days? These days we do the same, but we also search the Internet. And we seem to do it with special fervor when it comes to questions about our health. I can’t throw any stones here. Even a physician has knowledge that is limited to his or her ...

Read more...

One of the most notable things so many of last year’s biggest health stories have in common is that they envision an increased role for shared decision-making in primary care. Some patients will want to receive few aggressive interventions at the end of life; others will want more. Some women will be fine with waiting until age 45 or 50 to get their first mammogram; others will still want to start at ...

Read more...

The customer is always right, or so the saying goes. If you have ever worked in retail, you may have been frustrated by buyers who ransack neatly folded tables of sweaters and leave them strewn about like tornado wreckage. If you are in the food industry, you may be annoyed by a diner who complains his soup is too cold even as you see steam rising off the bowl. It can sometimes ...

Read more...

When I was a new attending, an older man came to see me as a new patient.  He had not seen a doctor in over thirty years and was experiencing worsening chest pain that first occurred when he walked upstairs but had progressed to pain at rest.  An electrocardiogram in the office showed signs of ischemia, and I advised him that I wanted to call an ambulance to take him ...

Read more...

burnout Please stop using the word burnout. You are not burned out. You’ve been abused. Let’s get the diagnosis right. We enter medicine as inspired, intelligent, compassionate humanitarians. Soon we’re cynical and exhausted. How did all these totally amazing and high-functioning people get so f'd up so fast? Attention medical students and doctors: It’s not your fault. Burnout is physical and mental collapse caused by overwork. So why ...

Read more...

Today so many physicians are not able to see pharmaceutical representatives (PRs).  However, PRs do serve as a great resource and finding a way to make their visits more efficient and focused is an objective we all need to strive for. I recall requesting an interview with Lou Holtz, then the head coach at Notre Dame, and was told by his secretary the date and time that the interview would take ...

Read more...

I have a dream job. I make my own hours, working three 12-hour shifts on Tuesday, Wednesday, and Thursday.  I’m off Friday through Monday, and I don’t take any call.  I take as much vacation as my budget will allow, and if I wake up with the flu, I call off from work without the usual feeling of guilt and anxiety. It wasn’t always this way.  Like all new doctors recently out ...

Read more...

After months of negotiations, the Conference of Parties 21 (COP21) adopted a historic and unprecedented climate change agreement in Paris recently. The Paris Agreement reflects nearly universal recognition among parties that climate change demands an urgent, coordinated response. This agreement includes cutting greenhouse gas emissions to curtail the average global temperature rise to “well below 2ºC above pre-industrial levels and to pursue efforts to limit the temperature increase ...

Read more...

Thank you for another great year!  I sincerely appreciate your continuing readership. Here are the 10 most-read posts of 2015.  Enjoy. Watch 2 magicians destroy the anti-vaccine movement in 90 seconds.  Measles in Disneyland should be a wake-up call for the anti-vaccine movement.  Will it? Magicians Penn and Teller do their part and show us why anti-vaccination is nonsense. (Warning: explicit language.) An R&B anthem on hospital readmissions. It captures what’s wrong so perfectly. ZDoggMD ...

Read more...

Most Popular