As a physician from Ghana brought up in a very religious family, I must admit that when it comes to gay rights and other issues related to sexual minorities I was as far to the right as anyone could be.  My first experience with openly gay individuals was when I came to the United States. Needless to say, gay behavior in Ghana was so stigmatized as to be nonexistent in ...

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The reason for Chandra’s office visit is to fill out form N-648. Chandra* is a fifty-nine-year-old Bhutanese refugee who has been my patient for the last nine months. Form N-648 is a six-page bureaucratic nightmare that is guaranteed to bring my clinic day to a grinding halt. My refugee patients bring me this form to certify that they are unable to take the test to become a U.S. citizen due ...

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I am a family physician who has been in practice since 2007. My practice is broad in scope; immediately out of residency I worked in a community health center where I practiced obstetrics, newborn care, and inpatient medicine and pediatrics, along with my outpatient obligations. Since 2011 I have been a locum tenens physician working in rural Colorado in emergency departments, clinics, and hospitals. I recently received your American Board of ...

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An excerpt from Physician—Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management. What is an essentialist? What is an essentialist lifestyle? Essentialism focuses on identifying the important signals in life and eliminating the noise. The noises are the distractions that add no value to your life and frequently monopolize time and meaning. When you assume the role of an essentialist you will ...

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Physician burnout has become a popular buzzword in the medical community causing physicians, organizations, and medical education programs to seek solutions to what seems to be a growing problem.  The result: Tons of research, new pilot projects, and burnout prevention programs are being implemented to try to “treat the problem.”  Yet, for all of the research that is being done, there has been no one good “solution” for doctors burning ...

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I knew the patient was fuming mad and I could hardly blame him. His symptoms were debilitating and the battle to get a diagnostic test authorized by his insurance company set him over the edge. My staff fought a hard war convincing the insurance company that the patient needed the test and lost. As the patient sat in front of me yelling practically in my face, I felt like the ...

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Physicians have long been seen as superhuman -- able to jump the academic hurdles required to gain entrance to medical school, willingly delaying many of the gratifications associated with young adulthood, surviving long hours during training and later when in practice, keeping a cool head amidst crisis. In many ways, we physicians thrive on this image. Personally, I was unaware of how much I enjoyed the mantle of hero until I ...

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Sir William Osler wasn’t exactly wrong when he said, “Listen to your patient, he is telling you the diagnosis." But he didn’t mean it literally. His patients did not offer up esoteric and complete medical diagnoses on a silver platter. They left him clues in plain language that he listened to carefully in order to make the correct diagnosis. He penned his words in an era when medical information was scarce ...

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Medicine has become increasingly stressful for all levels of health care providers. Every year, nearly 400 physicians commit suicide, and in a study published in the Journal of Academic Medicine, researchers found that almost 10 percent of final year medical students and first-year residents (called interns) reported having suicidal thoughts. Previous studies from the National Institutes of Health found that physicians were twice as likely to ...

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When I started medical school, my classmates and I attended a special ceremony where we stood in front of our friends, family, and professors and recited some modern version of the Hippocratic Oath. For years afterward, I only remembered the “do no harm” bit, which is a lazy approximation of the actual words. I recently reread the oath, and even though I’d completely forgotten, it also said this: “I will ...

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