I get on the phone with a physician. She is stressed. Her tone is exasperated. Her frustration has been building and building. I hear the stress in her words. She feels like she has been juggling ball after ball after ball. Living her circus of a life. Taking care of her patients. Pulling extra shifts and doing locums. Somehow, fitting in a little bit of time when she can for her caring ...

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I feel privileged to be practicing medicine. Many people consider doctor careers and imagine how great it may be. Is it the right thing for you? Yes there are days of frustration, exhaustion, and utter defeat, but at the end of the day I home and know that I helped at least one person if not two from the 16 I meet. The fact that I alleviated one individual’s anxiety or ...

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Recently, getting dressed after working out in the gym, the guy in the next locker decided to complain to me about his recent surgery. Having lockers next to each other had led over time to "What do you do for a living?" After discovering that I was a physician he has occasionally asked some medical questions, and done what a lot of people do when they know you're a health care ...

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Many people love to vilify doctors. They think we are all greedy and we don’t listen. They say we perform procedures just for profit. We are not available when we need them. Sure, there are doctors that fit this stereotype. But, in my experience, most doctors do not and care about their patients trying to do the best for them. I hear patients complain about other doctors and some of the ...

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Being a doctor is about as much of a social job as one can get. Even though computers and healthcare information technology mean that physicians are now spending a disproportionately large amount of their time staring at their computer screens, there’s no getting around the importance of good old face-to-face interactions. That’s also what’s valued by your patients. In this time of great upheaval in healthcare, everything has ...

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Today's patients must adjust to seeing many physicians, many of whom are strangers. If you need a doctor on the weekend, at night or just need a same day appointment, you may very well not be seen by your physician. This is not your father’s medical practice. The days of the physician house call have vanished. There are many reasons responsible for this evolution (or devolution) in medical care. Patients ...

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Over the past decade, I have thought often about the benefits and the problems of clinical guidelines. The first concept that attracted my attention was reading about conflicting guidelines.  Given the same data, different guideline committees would have significantly different recommendations.  At the least, this problem raises questions about guideline validity.  It makes clear that committee perspective could influence recommendations.  Guideline recommendations sometimes are clear and demonstrably evidence based, but too ...

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June 30 is a date that those in the medical world know well; it’s the official end of the medical training calendar year. July 1 represents new beginnings: beginning of the academic year, an internship, a residency, or a fellowship. This year was our tenth and final passing through the medical new year. Looking back, I realize that we never would have predicted what we were going to learn and ...

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Much has been written in recent weeks about the failure of direct primary care giant and pioneer Qliance. Much of the conversation has examined the reasons for their closing and the negative impact it will have on the direct primary care movement. Questions have been raised about the longevity of the movement, with many exclaiming that "If they can't sustain it, no one can." While I don't pretend to know all ...

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Humanity often exists as a bell curve which cuts off and marginalizes its own tail. We judge individuals at the end of a spectrum rather than recognizing them as products of deeply rooted systemic failures within a society. In all cultures, both ancient and modern, humans have created scapegoats — individuals designated to “take on the sins” of a people, to represent and be held responsible for the shortcomings of ...

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