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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Science, to use the term correctly, isn’t a body of knowledge or a bunch of facts written up on a whiteboard by a crazy-haired professor. It’s a method, or way of figuring out things. Thinking and reading and learning from experts are all important, sure. But real science relies on experimentation. First, make an educated guess about how something works. Then design an experiment to test your guess. (I’m oversimplifying here. ...

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You have a persistent cough and poor appetite, but for six months your doctor has prescribed an assortment of antibiotics after an initial chest x-ray showed a small pneumonia. Finally, short of breath, you go to the emergency room where a CT scan reveals untreatable lung cancer. Later you find your doctor has received a bonus from your HMO insurer for not ordering a CT scan earlier. Physicians count on experience ...

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Physicians today are increasingly viewed and treated as skilled workers instead of professionals. The difference is fundamental and lies at the root of today’s epidemic of physician burnout. Historically, there have been three learned professions: law, medicine, and theology. These were occupations associated with extensive learning, regulation by associations of their peers, and adherence to strong ethical principles, providing objective counsel and service for others. Learned professionals have, over many centuries, worked ...

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