Most physicians, including me, would fall into the category of type A personalities, always on the go with a constant need to be productive. We cram every minute of the day with productivity and leave little time in our schedule for fun and recreation. Even type A personalities need a break from working to recharge their personal batteries. How often have you been packing for a vacation and included work ...

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Many of my best friends are in the medical field, and there are practical reasons for that.  That said, I don’t think I could survive without the perspective of my equally good friends outside of medicine.  In one way or the other, they are always reminding me of the following things: 1. Don’t take yourself so seriously. It’s true that at work we often deal with life or death situations.  But ...

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In the current climate today, the awareness of racial discrimination has risen in most communities. However, dealing with racial bias in medicine is a rare topic, and while few studies have been done to show that racial bias and microaggressions do exist and have an impact on the care of our patients, racial bias within the physician community is not widely discussed. Though not a popular topic, racial bias does exist ...

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Domestic violence is ubiquitous in our society. Few are untouched by the physical and emotional consequences of abuse -- whether they were directly abused or know others who were. However, little has been done to prevent it. We’ve recognized prevention as critical to national health. This awareness has led to everything from decreased vehicular deaths by 90 percent since 1925 to millions of lives saved from vaccines. But even with all ...

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After the birth of our second child, the two of us waved a white flag and started working part-time. We surrendered the notion that we could maintain two full-time health careers and still be effective parents and loving spouses. Not to mention sane and happy human beings. It wasn’t supposed to be that way. Doors were opening to professional women, to two-career marriages, and to flexible work arrangements. Ours was the ...

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Sometimes we get help from unexpected sources.  Two of my patients showed me this, during their recent hospitalizations. The first is a woman I'll call Hazel.  I've taken care of her for twenty years, and she's probably had emphysema for ten of those, but had not yet ever been hospitalized for it.  She has continued to smoke, and I suspect that she has not gone out of the house much for ...

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Not only have we shortened medical appointments to 15 minutes — we sometimes double book them. I get the feeling that non-providers think of this as something fairly ordinary, and even reasonable. But it is often a very difficult and destructive thing to do. The term “double booking” and the way it looks in an ordinary doctor’s scheduling grid suggest that the physician might possibly be expected to be in two places ...

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I recently learned of yet another medical student suicide. Ari Frosch, a second-year student at Penn, died by suicide by walking onto the northbound tracks as a Boston-bound Amtrak train passed through Mansfield station. Amtrak trains do not stop at Mansfield station. Police have surveillance tape of the victim trespassing and walking right onto the tracks. There’s no mystery surrounding this medical student’s very public suicide. Yet his ...

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It’s that time again. As the year draws to a close, various insurance plans try to finish collecting data to calculate bonus payments as “incentives” for “Quality” care. The only problem is that, as I’ve written before, all of their “Quality” measures are in fact nothing but proxies for cost, most of which I have no control over. Back in the 1990s ...

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As an internal medicine physician, the #3 question people most often ask me is why I chose to be an internist. (The top two being “What is internal medicine?” and “What’s this thing growing on my genitals?”) So I thought that I would pull back the curtain and show how I made my decision. According to Wikipedia, "Internal medicine or general medicine (in Commonwealth nations) is the medical specialty dealing with ...

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