Despite all the challenges that we, and every other nation, faces with their health care systems, it’s worth remembering that in the broader picture we really have progressed in leaps and bounds over the last several decades. How easy is it to forget that only 100 years ago the average life expectancy was in the 20s to 40s in most parts of the world (just as it was for nearly ...

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"One of the most prominent definitions describes burnout 'as a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who work with people in some capacity.'" - Maslach, Jackson & Leiter, 1996 In 1974, the year I started medical school back in Sweden, the German-born American psychologist Herbert Freudenberger published a journal article titled “Staff Burnout." In it, he wrote about the physical and emotional symptoms of ...

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As a primary care physician at one of the nation’s leading academic medical centers I’m still hanging on. Over my 32 years, I’ve seen how my ability to interact with patients has been diminished by an ever-encroaching health care system. There’s a clock keeping track of how much time a patient’s chart is open. I have less than 15 minutes on average to assess my patient’s symptoms and discuss treatment options, ...

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A friend posted an article on her Facebook page discussing a recent research study out of Sweden showing that people on the autism spectrum have a decreased life expectancy. This friend has a child with autism. Autism coupled with learning disability, according to this study, is associated with the largest decrease in life expectancy. This friend’s child has learning disabilities along with autism. My friend is scared. On top of her worries ...

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My last post discussed the wide gulf between health care and the rest of the world in the area of customer service.  To sum up what took over 1,000 words to express: Customer service in health care totally sucks because the system promotes that suckiness and does nothing to penalize docs who make people wait, ignore what they say, rush through visits, and over-charge for their care.  We ...

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The consult was for “decreased vision and eye pain.” Inpatient consults at the VA hospital come up infrequently, but when they do, it’s inevitably something interesting. As soon as I access the patient’s medical record, a flashing rectangular box encasing a smattering of phrases such as “warning,” “inappropriate behavior,” and “female employees” pops up on the screen. I’m accompanied by one of our female residents, Dr. Smith. Once we leave ...

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One year ago (read: before intern year), pretty much the most exciting part of my fourth-year emergency medicine rotation was having my pager go off. BZZZZ! I leapt into action, excitingly reading the text page: “Leg lac in E9.” I was on it. Suture kit in hand, I burst through E9’s thin emergency department curtains with abandon; I was going to fix this. The “leg lac” turned out to be a ...

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No, customer service in the U.S. is terrible when it comes to health care.  No, the customer service in the U.S. health care system is horrendous.  No, health care has the worst customer service of any industry in the U.S. There.  That seems about right. What makes me utter such a bold statement?  Experience.  I regularly hear the following from people when they come to my practice:

Back in my first year of blogging, I wrote a post, titled "A Day Without a Diagnosis," about the way we now spend most of our time “managing” chronic diseases, some of which weren’t even considered diseases when I went to medical school. That’s not how all my days go nowadays: A week ago I had a day of some very real doctoring. My first patient of the day was ...

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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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