"Doc, if I have cancer, I don’t want to know. Stop bugging me about this colonoscopy.” Mr. H said to me, his primary care physician, during our appointment. He folded his arms and nodded his head, indicating that his decision was final. “Mr. H, as uncomfortable as colonoscopies seem, they can actually find lumps that might grow into cancer, and cut them out before they ever become cancer. That’s why I’m bugging you so much about this.” I ...

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burnout To the literal-minded, burning out is the fate of light bulbs and matches.  But whether you read the popular press or medical journals today, you’re likely to find writers who are deeply concerned about physician burnout. What defines physician burnout, and who exactly is suffering from it?  Is burnout an actual clinical syndrome, a slang term connoting fatigue and boredom, or a hazy ...

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acp-logoA guest column by the American College of Physicians, exclusive to KevinMD.com. I will begin this month’s column with a confession on something that most people don’t know about me. I hope it doesn’t lose me any friends. I am a member of the AMA/Specialty Society Relative Value Scale Update Committee, better known as the RUC. Actually, I'm an alternate, but ...

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Don’t ask me nothin’ about nothin’, I just might tell you the truth.  – Bob Dylan I just read an interesting post by Dr. Jennifer Gunter. Apparently, the entirety of what we are doing here at Dr. Whitecoat, and on internet communities and blogs like Student Doctor Network and Sermo, is unethical, according to the General Medical Council in Britain. How dare we not use our real names on social media as physicians and physicians-in-training? According to ...

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As a little boy I had a dream that I have always wanted to join the circus.  I thought for sure I could be a clown or even the ringmaster.  At age 34 a friend who did public relations for Ringling Brothers and Barnum & Bailey Circus gave me the opportunity to make my dream come true and I was invited to be a clown in the circus. The show was to ...

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If you are a healthcare provider—physician, administrator, or some other leader at a healthcare site—then you know that you face many challenges.  Some seem overwhelming and you may be thinking that you may not be able to handle some of them well.  Perhaps the transition to ICD-10 coding is your main concern right now. The solution to difficult challenges begins with the first step.  I am taking the liberty of adapting ...

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When an employee leaves a position, management might conduct an exit interview. The idea is obvious: one can learn a lot from those who are free to speak candidly. This is why I think it’s worth listening to doctors who no longer practice medicine. Enter Dr. Ed Marsh, a former pediatrician, who writes this poignant and relevant essay. His tone and candor is one of a man who still cares about ...

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New research just out in the journal Psychology and Aging says pessimists live longer and healthier lives. If this is true, then contemplating the future of anesthesiology ought to make us immortal, because our professional prospects don’t look bright.  As we teach residents to do what we’ve always done, shouldn’t we ask ourselves honestly if we’re training them for a future that doesn’t exist? Especially here in California, it seems ...

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In 2012, tension over online doctor reviews ran high. As the New York Times reported, physicians were turning to third-party reputation management firms who used legal threats to silence critical patients on the web. Information freedom non-profits and tech media outlets responded with investigations and an FTC complaint. As a former practitioner, I sympathize with some doctors’ apprehension about online reviews; the desire to protect oneself from unfair or ...

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A response to The creative destruction of the American family physician. Dr. Brooks' column shines a bright light on the misconception that some subspecialists have about the core of primary medical care and family medicine. As a former nurse practitioner and current family physician, I'd like to point out the flaws of his argument. At a time when the health care community is working to end the fragmentation, duplication and gross ...

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