Following one of my recent articles on how physicians can improve their communication skills and ultimately help attain better patient outcomes, I received an interesting comment from a physician. It went something like this: “Sorry, but I’m not an actor.” This response typifies a small (but not insignificant) subset of responses I get when I’m discussing and promoting techniques that any doctor can utilize to better their skills in this area ...

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When we studied ward attending rounds, the thought process represented the top attribute that learners valued.  Learners can learn facts from textbooks, but using those facts requires experience and role modeling. I have given many lectures on clinical reasoning, and I have attended many lectures on clinical reasoning.  These lectures can entertain, but one lecture does little to help our colleagues and our learners. We must structure case conferences as a primary ...

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Dear science, Today my sons, Oliver and Victor, are 15 years old. It is not a miracle; it is thanks to you. Unable to get pregnant I needed infertility therapy. If you had not isolated the hormones, developed tests, and then designed medications for ovarian stimulation and to trigger ovulation I would never have become pregnant. If ultrasound had not been developed I would not have known I was pregnant with triplets and then ...

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STAT_Logo "Better patient care” is the reason hospital and health systems usually give when they merge or acquire one another. Our research suggests that mergers and affiliations might, paradoxically, increase the risk of harm to patients in the short run. Improving the safety of patient care is possible during mergers and affiliations, but requires intentional efforts. What happens after ...

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It's easy to get excited about technological advances such as nanobots that swim in blood to deliver drugs or 3-D printers that print human tissues. However, in our enthusiasm to find the next fix, we are failing to notice the ground slipping underneath the health care industry. Here are four trends that are changing health care but on the surface are too unsexy for us to care about. Trend 1: The doctor-patient ...

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Let’s begin with a quiz question: Patients may be allergic to: A. oxygen B. carbon C. iodine D. none of the above If you answered anything but "D," better keep reading. Consider this scenario: If a patient is allergic to penicillin, you would document “penicillin” in the medical records. It would never occur to you to list “antibiotics” as an allergy, and you certainly would not call it a “carbon” allergy for slang, just because penicillin contains ...

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It's that time of year again. The start of a new academic year, marked by the arrival of a brand-new class of interns starting out in their training. Clutching their freshly-minted medical degrees, they appear so ready, so anxious, so excited, so eager to learn. Now it's our job to make sure they stay this way. (Have I written this column before? Every year ...) We need to make sure we have a world where ...

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Doctor: (from Latin docere “teach” Greek phusikḗ epistḗmē “knowledge of nature”) a specially trained and skilled person who holds an advanced medical degree and is licensed to practice the healing arts. My definition of doctor keeps evolving. As a child, I was cared for by FPs who helped set bones, suture skin and fight infections like measles, chicken pox, and strep. Though I didn’t like going, I usually experienced healing on ...

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I subscribe to a financial newsletter that happens to be written by a non-practicing physician in a highly specialized field. His daily updates are a mixture of financial and health advice, and he is a proponent of evidence-based medicine. Based on the letters from subscribers, they are willing to follow his advice eagerly, and when he gives some references to support his medical opinions this seems logical. But he is ...

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It’s been a gut-punch kind of time for many of us, and I want to say a few things that I think are important. First of all, I really love working with you guys. It is the best part of my job, hands down. I have taken stock of my career lately, and I keep coming back to that. You are young and optimistic and funny (so, so funny). You are ...

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“My group has been approached by a private equity company.  It sounds like a great deal!  Any questions I should ask?” Whether it be through one on one discussions or through the Physician Side gigs group, I’ve found myself having this conversation with increasing frequency.  Part of the reason for that is because I find it fascinating, albeit also sometimes terrifying.  As the trend towards consolidation ...

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Health care is buzzing as Atul Gawande has been selected as CEO of the Berkshire-Hathaway/Amazon/JP Morgan strategic venture. I was thrilled they picked a physician, like myself, in the trenches to run their gig. After hearing the news, I remembered Gawande’s TED Talk from 2012 and decided to catch up on it during my flight to the Healthcare Finance Management Association Annual Meeting and Innovation Lab. After watching the ...

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By now everyone has heard that the Centers for Medicare and Medicaid Services (CMS) has proposed to dramatically change the way physicians get paid for evaluation and management (E&M) services in the office as part of the proposed 2019 Physician Fee Schedule Rule. In fact, as of the end of July, CMS has received over 600 comments on the proposed rule, with virtually all of them criticizing the proposal. I ...

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This one’s for the new interns. You’re excited, you’re about to start residency. You’re a doctor. No more short white coat. You’ve got the long white coat that you’ve been waiting for. You’ve arrived. But actually, there’s one more thing you need before you really feel like you look like a doctor. It might be a few months. There’s going to be a long process. Someone in your program, maybe the chief ...

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Fortnite Season 5 has officially arrived — bringing new features, a new maps, and new skins. Parents can anticipate battles over the amount of time spent playing the game to “level up” with your teens. If you are not familiar with this game, then it likely means that you are not the parent of a teenager (I nearly wrote “teenage boy,” but it is important to appreciate the growth of female ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man with a 15-year history of type 2 diabetes mellitus is evaluated for bilateral burning sensation in his feet for the last 6 to 12 months. The sensation worsens at night. His HbA1c levels have remained less than 7.0% for the last 2 years but were between ...

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Putting physicians in charge of hospitals seems like a no-brainer, but it isn’t what usually happens. A study published in Academic Medicine states that only about four percent of hospitals in the United States are run by physician leaders, which represents a steep decline from 35 percent in 1935. In the most recent 2018 Becker’s Hospital Review “100 Great Leaders ...

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Now that you’ve turned in your AMCAS (phew!), you’re probably wondering how to tackle the monster of secondaries coming your way. One of the most common questions asked in one form or another is the diversity essay for medical school. Have you ever wondered why diversity is such an important component of the medical school admission process? I’ve heard a lot of pre-med students eager to write this off ...

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An interesting phenomena recurs when I work with physicians to makeover their finances. They almost never believe that overspending is the problem. They believe the reason their credit card balance is growing, and their large monthly income isn’t enough to pay their expenses can’t be due to their own choice to overspend. They always have a reason for the lack money: They have huge student loans. They have eight kids. They are in ...

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Last year, my high school aged son took an interest in healthy eating. He began examining nutrition labels and scrutinizing the foods that we routinely keep around the house and came up with a list of criticisms and suggestions -- some well-founded, and others a bit extreme. At first, my wife and I were quick to debate him on certain choices like eliminating any breakfast cereal that has enough sugar ...

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