Professional burnout is widely identified using the Maslach Burnout Inventory, which defines it along psychological lines: emotional exhaustion, a feeling of depersonalization and cynicism, and a low sense of personal accomplishment. Accordingly, the phenomenon of physician burnout is often framed as a personal problem to be solved by means of self-care. While this approach is undoubtedly helpful, it doesn't sufficiently address the structural factors that contribute to burnout in the first ...

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I admitted an elderly woman to the hospital recently.  The previous week, she had presented to the emergency department (ED) with chest pain and shortness of breath.  For some unknown reason, a urinalysis was obtained and was found to be abnormal.  The patient left the hospital with a prescription for cephalexin, in addition to unexplained chest pain and shortness of breath.  The patient presented to the hospital this time with, ...

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She was new to this ICU. She was young, smart, funny, and considered one of the “cool” nurses. Before we could really get to know her, she exposed her wonderful, fantastic, perfect life all over social media. Their perfect two-story brick house, their two little, perfect angel daughters — the perfect life in the perfect town. But what was most important was her perfect, handsome husband. He was bound to be a self-employed ...

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Doctors dispense medical advice. That’s what we do. Folks come to our office with various medical issues. We talk to them. We poke around some of their body parts. Then, we exercise our medical judgment. We might order a CT scan. We might prescribe stuff. We might simply reassure them and send them on their way. This is a typical day in the life of a health care provider, formerly known ...

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During the winter months, it's common for many families to spend more time indoors due to colder weather and fewer daylight hours. Unfortunately, children may also end up spending an increased amount of time using electronics to entertain or divert themselves from the dreaded childhood condition commonly known as "boredom." As parents and caregivers, we must be aware of the time our children are committing to digital media and regularly monitor ...

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An excerpt from Fallible: A Memoir of a Young Physician's Struggle with Mental Illness. Jason had an entire group of voices in his head that he called “the committee.” They talked nearly constantly, sometimes in a flat roar but often escalating to shouting. He described it as ...

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What seems like a tidal wave of pages washes over you. Drowning in a torrential sea of order clarification, bowel regimens, and vital sign deviations — you struggle to stay afloat. Medical school did not prepare you for this. Patients and nurses are calling you, “doctor,” you wish to return to that minimal responsibility role as a medical student. Welcome to your first on-call weekend. These first few days, weeks, and months ...

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asco-logo Mr. G* was diagnosed with advanced prostate cancer two years ago and has been on a succession of medications to control a progressive cancer. His PSA never nadired after surgery, and adjuvant radiation only increased his urinary problems. Androgen deprivation therapy added to his symptoms, and he is now considering taking a second-generation androgen-receptor antagonist. Fortunately, his cancer has not ...

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I'd known Ellis for years — he once hired me for a social work job. Yet when I think of Ellis Ledger, I remember him best the night I encountered him outside of his apartment building. I was out late walking my dog. Ellis stopped to talk. He clearly was drunk, not falling-down-drunk (he never was), but feeling no pain, as they say, and he was upset about something important ...

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When my peanut-allergic son was five, he suddenly blurted out, "Mom, don't worry about me, if I eat a peanut by mistake and it kills me, I can just hit the redo button and get another life, like in the video game." I became really scared that his child-like innocence prevented him from understanding the potential adverse ramifications of his own food allergy. The sad truth is that there are ...

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