Doctors and policy wonks hear a lot these days about “low-value care.” What exactly is that, and should you care? The term refers to tests, medications, and procedures that add little to a patient’s health or well-being but which cost them or the system more money than any benefit warranted. Some of the earliest research that looked at this was done at Dartmouth, where they found enormous variations in the cost ...

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As a trauma surgeon, it’s my job to diagnose and fix the violent destruction of the human body. One of the questions I get asked very frequently is, “How do you deal with that?” My standard answer is, “After a while, you get used to it.”

And while I recognize there is some truth to that, lately I’ve been more honest with myself about the emotional toll that violence ...

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I made my 10:20 a.m. patient wait while I told my support staff about my day off. "I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there were no serious injuries and all I did was to distract the passenger so she wouldn't panic while we waited for EMS. Her husband hit a tree with their van, and ...

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Some radiologists perceive teleradiology as the “dark side” of our profession. I may have counted myself among those skeptics, but I now see the light and am happy to share a place among the converts. Most of my career has been in traditional private practice, but there’s not a great deal of difference in how they operate versus a teleradiology practice. Both organizations exist to provide clinicians and patients with diagnostic ...

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One of the great nuisances in medicine is diagnosis coding. According to Medicare and insurance companies across the U.S., each and every disease must have a unique number. Everything must be quantified and recorded. Why? To facilitate analysis, number-crunching, regulations, reimbursements and, of course, we sometimes joke, to perpetuate the jobs of the coders. They usually know the nuances better than the doctors. Is it truly possible to describe Mrs. Brown's ...

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The one thing doctors want to avoid like the plague is a lawsuit — a medical malpractice lawsuit. To be sued means the doctor loses precious time from work, endures emotional personal and family distress and is unable to fully invest oneself in providing the very best medical care possible. It is a dark cloud that hovers over the majority of physicians at least once in their lives. Some medical specialties, ...

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People often compare internship to drinking from a fire hose. Overwhelmed by new information and workflow, interns (especially international) usually do not have a clear direction about how to optimize their working/learning experience. Here are some tips for interns to smooth their transition from a newbie into a high-functioning intern in the setting of medicine inpatient wards. Success leaves clues Don't explore yourself, specifically ask your upper-level resident about the most productive ...

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Being a medical resident is really hard. This is not only due to the infamous number of hours you work, but you are truly responsible for patient care for the first time. That is a heavy responsibility, especially when you constantly feel inadequately prepared. You never feel like you have enough time to read, and you never stop feeling like you could be doing a better job. Despite the schedule and ...

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Jeffrey Epstein's apparent suicide while in custody at a Manhattan detention facility has focused intense media scrutiny into jail suicide prevention procedures. Suicide is the biggest cause of death in jails in the U.S. -- by far. Because of this, all jails (including the facility where Epstein was housed) have a suicide prevention policy. Since the process was an epic ...

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According to a recent Harvard report, physician burnout is “a public health crisis that urgently demands action.” Half of all doctors report troubling symptoms: depression, exhaustion, dissatisfaction, and a sense of failure. These physicians are twice as likely to commit a serious medical error, research finds. Experts predict that if left unaddressed, burnout will further erode the mental health of doctors and radically undermine patient care. At ...

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