Measuring metrics is a common catch-phrase in health care. The goal of capturing certain data is to improve patient outcomes. But, as doctors, we were taught to treat the patient and not the numbers. While optimizing clinical outcomes is a needed goal with all the complexities in medical treatment currently, the system seems to have gone too far in its quest for targeted numbers. If, for example, a patient suffers metastatic ...

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The presidential symposium at this year’s Annual Meeting of the Child Neurology Society of America in early October in Kansas City raised many eyebrows. The first presentation of this symposium focused on burnout rates among neurologists around the country. Many of my colleagues felt that this was an inappropriate choice, especially with so many trainees and young child neurologists in the audience. Typically, the presidential symposium at a conference of such ...

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I first noticed this phenomenon while watching the world news on a weekday after work.  It was a commercial for a new diabetes medicine that showed overweight people dancing at a barbecue, cooking and enjoying life.  How different this was from my day in the wound clinic, where I saw patient after patient with obesity, diabetes, and nonhealing wounds, as well as other dire medical complications. So I tucked this image ...

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As a corrections physician I frequently heard the question, “How can you take care of those people?” I understood what they were asking, after all, I was caring for people convicted of such crimes as murder, rape and child abuse. And yet I had very little difficulty providing the same care to inmates that I provided to everyone else. In fact, the corrections environment was generally easier to work in and ...

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Flu season is upon us, and with it a chance to test out my persuasion skills on a deeply skeptical public. Consider this recent patient of mine, a young man in college who came in for an ankle sprain. “While you’re here, why not get a flu shot?” I asked. He looked at me as if I were a car mechanic offering a few more add-ons to his maintenance exam. “Oh, I don’t ...

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Here it comes — another email about “physician wellness,” advertising mindfulness training, an ice cream social, or a volunteer day. As a psychiatrist, I can attest to the importance of tending to one’s own mental and physical health in order to strive for wellness. However, the trend of implementing physician wellness programs throughout the U.S. is nothing more than putting proverbial lipstick on a pig. Or, stated differently, this may ...

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A little ways back, I was at a gathering of friends and family and was in the kitchen setting out a dish of black bean and quinoa dip. Suddenly, I heard someone from behind me exclaim: “What is that? If that’s something healthy, I am not eating it.” Although somewhat intended as a joke, there was no doubt a truthfulness to what was said, just as exists in similar comments which ...

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Recently, I was challenged by the mother of a trauma patient. She had read about traumatic spleen injuries online and was concerned about the risk a hematoma presented and wanted the ultrasound to look at the hematoma. I found myself floundering around trying to explain how this study was unnecessary. In frustration, I turned to my nurse practitioner and said, “Heather, can you translate for me?” This is a common problem. ...

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Why do we want to become doctors? What was our main motivation that we have written in our motivation letters and repeated in our interviews? Regardless of the specific incident or the general motivation, it can be all summarized in one sentence: We are here to save lives. After all, this is what the physicians do, isn’t it? Preventing deaths is actually hinted to by the original Hippocratic Oath, written between ...

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Here’s some advice for your career in health care: Leave the country as soon as possible. This has nothing to do with the president’s attempts to euthanize the Affordable Care Act. Or with EMRs, Medicare reimbursements, or the burnout surveys you get from your employer, who also sends emails aimed at getting you to work faster and more efficiently. It’s none of that. You need to leave the country, just for a ...

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