I am beginning to think that we should not see chronic care patients between Thanksgiving and New Year’s Day. It just makes us look bad. Our quality metrics make the last blood pressure and the previous diabetic lab test of the year for each of our patients our final report card. We should quit while we’re ahead, in mid-November. So here we are: The office has Christmas decorations up. There are trays ...

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This article is sponsored by Careers by KevinMD.com. It's no secret that some businesses are family businesses and medicine is no exception. The anonymous Northern California cardiologist known as "Dads Dollars Debts" confesses in a blog that, yes, some days he feels like he's made a difference, and other days, "I just feel like a customer service rep at ...

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1. Very little revolves around the patient. For a place dedicated to healing, the hospital does a poor job accommodating patients. Labs are drawn in the middle of the night, so the doctor has them early in the morning. There is no standard rounding time, so the patient is constantly awakened throughout the day. Vitals must be measured every few hours. Patients often comment about being happy to be discharged ...

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Last year, in response to a continued groundswell of criticism focused on requirements for maintenance of certification (MOC), the American Board of Medical Specialties (ABMS) formed an independent "Vision Commission" on MOC, designed to "reimagine a system of continuing certification." Although led by ABMS board members, many of the 27 commission members are not directly associated with ABMS. After ...

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I have been a neonatologist for 30-plus years. Throughout my career, nurses and neonatal nurse practitioners (NNPs) have guided me, assisted me and comforted me through difficult patient care issues that arose. Even more importantly, they allowed me to leave the neonatal intensive care unit (NICU) without worrying about how my patients were being taken care of. I am writing this because our profession (MDs and DOs) continue to devalue these ...

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How can you work for 24 hours in a row? My friends outside of medicine ask me that often. What is it like? I wondered the same thing the night before my first 24-hour shift or “24.” I lay awake worrying, ironically, that I should have gone to bed earlier to rest up for the ordeal. When I get to work, full of nervous energy, I am relieved to find out ...

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A commentary in the New England Journal of Medicine titled "Beyond Evidence-Based Medicine" received much well-deserved criticism for not only mischaracterizing EBM, but advocating for a novel approach, "interpersonal medicine," that was explicitly codified in the recognition of the U.S. specialty of family practice nearly 50 years ago. Here's what the authors wrote about this practice of medicine that is, apparently, new to them but well-known to the ...

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I have had a complex relationship with music. As a child, I had several instances of feedback that I was “bad at music.” When my class would sing at assemblies, I would get side glances and subtle and not so subtle clues that I should be at the edges and sing quietly. I played the viola from second to ninth grade. I had fun in orchestra class. For the rehearsals, I ...

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I sat knee-to-knee with a nurse practitioner at a school-based clinic in rural Ohio. Choking back tears, she described a patient she couldn’t get out of her head: a middle-school girl, accompanied by her mother and a social worker. Just days prior, the girl was dropped off at her father’s home for the weekend. Before the promised Friday night football game, she discovered him unconscious on the bathroom floor. Within ...

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There is no doubt about it, I am my mother’s son.   What would you expect? My father died when I was eight years old.  During my formative years, I was brought up solely by my mother.  I believe this is a unique lens in which to see both life and financial independence.  As the years pass, I feel lucky.  The importance of female role models cannot be ...

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