One of my colleagues sat on a wheeled clinic stool at the end of the examination table and told the patient, which was in this case an actor, “Everything looks great.” After, he swiveled around to face the instructor and the small group of onlooking medical students behind him. Our instructor also turned to us and said, “Very good job. But can anyone tell me what he did wrong?” He ...

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There are 168 hours in a week and 8,736 hours in a year. There are 10,080 minutes in a week, and 524,160 minutes in a year. Residents and fellows working in an academic environment often work close to, if not in large part, more than 80 hours a week, or 4,160 hours a year. They work 4,800 minutes a week, and a staggering 249,600 minutes a year. In medicine, it’s ...

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I came across a letter I wrote to a patient while rummaging through some old files on my computer. I flashbacked to what triggered this: a response to a letter she had sent me, one that was, shall we say, extremely unflattering and quite scathing in the way she described me and our last encounter. From the letter’s tone, I sensed she held back on using more profane language to ...

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As medical professionals we often see people at their worst: battered and broken, bothered and in pain, no make-up, bad hair day, naked and too ill to even care about modesty. At those critical moments, in our patients' hour of desperation, they hand over their lives to us … and the lives of their family. All that they are -- they willingly place at our mercy. At times, burnout, and ...

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My father, recently retired, spent over 40 years in private practice. After dinner, he would sift through piles of paper charts and call patients with their lab results. As a grade schooler, what impressed me the most was that he knew many of his patient’s phone numbers by heart. Of course, this was in the days before HIPAA and caller ID, so scattered charts on the dining table and calling ...

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Noticing. If you think about it, that's really a lot of what we do a lot of the time. As clinicians, we are trained as observers to notice, to use our eyes, our ears, our hands. To notice. We notice that our patients seem different today. More tired. A little pale. Notice a change in their gait. Notice they are in pain. We notice swelling in their legs, a new heart murmur, a ...

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An excerpt from The Choice: Medicine vs. Nursing. An extensive amount of data now exists in the science of choice.  Social researchers such as David Kahneman and Dan Ariely have conducted numerous experiments which suggest a number of ways in which humans are led ...

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How do I balance my home life with physician life? I really want to do a research study. How do I start? How do I get involved in my specialties society? I am overwhelmed with clinical duties. How do I negotiate for nonclinical time? My manuscript was rejected. What should I do next? I had a bad clinical outcome, and I can’t seem to recover. How do I move forward? Joining this committee will be a ...

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That statement from a recent patient was a summary to me of what is bad in our health care “system.”  It’s a terrible summary of what is seen all over this country with people who must make the choice between financial solvency and health. Here’s what happened:  It was a new patient I saw, who is a veteran who owns two businesses.  He went out on his own when he “kept ...

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Written by George Kamajian as told by Bob Fedor. I'm an old family doctor. I've seen much and forgot more. Life has taught me that we touch our patients’ lives for a moment, a season or a reason — and sometimes with unforeseen consequences. I grew up in Erie, Pennsylvania. In 1968, when I was 19, the Tet Offensive in Vietnam caught the American military off-guard, and the Pentagon began frantically drafting ...

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