Spring cleaning is a tradition in many homes. The occupants open up the home to the spring air, thoroughly clean the home, and sort through the accumulated goods, getting rid of things not used for a long time and which no one wants anymore. It gives one a sense of accomplishment, makes for a more pleasant surrounding and frees up space. Is this something that you do at your healthcare site ...

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I believe in the peak oil theory. Think about it, in a closed system nothing is infinite. Since oil is a product of millions of years of decay, unless we use it at the same rate that is it produced, we will run out. I do not have a crystal ball any more than anyone else I know, so I will not hang my hat on when, but will commit to ...

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People like us, who believe in physics, know that the distinction between past, present, and future is only a stubbornly persistent illusion. - Albert Einstein The surgical case is delayed for ten minutes and I am getting restless. I anticipate a very difficult dissection. The cancer has returned after extensive prior treatment with surgery, chemotherapy and radiation. I have enlisted additional help to make certain that everything goes as smoothly as possible. ...

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There is an aspect of professional sports that I greatly admire. This transcends the athleticism and skill of the athletes, the work ethic, coaching expertise, teamwork and the thrill of the game. This is one of the only institutions that is a pure meritocracy. The philosophy is simple and not blurred by arguments for diversity or massaging the qualifications for admission to serve another agenda. Coaches, managers and owners want ...

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by Emily P. Walker If a Martian visited Earth and wandered into a primary care physician's office, he'd marvel at how inefficiently the average doctor spends his or her time. The Martian might wonder why the primary care doctors sees 20 or 30 patients a day when many of the consultations could be done over the phone, which would make things easier for both doctor and patients. At least, that's what Larry Casalino, ...

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Physician rating sites have caused some consternation among doctors. I wrote about it last year, pointing to a Slate piece which demonstrated their lack of rigor and reliability. Besides, there was a suspicion that doctors' negative reviews are overblown, and could be easily outweighed by a physician encouraging patients to post positive ones. Now, there's some ...

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Those who hate hospitalists believe that students and residents are choosing hospital medicine over primary care so hospitalists are to be blamed for the primary care shortage. They also believe that the rise of hospital medicine has made primary care less attractive. Then, there is the salient argument that care transitions are more inherent and vulnerable due to hospitalists. Of course this hatred is not new. As a ...

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Locking the entrance to the emergency room: there could not have been a more potent image to the final day of St. Vincent’s Hospital in New York City. After 160 years, St. Vincent’s closed because of financial problems. It was the only hospital serving Greenwich Village and the last Catholic hospital in Manhattan. The closing of a hospital can feel like a death in the family. A hospital is a stalwart member ...

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Much has been recently made about the bureaucratic obstacles that primary care doctors face. With good reason. The impetus was a recent New England Journal of Medicine paper from Richard J. Baron that I mentioned recently. The New York Times' Pauline Chen interviewed Dr. Baron, who shared some interesting insights on what needs to be done. He contrasts the inertia in primary care to drug manufacturing. If you took ...

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by Emily P. Walker I was covering an FDA tobacco meeting a while back when I heard a Howard Koh, MD, assistant secretary of health at the Department of Health and Human Services (HHS) start his speech with the World Health Organization's definition of health. "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." That ...

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