As a physician, I was inspired by the Lesley Alderman article –"The Doctor Will See You ... Eventually" – that appeared in the New York Times recently. There is a great deal of emotion in this country surrounding the debate over waiting-room delays in physicians’ offices. Doctors feel as though they are being unjustly blamed for making patients wait when physicians are now forced to see more patients in less time, and ...

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Picture this: A medical journal receives an unsolicited manuscript from an unknown author, and then ... Type 1 medical journal. The peer review process employed by Type 1 medical journals uses secret, anonymous peer reviewers working behind an opaque shield hiding clueless and spineless editors who may use either no reviewers, or a few cronies, or those reviewers known to be opposed or known to be in favor of some ...

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Some hospitalists are in denial.  Some hospitalists have become methodologic critics.  But all hospitalists should take the findings of the recent Annals of Internal Medicine article seriously.  We should not argue about the article, but rather ask whether these findings point out a weak point in our care of patients. This article provides an opportunity, not a scolding:

In an accompanying editorial, two other researchers from the VA Medical Center in ...

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It may sound obvious. But many years working in and with hospitals has taught me that many health care providers, although they want to treat their patients in a culturally and spiritually sensitive manner, often don’t know how. It seems that every day as our country becomes increasingly diverse, health care clinicians are confronted with someone from a cultural or ethnic group they have never encountered before. At the same ...

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What do you regret about your medical training or specialty selection? Anything? One thing I regret is not taking advantage of the Masters degree in Health Administration program at my medical school. At the time, I was focused solely on medicine and on being a doctor. I didn’t think the business side of medicine was all that important. In fact, I didn’t consider the business side of medicine at all. I regret ...

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"I'm sorry." I said that phrase a lot last night during evening patient hours. With an overfilled schedule, I mostly said it to patients who waited twenty, thirty, even forty-five minutes for me to see them.  "I'm sorry for your wait.  I appreciate your patience."  I say these sentences far more often than I should. Why is it so difficult to stay on time? I could blame my inadequate supply of nursing staff; ...

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I’ve heard patients say, “How could she smoke and she’s a doctor?” Alarmed and bewildered by the fact that an agent of health could partake in one of the most harmful acts of bodily destruction. In medical school, a sizable number of my classmates smoked and I always found it so counter-intuitive, mind-boggling that they would be learning about smoker’s lung in pathology and on class breaks would huddled outside ...

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I was working in the bone marrow transplant clinic of an internationally known cancer center.  When I looked into the patient’s faces,  I saw hope as they were being worked up for a possible transplant. I went into see a new patient.  She had leukemia and had relapsed after her remission.  Her sister would be the donor. Gretchen, age 19 came in with her mom for the appointment.  She was tall, youthful ...

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"My grandson has HDHD." This was intriguing. I had just asked her one of my standard psychiatric interview questions about family history of mental illness. Maybe I hadn’t heard right, but it sounded like she was telling me about a new flat screen. Had her grandson just bought a fifty-two inch LED set in time to watch the Final Four this weekend? Had he mounted it on the wall on ...

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Someone has gone and rained the facts down on what is generally considered a feel–good story in American medicine, the dramatic increase in female doctors in America. In response to Dr. Herbert Parde’s "The Coming Doctor Shortage" article in the Wall Street Journal, Dr. Curtis Markel pointed out that there is a difference between the raw, gross number of physicians in America, and the effective number of practicing physicians.  Not only ...

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