by Shawn Vuong Recently, our class learned and practiced how to correctly 'scrub' for surgery. During this little lab activity, we were all gowned up and washing our hands when a couple of classmates asked if I was going to be a surgeon. I said I didn't really know yet, although I did find surgery pretty fascinating. With that, they told me that they thought I would make a good surgeon. due ...

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The following op-ed was published on July 18th, 2010 in USA Today. A new patient recently said he was referred to me after his last doctor had left medicine. His old doctor always looked unhappy and burned out, he noted. Burnout affects more than half of doctors, according to researchers at the University of Rochester School of Medicine. Beyond mere job dissatisfaction, these doctors are emotionally exhausted to the point ...

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by Robert Graham, MD As the nation works to reinvigorate primary care, a lot is riding on the medical home. Some see it as an answer to a fragmented health care system that is not responsive to patients’ needs for coordinated, comprehensive care. Others have invested in it as a vehicle to improve both the quality of care and control costs. While we work to address ...

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Dr. Marcus Conant, among the first AIDS specialists in San Francisco, who for decades had one of the world’s largest private practices for patients with AIDS and HIV, has left town and moved to Manhattan. He has been a physician for nearly 50 years, but like many doctors, in the past decade he has become increasingly frustrated with insurance challenges that made running a private practice unnecessarily complicated and a financial ...

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Eating right, exercising, avoiding the sun or using sunscreen, moderating alcohol consumption, abstaining from tobacco use, getting mammograms, Pap smears, colonoscopies—almost every measure we’re asked to take to safeguard our future health is difficult.  It’s a strange paradox that we have to work in some way, to expend energy, and experience discomfort of some kind in order to gain benefit in life. Wouldn’t it be nice if the most pleasurable things ...

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Medicine is a very old profession. Ancient and honorable. Sadly, for the vast majority of recorded history, honor was pretty much all it had. The Hippocratean ideals of “first do no harm” and putting the patient first and all held special importance when medicine truly had nothing to offer. Make no mistake: up until the last two centuries, the vast majority of what passed as ...

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Recently, I had a discussion with a prominent academic family physician.  I had last seen him 37 years ago when he was getting ready to graduate from medical school and I was a new medical student. We had a wonderful discussion and agreed to disagree about merging primary care.   Long time readers know that I dislike the term for the tasks that outpatient internists do.  Most of the push for merger ...

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Did you know that international medical graduates account for 30% of primary care doctors in the United States? And with American medical graduates continuing to shy away from the field, that number will undoubtedly go up. But that's not necessarily a bad thing. Recent news stories, like Pauline Chen's New York Times column, have focused on a landmark study comparing patient outcomes of doctors educated in the United States versus those ...

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Not long ago, we interviewed a physician for possible partnership in our practice. After showing him around our town, some of us partners had dinner with him to discuss business. He was a quite pleasant fellow, well trained, and seemed to be a good ‘fit’ for our practice. As dessert was being served, he said he needed to get one more thing off his chest: he prays aloud in the ...

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Abraham Verghese is a professor of medicine at Stanford University, and one of the most articulate physician-writers today. He recently wrote an op-ed highlighting primary care's plight, and focuses on the scarcity of time:

The science of medicine has never been more potent - incredible advances and great benefits realized in the treatment of individual diseases - yet the public perception of us physicians is often one of a harried individual more ...

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