I had a great case the other night. Around midnight on a Friday, the hospitalist physician called me to evaluate an incarcerated femoral hernia. I thought this elderly and medically ill patient would likely die no matter what I did. I spent a grim half-hour at bedside explaining the dilemma to the patient and her family. She needed surgery, but surgery would probably kill her. The patient chose surgery. And she ...

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What do our patients really want from us? When a patient calls up to schedule an appointment, or sends us a message through the patient portal, or calls our front desk staff to leave a message, what is it that they're looking for? I think, more than anything else, our patients are looking to us as health care providers to be able to be there for them, to address their health needs ...

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Burnout and dealing with its symptoms has become a hot topic in the last decade. It’s a problem that has multiple contributing factors. Some of those factors are thrust upon us and are beyond our control, such as government regulations. Other factors are self-imposed, and thus under our control, such as volunteering for extra call shifts. One self-imposed factor is a little thing we use to improve our lives, our ...

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Among the many recurring topics, this year has been the impact of machine learning in our lives, especially the implications for our future work life. Prophecies range from ubiquitous utopian machine servants to a dystopian ravaging, hollowing out the work and economic standing of the middle and lower classes. “What can machine learning do? Workforce implications” by Erik Brynjolfsson and Tom Mitchell in Science provides some perspective on machine learning ...

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I came across Dr. Kevin Tolliver’s post, "Beware the Limits of Telemedicine," and found it to gloss over the benefits of telemedicine and the opportunities that increasing telemedicine uptake can afford to the patient and provider. With this post, I aim to show that these opportunities for systemic change to the health care delivery model – particularly driven by telemedicine – surpass the listed limitations of telemedicine. The ...

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Recently, several high-profile institutions have called attention to the issue of inclusion and equity when artificial intelligence (AI) algorithms are applied in medicine. Leaders from the law, medicine, social sciences and computer sciences are speaking out about the challenges of using smart algorithms to solve social problems. While this topic might easily be dismissed as anti-progress by the tech community, it ...

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The Kaiser Health News article, "Spurred By Convenience, Millennials Often Spurn The ‘Family Doctor’ Model," caught my eye. Millennial patients want “convenience, fast service, connectivity, and price transparency” while doctors and health experts worry about “fragmented or unnecessary care, including the misuse of antibiotics” and loss of  “care that is coordinated and longitudinal.” It’s as if the needs of the patients and the concerns of doctors are ...

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We have a new electronic medical health record system at our hospital. It was introduced with what I believe is a short and ineffective training program for physicians followed by a far too short on-location use of experts to help the doctors and nurses learn the new system. It is frankly a pain in the neck to access the computer from outside the hospital due to the multiple layers of ...

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To paraphrase Bill Gates: "The purpose of humanity is not just to sit behind a counter and do things. More free time is not a terrible thing." I have innovated. I developed a mutation assay. I discovered that vacuum ultraviolet light from excimer lasers is safe to use on human tissue. I invented an imaging device to detect burn wound depth and discovered the best laser to debride burn wounds. I ...

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I mused while staring blankly towards the electronic tracking board, where I foresee reading the triage call "My tracker said, I have AFib." I delved into what is in my armamentarium to handle this crisis of the digital age. The stethoscope around my neck suddenly seemed archaic. We the physicians have resigned to the redundant clicks on the electronic medical records (EMR). While still recovering from this inescapable occupational hazard of ...

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