Many years ago, on a busy day in my obstetrics and gynecology office, one of my partner's patients came in for "bleeding, early pregnancy." Since my partner wasn't in that day, I saw the woman, whose name was Sarah. After we'd talked a bit, I examined her and did an ultrasound. As I'd expected, she was having a miscarriage. Feeling sorry that Sarah had to hear it from me, rather ...

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Since the birth of our nation, labor unions have existed in one form or another in the United States. Unions are a force to protect the "working population" from inequality, gaps in wages and a political system failing to represent specific industry groups. Historically, unions organize skilled workers in a specific corporation, such as a railroad or production plant. However, unions can organize numerous workers within a particular industry. Known ...

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Five years ago today I was at a memorial. Another suicide. Our third doctor in 18 months. Everyone kept whispering, “Why?” I was determined to find out. So I started counting dead doctors. I left the service with a list of 10. Now I have 547. Immediately, I began writing and speaking about suicide. So many distressed doctors (and med students) wrote and phoned ...

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It’s every emergency resident’s dream to be part of a big procedure: The rush of a heart-pounding, adrenaline-filled moment of slamming in a chest tube, "criching" someone or being part of the big show — a thoracotomy. The holy grail. Cracking a chest, performing intracardiac massage, cross-clamping the aorta. A last-ditch effort to pull a patient away from the clutches of the grim reaper. A typical level-one center hums to ...

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There are a couple of times a year when there are no house staff to be found anywhere in the hospital or the outpatient practices. These include the holiday and end-of-year parties, resident retreats, and the annual house staff picnic. The house staff picnic is a particular favorite among the interns and residents, a full day away from the hospital, dressed like civilians, fun in the sun, barbecue, softball with their ...

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They come in all shapes and sizes. They are health care customers. The conveyor belt works relentlessly, and takes them to caring providers eagerly waiting for them. What is on the menu? Healing, understanding, human touch, reassurance, medical advice. All of that in a time efficient manner, in accordance with the sacred laws of productivity. It’s a miracle how top-notch care and productivity are ...

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The prevalence of burnout among physicians is estimated to be more than 50 percent and has grown in recent years. This alarming trend is largely due to changing patient demographics, increasing cost constraints, new federal and state regulations, and other external factors that have reshaped the daily work experience of physicians. Too often today, physicians spend more time on data entry than in direct patient care. Professional burnout, ...

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Empathy is a cryptic term. Those in the health care profession can certainly spout off a variety of phrases and metaphors that are typically used to describe the concept of empathy in the educational setting. Throughout my medical education thus far it has been described as “putting yourself in another’s shoes” or “sharing in another’s emotion.” We are also taught early on what empathy is not. Empathy is not feeling sorry ...

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I was a chubby kid, but my parents still introduced me to lots of sports. Soccer, swimming, tennis, basketball; so many sports, when all I wanted to do was read and eat Doritos.  I wasn’t particularly good at any of them, but some of my teams were better than good. We were champs. My swim team won the Cape Cod Summer League, my soccer team won its division one year, ...

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I walked into the ICU amidst a chaos of harried residents, chirping alarms, and the whir of the portable X-ray machine. Aromas ranging from old coffee down to vomit and stool mixed together in the usual fashion. In other words, it was a typical morning. I watched as my team gathered into a semicircle around me outside the first patient’s room and I got into my morning rounds stance: leaned ...

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The diversity of patients seen in any oncologist’s clinic is a microcosm of what makes America so unique. From one room to the next, I am amazed by the various ethnicities, economic backgrounds, and religious faiths that I encounter. Each of these patients forms a composite of beliefs regarding their cancer; just as every tumor we treat is different, so is every patient. This diversity is what makes generalizations in ...

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The statistics are staggering. The high maternal mortality rate in the U.S. has been a matter of great interest and debate, spurring a reflective look into our health care system to determine why our country is on the wrong end of this statistic. The reasons and numbers vary across the country and notably in the state of Maryland, which has had a higher than average maternal mortality rate, the number of ...

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"She doesn’t look like a person with an addiction problem to me," replied the physician to the psychiatrist, referring to a patient who was admitted to the hospital for confusion. She was found at home amidst an array of bottles containing various controlled substances, and a toxicology screen positive for cannabis. She was in a higher socioeconomic bracket having retired from a professional job. The psychiatrist explained that addiction crosses ...

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Brooklyn, New York, Spring of 1992. As I looked out of the New York City taxi window on Avenue T, I saw the building. It had always appeared to me as the most magnificent building I had ever seen that housed people in need of rehabilitative care. I was happy; I was ready, I was in great spirit. “Let’s do this!,” I thought to myself as I stepped out of ...

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It’s no secret that the United States is in the midst of an opiate epidemic. Almost 60,000 people died last year from overdoses, and overdose deaths are now the most common killer of Americans under the age of 50. Physicians and our patients have finally started the difficult conversation about what it will take to stop the suffering. But what’s been missing from this conversation is that this is not ...

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“Aren’t you cute,” he said as he smiled and squeezed her cheeks. On the start of a new rotation, a medical student walked into clinic and introduced herself to the attending physician. With all of the news surrounding the Weinstein debacle, Alyssa Milano has urged women to share their stories of sexual harassment or abuse using the words “me too.” What has transpired is that a whole community of women from ...

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“How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving and tolerant of the weak and strong. Because someday in your life you will have been all of these.” —George Washington Carver Earlier this week, I walked into the exam room and introduced myself to a 48-year-old male.  As I generally do, I sat in front of him and asked, ...

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When I became a caregiver to my dad, I quickly realized that I was not going to be able to keep all of his medical information in my head. My smartphone became my second brain. It helped me to track his symptoms, keep up with the dates for his appointments, document recommendations, and share this information with my sisters in a timely and coherent manner. Here, I share five ways ...

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It’s something that’s not taught anywhere near enough as it should be in medical school, but every practicing physician quickly realizes that communication is everything in health care. It’s the foundation of the doctor-patient relationship, and what patients will judge you on. Sure, doctors are among the busiest professionals out there. We do an incredibly hectic job. But it’s so imperative to remember the importance of that interaction with your ...

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In theory, of course, it’s a great idea for people to give their opinions and rate their experiences with any goods or services they buy. The notion goes back long before the Internet with publications like Consumer Reports, which is now itself online. Sites such as Angie’s List are very popular and can give you testimonials about providers of everything from home renovations to car repair to daycare. So it’s not surprising several ...

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