178 measures. This is what we're up to -- the collected compilation of quality and performance metrics for our ambulatory care network, across all the different divisions. Where did these come from, who decided this is what we should measure, does anyone really have any idea if measuring these things reflects the true quality of the care our patients receive? That's a lot of questions all at once, and I'm not sure we're ...

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The committee that plans and oversees medical care for the county of Hertfordshire, England announced recently that unless obese patients lose a specified amount of weight and smokers quit smoking for at least eight weeks, they will not be allowed to undergo elective surgery. Patients with a body mass index (BMI) greater than 40 must lose 15 percent of their weight within nine months, and patients with a BMI over 30 ...

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The commentary below is meant to invoke meaningful discourse rather than incite an unpleasant argument. Less than a year ago, I heard Ben Stiller doling out kudos to his heroic doctor who diagnosed him with early-stage prostate cancer by using a simple, widespread screen. What was interesting was that Stiller was actually underage. What I mean is that the star was not of age to be screened, according to current prostate cancer ...

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A recent post about a physician using her maiden name professionally generated major controversy on a physicians’ group. Hundreds of comments later, it became evident that female physicians who chose to use their maiden names are subjected to negative judgment. I am a physician married to a supportive man who understands my choice to keep my last name. I am not unique in my circle. Most of my female physician friends ...

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According to published reports, over 50 percent of doctors are burned out. The reason? They are overwhelmed by payment and quality rules as well as poor information technology. It’s no secret that physicians spend long hours seeing patients. But as financial pressures have mounted within hospitals, doctors are forced to perform more administrative tasks. In fact, administrative tasks account for nearly ...

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I owe a lot to Robert Kiyosaki. His book, Rich Dad Poor Dad, actually helped start me on my path to financial freedom, and his other writings have all taught me very valuable lessons. While I don’t agree with everything, he says in every book, one thing that really cemented the idea of passive income in my mind was the concept of the “cash flow quadrant.” This concept is so important and ...

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There is a movement afoot. I can feel it. I can see it. Women in medicine are no longer going to tolerate the subtle and not so subtle discrimination that has stymied their career growth. They are not going to be complacent while their male colleagues are paid higher salaries, offered speaking engagements and research opportunities and promoted at a greater rate. Women in medicine are pulling together in an ...

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I often say that electronic health records (EHRs) is like Skynet in the Terminator. I expect to turn around from my screen someday, and Arnold will lift me by my throat saying, “You haff not been doing yuh meaningful use.” We practice in a time when EHR confounds us by freezing, crashing and chaining us continuously to our work, as we spend evenings and weekends on documentation. ...

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About a year ago, I did away with TV. It was an overwhelming expense with little personal utilization. I thought to myself while struggling with the decision to cut the cable, “What will I be missing?” I may no longer be "Keeping up with the Kardashians," but I do keep a regular eye on my iPhone news feed. It is an addiction many people share. That itch to grab our ...

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Recently, there was a fascinating article in the Wall Street Journal regarding robot-assisted surgery. It reported the results of two articles published in JAMA that demonstrated that robotic-assisted surgery cost more and took longer without achieving superior results to laparoscopic surgery on average. With this, my LinkedIn account lit up. Here are several of the comments that came through: “I've come to assume that robotic surgery is better ...

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I am an Olympian. I am a retired All-American student-athlete.  I am a resident.  I am burned out. Let me be clear: I love medicine and the opportunity to have privileged relationships with patients and their families.  I thrive on the fast-paced environment, growing to-do lists, and the chance to work in a field with endless learning.  I love working in team environments to provide optimal care for patients and their ...

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In order to safely plan for a successful retirement, it’s imperative to have a general idea of what your spending needs will be when retired. We cannot calculate whether or not our anticipated withdrawal rate would be considered safe (in the range of 3% to 4%) without knowing the size of the annual withdrawal. That number can be difficult to pin down, as there are many variables. It can be informative ...

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Just under half of health care workers do not get their annual flu vaccine. Some of these workers contract the flu and unknowingly transfer it to their sick hospitalized patients, and in some cases, because of them passing the flu along, those patients die.   We know the most important reason for health care workers to get vaccinated against influenza is that it is the most effective way of preventing influenza ...

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When interviewing for my book, I asked about insurance, but the topic came up even when I didn't specifically ask about it. It was never positive in relation to practice. A doctor said, "I expected to be around tough and hard cases. I expected it to be hard. I did not expect to have to think if the insurance company will not pay for it."Another one said, "This completely changes the ...

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It was nearing the end of my day at the mobile health clinic where I work as a nurse practitioner, providing free, comprehensive primary care to uninsured patients in central Florida. Clinic was officially over, and we were no longer taking patients; I was signing notes and finishing up some teaching points with a PA student when a woman walked up and asked me if she could “talk to me ...

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We often pull comparisons between unexpected resources in any given profession, especially when it comes to adopting tried and true best practices. For example, I always encourage hospital systems and training institutions to look to the hospitality industry for the treatment of patients and guests, among other areas. Last year, as I settled into my seat on a cross-country flight, I witnessed a textbook example of looking outside the box ...

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The familiarity that health care professionals develop with complex medical procedures and topics is the result of years upon years of hard work, and over time we become accustomed to the jargon. We use phrases like "lap chole" and "appy" without much thought when talking to each other and (if we have a momentary lapse) with patients. We take the fantastic array of medical specialties, procedures, and knowledge in our ...

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Most people’s monthly spending is a series of recurring payments, like rent, food, and utilities. There are also some one-time purchases that might require a few months of saving, like a nice vacation or a new suit. And then there are some things that require many months or years of savings. An engagement ring. A wedding. A new car. A down payment on a house. When saving for big purchases, how do you ...

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Technology makes this an exciting time for health care. Not only are technological advances making health care better, they’re also making it more affordable. To get a taste of the potential of where health and technology are going, you only need to look as far the recent Fortune article titled, “Prepare for a Digital Health Revolution," or to search through the more than 300,000 ...

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This summer, a controversial memo written by a Google employee was leaked to the public. Within the memo, the author James Damo, details how the biology of men produces “a higher drive in status.” Google quickly condemned the statements and fired Damo, citing their pledge to standup diversity within their company. And similarly, Denise Young Smith, Apple’s vice-president of diversity and inclusion, ...

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