Change and health care are closely interconnected. Health care organizations are continually faced with the need to adapt to change, whether it be advances in medical care or technology, growing demand for care delivery, a patient population that is increasingly active and involved in their own health and well-being, or evolving reimbursement and cost models. By recognizing that change is inevitable in the health care sphere, organizations can focus on ...

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The two-page letter of complaint was typed on crested letterhead. The words "utter disappointment" jumped off the page, bold-faced and caps-locked. "The doctors left me to bleed," she wrote, banging on the exclamation key as if she was firing lasers in a game of Space Invaders. "I was hemorrhaging, and they did nothing except pop in and tell me it would stop." The tirade was directed toward me and the ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. I love to see the pure joy that floods over mothers as they hear their new baby’s first cry!  The ability to help make childbirth safer for mothers and babies led me to a career in obstetric anesthesiology -- in the high-risk, high-reward ...

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I was recently asked what I thought was the number one problem that caused unhappiness in America. We are one of the most prosperous nations in history. You might think that with all that prosperity and wealth, Americans would be happy. Obviously, wealth does not equal happiness. Many would argue that since America has a lot of poor people, it can’t be considered a wealthy nation. But our poor are still ...

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The “Great Man Theory” of history was popularized by the Scottish author Thomas Carlyle in the mid-19th century. In his 1840 “Lectures on Heroes,” he famously wrote: “The history of the world is the biography of great men.” Carlyle claimed that history was made by “great men” possessing personal courage, vision, charisma and political or military genius. Our more egalitarian age has favored mass movements, social forces and “great ideas” ...

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Hello, premeds! There’s so much advice out there from so many sources. Your aunt, cousin, and grandpa think they know what to do to be successful in your pursuit of medicine. All of your friends are experts -- and why aren’t you a doctor already? I know, I know … This time in life is hard. You are comparing yourself, and you are hearing so many messages. So, I’ll make it simple. Here are ...

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Artificial intelligence, or AI, is a term that is often associated with robots or computers that “learn” by having material introduced to them. Different people have different reactions to the idea of AI, especially with its potential use in medicine. AI can perform many tasks at the same time and in the same way producing results that will always be precise, but not necessarily accurate. This is relevant to fields ...

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Do you ever feel like time is always slipping away? Do you feel like you hardly get time to enjoy the things you love? For example, do you feel like you get enough time in your day to spend with your kids? If your answer is “no,” welcome to the club. You are not alone! I am a physician mom of young kids who used to feel like I never ...

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asco-logoI’ve written in the past about how words are powerful — that they can have multiple meanings, how they can change depending on context. I am often reminded of how true that is in everyday oncology practice, especially when it comes to meeting new patients. Some are diagnosed with cancers that carry a relatively good prognosis, ...

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I say that financial independence is bittersweet and you look at me with your jaw slack, your eyes questioning.  You scan to the top of my blog, and you see the words “personal finance,” and you’re wondering if I’ve gone slightly daffy. But then I point to my byline, personal finance with a twist, and continue on my belligerent rant.  I have said before that money is ...

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We are living in times of extreme political polarization in the United States. In fact, it’s a trend sweeping the Western world right now. I’ve always considered myself somewhat middle-of-the-road, and I vote much more for the candidate than the political party. Of course, I have my own strong views on certain issues, but I’m probably the type of swing voter that parties want to target because admittedly my voting ...

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May lay in a hospital bed, her wrinkled skin covered with sensors that monitored her every breath and heartbeat. Her husband sat at her bedside gently stroking her withering gray hair as her chest moved slowly up and down accompanied by the soft whoosh-whoosh of the ventilator that breathed for her. He stared expectantly at her face as if at any moment she would rise and free herself from the multiple ...

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Whether to circumcise a newborn male child is not the simple, binary “yes/no” question it appears to be. Rather, the choice is affected by an astonishing array of issues: religion, culture, health and hygiene, sexually transmitted infections, expense, pain and medical recommendations. Some cite ethical concerns regarding usurpation of a child’s free choice. Others claim an equivalency between neonatal male circumcision and the practice of female genital mutilation. As a practicing ...

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Proponents of universal health care believe that health care is a universal human right, but is it a constitutionally-protected right, and if so, how does the U.S. Constitution compel the government to protect that right? We can make the argument that the right to health care is indeed protected under the Ninth Amendment, which states, “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage ...

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We had no choice in becoming the “crazy” family that left a hospital against medical advice. Our four-day-old daughter was completely helpless, her condition deteriorating and the staff was ignoring our concerns. I carefully turned off the blue lights, removed her from the isolette, placed her in a car seat and eloped from the pediatrics unit. As a hospitalist, I constantly obsess over medical errors. The majority are more subtle than ...

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A few months ago a nurse I know vented her frustration at a misperception she had received several times, unfortunately. She recalled a conversation in which someone had asked her in a condescending manner if she does anything else at work besides “handing out pills.” I became visibly irritated at this, not only was this person purposely making disrespectful comments to bring her down but was also perpetuating her own biased ...

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Multiple strokes, respiratory failure. Cardiac arrest — twice. At first glance, I thought that I was reading the medical chart of an elderly person or at least one who had some other predisposing medical conditions to explain her current state. But I was staring at the body of a 28-year-old woman. She had a youthful face and frizzy hair from being propped up on the same static-charged pillow for the last few ...

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I was a foreign medical graduate who in addition to some clinical practice, had begun a career first in managed care as a utilization management coordinator and then as a clinical researcher after finishing medical school and then pursuing a public health degree. A few years ago, life took some unexpected turns, and I found myself in a rather new field of health care known as clinical documentation improvement (CDI). I ...

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I am a resident in a fancy hospital in New York. We focus a lot on value-based care, and technological innovations, and high reliability. This year, we are opening a multimillion-dollar new facility for specialty medical services. Our outdoor spaces have stone lions and grassy promenades. Our cafe serves world-class food. Today, during a beautiful new spring morning, I watched my colleagues sit, in disbelief and despair, crying with each other ...

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I’m an ED physician, so I’m used to patients screaming at me — sometimes with earsplitting demands for heavy-duty painkillers, morphine drips and similar remedies that will numb or “fix” them. I can deal with this. What I can’t deal with is a health system that incentivizes physicians like me to medicate adult patients, especially those at high risk for substance abuse, with little thought given to their long-term wellbeing. As ...

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