One of the most important tricks of the trade that I learned in medical school was what some might have considered a little throwaway bit of advice. During my psychiatry clinical rotation the preceptor advised that, when applying the stethoscope to the patient’s back, one should rest the other hand gently on his or her shoulder. Human touch was important. It would relax the patient and convey subconsciously a sense of ...

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It’s been a while since my last rant about electronic health records (EHRs), so let’s remedy that right now. EHRs in their current iteration are -- how to put this delicately? -- an unmitigated disaster. Nevertheless, much of the criticism of EHRs, including mine, has been in the destructive category. What about some constructive criticism? How could EHR software be made better? I am not ...

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There are few jobs more chaotic than that of physician, at least based on my own experience. Yes there is a schedule of sorts: hospital rounds, procedures, office patients. Unfortunately things rarely go as planned. There is a particularly sick patient on rounds who needs a temporary pacing wire placed. There are more consults than expected. The procedure that was planned to take up to 2 hours takes 4 hours because of ...

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To paraphrase General MacArthur, old doctors never retire, they just fade away. Despite having greater than average financial resources and more burdensome than average work load, many doctors seem to have a hard time knowing when it is time to call it quits. I know doctors who continue to practice into their 70s and 80s. Some continue to work until the day they die. Why is this? I think that some ...

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shutterstock_1634374 Taking call is the worst thing about being a doctor. There, I said it. But wait! What about medical malpractice lawsuits? What about dealing with patients’ suffering or dying either from their illness, or far worse, relating to decisions you made or procedures your performed? Certainly these are far worse events than being on call. Granted. However, these awful events are part of ...

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