Both in and outside of health care certain buzz words and phrases become so ubiquitously used that a shared understanding is assumed despite conflicting perceptions of what these sentiments actually mean. Examples in health care include: shared decision making, quality of life, professionalism, patient-centered care, and evidence-based. Each sounds positive and intuitive — what health care provider perceives her/himself as not professional and patient-centered or not providing shared, evidence-based, quality ...

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Both patients and providers realize that an internist is different from a surgeon, but specifically how they differ and how this affects their approaches to patient care is largely under-appreciated. Over the last four years, I have conducted over 250 interviews with physicians across specialties and institutions about what they do and why they do what they do. With each project, I continue finding remarkably distinct, specialty-specific values, perceptions, and ...

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Many recent articles, blogs, and presentations have focused on what American health care lacks and what additional skills health care professionals should adopt to “fix” our “broken” system. Third-party payers and health care organizations tend to promote the need for quality improvement and economic measures, while clinicians grapple with their transition to less-autonomous employees, noting increased job dissatisfaction and conflicts regarding administration and reimbursements. The theme that American health care ...

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Last August I sat surrounded by 163 other ambitious, new medical students on our “introduction to the profession” week. Anxiety was high with undertones of self-doubt mixed with lofty goals. Another distinguished figure had taken the floor to introduce us to the concept of medical professionalism: commitments to patient-centered care, intellectual honesty, social responsibility and advocacy. The long list of medical virtues we were to develop, cherish, and exemplify in ...

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“You will have 15 minutes to take a full medical history,” the moderator says in a plain, mechanical voice. We stand at our assigned exam room doors ready to embark on a mission that will be recorded, reviewed, and graded as part of an OSCE (objective structured clinical examination). “You may begin!” I knock, enter, and make a b-line to the soap dispenser -- check. I take the history in record time ...

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Over the last couple months, I have often been asked what I plan to do as a recent college graduate. My response has been that I will be attending medical school in Chicago. “Oh! Medical school!” many exclaim as their eyes light up, “So you’re going to be a rich doctor.” This response as well as most others I have received seemed to imply that medicine is an ideal profession if one ...

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