Words are powerful. So few symbols can evoke such deep feelings and rouse incredible emotion: "I have a dream." Language is the achievement that makes us who we are. But while you, I and everyone else employ the same words to communicate shared ideas, what those words mean precisely to each of us — among the many views and opinions that make us unique individuals — can be very different. I ...

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Burnout is a myth. Dedicated clinicians, working under circumstances that connect their skills and compassion with opportunities to impact patients, won’t experience burnout any more often than they might by doing other jobs. The story we tell -- the one that dissatisfaction is this system’s inevitable byproduct -- perpetuates more harm than we know. This is what I’d like to believe. I’d like to write about the many opportunities to do ...

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More than two-thirds of Americans use social media, and 90 percent of adults in the U.S. have a cell phone. With these tools surrounding us, we must be more connected with one another than ever before. Right? It doesn’t feel like we are. At least, the people who engage with the health care system don’t feel connected to the rest of us. They feel lonely. It feels like we send them ...

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In health care, we enjoy a unique opportunity to create special relationships with our work. Few enter these professions for practical reasons, and fewer still survive rigorous training without genuine belief in what they might accomplish. And cliched though they may be, the many mission statements which purport the "art of caring" do convey something real. But to even for the naïve, spending enough time around health care produces a certain ...

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Less than one year ago, on an early fall evening in Las Vegas, 59 people were killed at the outdoor Harvest music festival. A single shooter injured hundreds more, using firearms purchased through lawful channels. There have been many mass shootings in our country, before and since, and in 2015, deaths from gun violence eclipsed for the first time deaths from motor vehicle accidents. Not long after Las Vegas, discussion emerged in ...

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Medical care and understanding have changed since separation of physical and mental health made much sense. We know now that mental state and internal physiology influence one another and that social factors affect disease risk more powerfully than genetic ones. Still, as a health care system, we perpetuate a culture of division, and limit our capacity to help people because of our inability to categorize them neatly. There are so many with unmet mental health ...

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It’s a health care buzzword for sure, but when we talk about quality, what do we mean? We can compare the quality of similar things and focus on its absence, but otherwise, putting the idea into words becomes complicated. Context is important. And so is perspective: One’s position within the health care system influences how he defines quality to a larger degree than it does at a restaurant, or in ...

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I took a great continuing education course recently, and had an opportunity to review some useful skills and fascinating cases. Because health care knowledge areas expand more quickly than most and keeping current is an integral part of doing these jobs well, it was easily worth the time. The cost seemed unreasonable, but I was only superficially interested in that anyway; like most, I'm fortunate that my employer offers a generous ...

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In hospitals today, administrators are eager to impose guidelines and metrics onto any facet of patient care they can measure. The sentiment that business people and clinical people are at odds flares with each new initiative. Clinicians feel ignored. Patients complain about how little attention they receive. Administrators try to distill complex pieces of information into smooth line items. We all spend as much time with computers as we do ...

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Helping our patients make better health decisions can be a challenge. Whether we aim to get them out of bed in the hospital or off of the couch at home, factors contributing to follow-through may be complicated, and the best strategies to facilitate the right choices are seldom clear. As providers, we would hope that a long and healthy life would serve as the most powerful incentive for behavior change, but ...

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