I enjoy talking to random people about their experiences with health care. As somebody who regularly travels all over the country, for both work and pleasure (I far prefer the latter), whenever I meet people in situations where you end up talking -- be it on airplanes, a guided city tour, or at a social function -- as soon as I say I’m a physician, the conversation invariably ends up ...

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I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the ...

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The health care experience is so much more than a buzzword to be talked about in administrative circles. Some physicians I encounter (a minority, but still enough) really scoff when they hear this term. Responses I’ve heard from doctors include: “Hospitals are not hotels!” or “If that means giving our patients as much Dilaudid as they want, then count me out!” Aside from these sweeping statements being entirely silly, they are ...

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Shock. Horror. Did you just read the title correctly, or are you seeing things? Well, after you recover from the shock of reading a line you probably never thought you could possibly see in writing -- let me tell you this: Physicians and politicians are probably as opposite as you can imagine in terms of their daily work life, guiding principles, and yes, level of respect shown to them by ...

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On November 6th voters in Massachusetts are facing a very important health care-related question. In addition to voting for political parties in the midterms, they also face three ballot questions. The first of these is whether there should be mandatory state enforced nurse-to-patient ratios. For a general medical or surgical floor, this will be no more than four patients for every registered nurse. For other types of adult floors and the ...

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The discharge process has now been recognized as one of the most crucial points at which the actions of doctors and hospitals can have a huge impact on immediate health outcomes for our patients. At a time when 30-day readmission rates are still touching almost 20 percent for Medicare patients (higher for certain patients, with up to a third of these occurring in the first 7 days), there is an ...

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A physician recently recalled to me a situation he found himself in on the last National Doctors’ Day. Those of you reading who work in health care, will already be aware that this is on March 30th every year. I have seen this day celebrated in every hospital I’ve worked in since I first came to the United States over a decade ago. I actually think it’s a nice gesture, and ...

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A few weeks ago, I was giving a day-long seminar in California on improving communication skills, optimizing the patient experience, and how this is all ultimately linked to better proven outcomes. Part of the day involved doing role plays, playing the part of doctors and patients in various difficult hypothetical scenarios. My experience of this type of group exercise is that all clinicians usually really enjoy it, when it’s done in ...

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Physicians everywhere are having to deal with ever-shrinking time slots with their patients. Every doctor (or nurse) would love to have more time if possible, and it’s probably one the biggest frontline frustrations for any clinician who wants to do a good job. Time to go over the history in more detail, examine the patient thoroughly, and then spend adequate time discussing everything afterwards. Wouldn’t that be nice? The reality though ...

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When I’m working in a hospital setting as a physician, part of my everyday job duties involves going over consent forms with patients. I am of course a medical physician, rather than a surgeon, so generally don’t have to go over them as often. But I do have to take consent regularly for certain interventions including blood transfusions and minor procedures. The process of getting consent is something everybody is ...

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