Stress is one of the epidemics of modern-day living—especially work-related stress. At a basic fundamental level, it’s just simply a chemical reaction. Your adrenaline and cortisol levels shoot up in response to a stressful stimulus, the primitive “fight-or-flight” response kicks in, and your brain and emotions go into overdrive. The problem with this acute response, is that it tends to lead to illogical thinking and an inability to really find solutions. Research also confirms that having chronically elevated stress hormones is very detrimental for your long-term health and ...

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It’s no secret that America (and indeed a lot of the western world) faces an unhealthy lifestyle crisis. Shocking statistics suggest that over 70 percent of the United States population is overweight or obese (defined as a BMI over 25). The consequential health effects are well known, and don’t need further explaining. As a country and health care community, we simply cannot allow ourselves to get to a place where ...

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There’s so much negativity out there when it comes to health care, it must be a concern to any young person thinking about entering the field. I certainly spend a lot of time writing about all the challenges we face, and have to hold my hands up to (occasionally) spreading some of that negativity as well! Guilty as charged. That’s why it’s important for anyone outside of health care (or ...

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Since I last published a blog post dedicated entirely to the above graph a couple of years ago, very little has changed. In fact, I’m sure the divergence of the curves has only grown bigger, as more and more administrators are added to the ranks of health care. Quite often in life, the answers to some of the biggest questions we have, are staring us right in ...

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It’s difficult to imagine a world now without Google and the internet. It’s also strange to think that most people alive right now received the bulk of their education in the pre-internet era. I remember in the United Kingdom, where I went to medical school, Google only became a thing perhaps midway through university. Since then, of course, the internet has exploded and penetrated every facet of our lives. And ...

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Nurses are the very heart of health care. These wonderful professionals work tirelessly for the good of their patients, spending the most time with them and often being their biggest advocates and best friends during what is a frightening experience in the hospital. In my career, I’ve worked with some truly magnificent nurses, who would be an asset to any organization. Every practicing doctor has also been in situations where it’s ...

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A couple of months ago I was having a conversation with a good friend of mine, who is a doctor in England. We were talking sports, specifically tennis at Wimbledon and the superb performance of Roger Federer. He made a remark that I thought was great observation: “That psychological ability to raise your game rather than lose heart when behind is common to all elite sportspeople, but quite unusual in ...

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Working in both the inpatient and outpatient setting, I have to frequently recommend my patients follow-up as soon as possible with their primary care doctors. I work in a couple of different locations, urban and rural, and I must say I have noticed a rather disturbing trend over the last few years. When I ask my patients who their primary care doctor is, I often get the reply: “My primary care ...

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Long gone are the days of our parents’ and grandparents’ generations, when you would graduate, join a company or organization, and pretty much stay there for your whole career. Our own personal expectations have changed, and we are fortunate to be living in a time (and country) where we do not need to feel beholden to any one employer, or feel stuck in a job we are unhappy with. Obviously ...

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Admittedly, my views on funding health care have done a 180 since I left medical school. I grew up and went to university in the United Kingdom, which famously has one of the most heavily centralized socialized systems anywhere in the world. Born out of the ruins of World War 2, the core concept of the National Health Service (NHS) is to provide equitable care to the entire population, which ...

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The use of health care information technology has increased exponentially over the last five years, and as a frontline physician, I have seen this change at close quarters. In most of the hospitals I’ve worked in up and down the East Coast, it’s been interesting to observe this transformation. The process has usually started with nurses and then moved on to encompass doctors. It’s overall a good thing, as I 
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I was recently working in clinic on a Friday afternoon. I was on my last patient of the day, and it had been a particularly long clinic. I had big plans for the weekend and should have already finished. The gentleman entered the room, sat down, and we began the consultation. Because I was so behind, I went through everything a little quicker than I usually would, but still covering ...

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The changes that have occurred in health care over the last few years represent a sea change from the autonomy and clout that physicians once had. It’s no great secret to anybody working in medicine that most of these changes to practice -- including the push towards employment instead of private practice, and the need to now spend the majority of the day clicking boxes on a computer screen -- have ...

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Our job as health care professionals is not just to diagnose our patients by applying our scientific knowledge and clinical skills, but also to be the “communicator-in-chief,” “listener-in-chief,” and “reassurer-in-chief.” Any doctor who doesn’t fully grasp this, is not doing the best job they can or being the best doctor they can be. I truly believe that over 90 percent of our everyday job as a physician involves being a good ...

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Health care is a tough job to work in -- whether you are a doctor, nurse or any other professional. We are dealing with matters of life and death, our patients expect (and deserve) the best from us, and we always have a hundred-and-one things to do at the frontlines of medicine. I remember reading somewhere when I was a teenager that a career in medicine would be a “mentally, ...

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Talk about physician burnout and job dissatisfaction is everywhere right now. If you are a doctor, you cannot escape the news. Within the last couple of weeks, organizations in Massachusetts (a mecca of healthcare and hospitals) declared physician burnout a “major public health crisis.” This all sounds rather dramatic. On the surface, physicians are reasonably well paid, still enjoy a good degree of autonomy (certainly compared with many other ...

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No matter what profession you are in, having uncomfortable and difficult conversations is something you have to get used to. Tim Ferris said in his bestselling book, The 4-Hour Workweek (which I’d highly recommend), “A person’s success in life can usually be measured by the number of uncomfortable conversations he or she is willing to have.” It could be with another colleague, a client or customer. Even in your personal ...

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A piece of advice I would give to any younger physician, especially one who is just graduating residency, would be to expect a whirlwind ride into the realities of frontline medical practice. It’s something that you are totally not prepared for in the controlled environment of education and residency training. A steep learning curve awaits you once you start practicing medicine. And one of the biggest things you will have ...

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I recently wrote an article giving 3 reasons why any patient may not have liked their doctor. They included the physician being visibly in a hurry, appearing to brush off concerns, or giving a general sense of not caring. While no doctor deliberately sets out to do any of these things, complaints like these are all too common, unfortunately. The degree to which the practice of good medicine is ...

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One of the biggest changes to health care over the last 20 years has been the corporatization of medicine, from small independent physician practices, to large corporations that now run the show. Medicine has gone from good old Dr. Johnson’s office around the corner, to a world of boardrooms, megamergers and takeovers. This has enormous downstream effects -- not least to the way physicians practice medicine and their ...

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