Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a train wreck in progress. You may have thought about saying something, but paused and wondered, “Is this ...

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I just left the most unusual conference I have ever attended. First, it was small: 25 invited participants. Second, it was all women. Third, it was all women who have done amazing things ...make that “trailblazing things.” They were journalists at major news outlets, retired military officers from the highest ranks, senior leaders (in some cases, the most senior leader) at major federal and state health care agencies, Fortune 500 companies, large ...

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While everyone has heard the old adage about not getting sick in July because of new interns, the truth is that new interns nationwide have started already. Yet, you don’t hear much about the “late June effect?” So is the July effect overblown or true?  Well, there have been many studies – so many so there was a recent systematic review co-authored by one of my own co-interns a long time ago.    ...

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Recently, I was having a discussion with a colleague about being a doctor. She confided in me that if someone asked her about becoming a doctor, she would tell him or her to become a nurse practitioner.   After reading the emotional open letter to our policymakers in Washington DC, it may sound like a reasonable suggestion.  After all, why go into this much debt and spend so much ...

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I recently had the opportunity to read Daniel Pink’s Drive.  I read it partly to understand why pay-for-performance often fails to accomplish its goals for complex tasks, such as patient care.  However, the thing I found most interesting about this book was the way in which creativity is deliberately inspired and cultivated by industry. I could not help but think about why we don’t deliberately nurture creativity in medical trainees.  Why ...

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On my birthday several weeks ago, I was lucky to get an iPad Mini from my husband. I already have an iPad and have shared my experience. In fact, we gave all of our residents iPads (one of them contacted Steve Jobs and got a response), and documented an improvement in efficiency on the wards. So why the Mini? What is ...

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Last week, I tried something new with our residents. We tried to talk about why physicians overuse tests.   This is the topic of the moment, as the American College of Physicians (ACP) just dropped their long-awaited new High Value Cost Conscious Curriculum for what has now been dubbed the “7th competency” for physicians-in-training. In addition to the ACP curriculum, which I served as one of the reviewers for, I also ...

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I recently watched Dr. Atul Gawande on video describe how what American healthcare needs is pit crews and not cowboys.  This sentiment is also memorialized in his thought-provoking writings for the New Yorker. Interestingly, Dr. Gawande is not the first person I have heard to suggest such a thing.  A colleague named Dr. Ken Catchpole actually studied Formula 1 pit crews and used the information to guide improvements ...

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shutterstock_220419091 Amid the buzz about whether medical students should be sued and the bill currently debated in Arizona (a state which finds itself in the spotlight more than usual these days), I noticed some commentary from several people who do not think they would like a medical student on their case.  Sometimes patients do refuse to be cared for by medical students, often ...

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I recently saw a post in Yahoo questions entitled, "Is it illegal for a medical student to introduce themselves as 'Doctor' before they have received their MD?" One of the answers that was rated highly was "I think it is more unethical than illegal." Clearly, if a student is deliberately misrepresenting themselves as a ‘doctor’, it is grounds for disciplinary action.  More often than not, this misrepresentation is not ...

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I just finished another 2 weeks on service.  This time, I had also had a shadower, but one of a different kind.  As part of our Institute for Healthcare Improvement (IHI) Open School, we are making an effort to have collaborative learning opportunities for our medicine and health administration program students.   Achieving true interprofessional learning is challenging for schools like ours without a pharmacy or nursing ...

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I just finished another inpatient service stretch at our community hospital with some great cases and lots of good medicine.  While attending rounds may have changed a lot in the last 40 years as highlighted in a recent Annals of Internal Medicine article, some things have not changed – the focus on medical student presentations during attending rounds. Students spend hours through their call nights preparing for the visit ...

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I recently spent a week in Ireland, taking in the sights and spirits. I was actually there for work too – visiting the University College of Dublin and the Mater Miserecordia Hospital – or the original Mercy Hospital as they refer to it.   As the future of primary care, residency work hours, and the healthcare insurance system continue to cause angst in the US, we often find ourselves referencing what our European ...

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I am teaching a new course entitled “Turning your Clinical Cases into Scholarly Work.” I hope to draw on my own experiences through the years mentoring students and residents in writing up several clinical cases, but also in making diagnoses.  In preparing for this course, I have also learned quite a bit about the controversy surrounding case reports and the challenges that they face in today’s healthcare system. Unfortunately, case reports have ...

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I recently completed a two week tour of duty on the wards in July with new residents, interns, and students. Attending (serving as the supervising doctor for the team of residents, interns and students) in July can be challenging, but also one of the most rewarding clinical experiences as a faculty member.  The interns and residents are eager to learn and your teaching may have a more lasting impact as the residents ...

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At the recent AAMC meeting on how to integrate quality into teaching hospitals, the question that kept popping up from speaker after speaker was how to address the fact that doctors in teaching hospitals don’t get along. Unfortunately, all the specialty bashing that takes place prevents the adoption of a team based culture necessary to advance quality and safety.  As one speaker highlighted, how can we really start to address this ...

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On a recent Saturday, I rounded in the hospital.  I met up with Zainab, the president of the minority premed association for the University of Chicago, who asked to shadow me.  While she was doing research at the hospital, she had not ever rounded in the hospital before.  It was Saturday so our team was mostly off so it was just me and my very capable resident who is about ...

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Those who hate hospitalists believe that students and residents are choosing hospital medicine over primary care so hospitalists are to be blamed for the primary care shortage. They also believe that the rise of hospital medicine has made primary care less attractive. Then, there is the salient argument that care transitions are more inherent and vulnerable due to hospitalists. Of course this hatred is not new. As a ...

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My husband and I recently traveled to Wuhan Medical School in the Hubei Province in central China. Our medical school has partnered with Wuhan to help inform their curricular reform efforts. We spent 4 days touring the hospitals and teaching facilities, meeting students and faculty, going on rounds, and giving talks. Although the language barrier was challenging, we had incredible translators who worked to translate every slide we spoke ...

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I recently went to see Alice in Wonderland in 3D. This epic creation by part genius–part disturbed director Tim Burton features the wickedly talented method actor Johnny Depp as the ‘Mad Hatter.’  As I was watching Johnny Depp’s orange hair and freakish eyes, it occurred to me that some of the most popular fiction movies over the last several years have featured some notable legends and their medical ...

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