I am very resistant to burnout solutions that focus solely on the individual, as these seem to imply that the problem originates in the affected person. This approach pokes at a sore spot, because of the years I spent secretly worried that the reason I left practice was personal weakness or inadequacy, something I lacked or failed to do. When in 2013, I ran across the research on burnout, I learned ...

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For several years, Medicare has tied hospital reimbursement to its definition of quality of care. Poorly performing hospitals can be penalized as much as 2% of their Medicare payments. As part of Medicare’s assessment of quality, surveys are used to measure patient experience and satisfaction. One of the components of the Medicare survey is pain management, which Medicare describes as follows: I’m not sure who, if anyone, ...

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It was a typical weekend on call. The usual number of surgeries, ER calls and consults. I was called to consult on 47-year-old female who had been admitted with four days of left shoulder pain. She had gone through a cardiac workup and was cleared by her internist. So now, a consult was called to see if there was an orthopedic cause for the patient's pain — not an uncommon ...

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In my travels up and down the East Coast, I have been fortunate enough to work with some fantastic nurses. From what I hear, there was much more of an authoritarian relationship between doctors and nurses a few decades ago -- preceding the time I entered the medical profession. This has now morphed into much more of a collegial teamwork approach, as we battle to get our patients better at ...

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Communication is the cornerstone of good health care. Despite all the external challenges we face with the system in which we work, those few minutes we spend with patients and their families are precious -- and are what we will be remembered for. We, therefore, owe it to our patients to be at our very best and to make them the absolute center of our world for ...

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Would patients be admitted, or people be allowed to come to work, in a hospital that had Legionnaires’ disease spreading through its HVAC system or cryptosporidium in its water supply? When there is an unusual smell associated with headaches and nausea in a surgical unit or emergency department, do people continue to work there and show up for their next shift as though this is status quo? Of course not. Why is it ...

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I recently rounded on patients at Providence Hospital as the attending physician on the family medicine residency program's inpatient service. Providence recently closed its maternity ward as the first step in a planned redevelopment of the hospital grounds into a "health village." In the short term, the hospital's decision to stop delivering babies may worsen maternal health disparities, as the entire eastern side of Washington, DC is ...

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“Wow, cool case,” was the response from the residents in continuity clinic on Monday morning as I told them about a patient I had seen over the weekend at our main campus urgent care. Ironically, or maybe more tellingly, I thought the same thing; “that was a cool case.” The “cool case” was a senior in high school who was eagerly looking forward to her college career but woke up with ...

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Doctors who wear scrubs outside of a medical setting.  Here's what this physician thinks about that. Brad Nieder is a physician and comedian and can be reached at the Healthy Humorist.

How excited would you be about a medication that lowered your risk of cardiovascular death, heart attack or stroke by 1.5%? Excited enough to spend a few thousand dollars a year on the drug? I expect not. What if, instead, the drug reduced those same terrible outcomes by 20%? That’s probably enough benefit to interest some in the drug. Well, those statistics come from the same clinical trial, evaluating the same drug. ...

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