In a recent issue of the Annals of Internal Medicine, Terwiesch and colleagues propose “reimagining provider visits as the new tertiary care.” Initially, their arguments seem sound, even reasonable. Then, they conclude with this:

The conceptual change is to see every engagement with a clinician not as something to be celebrated but as a kind of failure — an inability to accommodate patient needs by any of ...

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After a complicated stay in the hospital, my patient was finally ready to be discharged. After all he had been through, I was excited to tell him the good news. “You will be leaving this afternoon,” I said, heartened by the smile I saw spreading across his face. He thanked me, and then said something that made me cringe. “Finally! I thought you guys were going to keep sticking me with needles ...

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As women in the medical workforce increase, women physicians are faced with the unique position of training the hardest they ever had in their lifetime cutting into precious childbearing years. Many women physicians seek time off or engage in part-time jobs to address the dilemma of fulfilling the obligations of their careers while enjoying the tender years of their babies. Others pursue non-clinical routes such as medical chart reviews or ...

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Why are there vending machines in hospitals? This seems like an odd question to ponder, and it certainly would seem to have nothing to do with the current state of medicine and health care in our country. But it is a question that I am having a hard time wrapping my brain around. Certainly, most hospitals do have vending machines that sell snacks and soda, and they are by no ...

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As I walked in the room, I noticed it immediately: Norman was worse. The recurrent invasive cancer in his neck was impairing the drainage of fluid from his face making it difficult for him to turn his head, and it had progressed overnight. Despite his alarming appearance, he seemed calm. There were no more cancer-specific treatment options: the surgeons had declined to operate again; he had received maximum dose radiation; and ...

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As a third-year medical student, fresh and green on my clerkship rotations, I was determined to stand out on my general surgery team. I knew this was not going to be easy; I was often the last item on many surgeons’ minds as they rush through morning pre-rounds at the hospital, flying around corners, their Nike sneakers squeaking on the polished white floors. In the OR, I observed from the corner, ...

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The ancient Greeks were one of the first groups of philosophers to recognize and describe the complexity of love. Eros: an intense, passionate form of love. Philia: a deep friendship or affection. Philautia: love for one’s self. Agape: an unconditional love for humanity. These same complexities in love forms described by the Greeks play an important role in how we treat our patients in medicine. Eros allows us to have the passion ...

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This was a momentous week for me. After 14 years of carrying a hospital-grade old-school text pager to receive messages at work, I finally traded it in for a cell phone app. It should have been easy to get rid of my beeper. But instead, I felt waves of nostalgia when I turned it off for the last time. Those 240-character, pre-Twitter, low-resolution LCD messages follow the arc of my ...

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They came from all corners of the globe to bid him farewell. He looked cachetic, his frail form interrupted by swelling in his abdomen and legs, a result of end-stage pancreatic cancer. It was Dr. Yeat’s last week in the hospital before being transferred to a nearby hospice.  He was now on morphine, and despite severe fatigue and difficulty breathing, he always managed a smile. Some of his visitors were former ...

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The public’s apparently insatiable appetite for medical drama continues unabated as yet another prime-time TV show set in a hospital has hit our screens. FOX’s The Resident has generated discussion like no other. This may simply be due to the fact it’s the first major launch in the era of widespread social media, but it seems to have enraged a vast swathe of our ranks. Has The Resident crossed a ...

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