One day, I was full of moderate despair, overworked, befuddled by the EHR with a tinge of burnout, staring at my computer, I treated myself to something I’ve not done before. It was my 62nd birthday that day, and I gave myself a birthday present. Before rising from that swivel chair, I had written down on a sticky pad the day that would be my retirement date, exactly one year ...

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An excerpt from the Docs Outside the Box podcast, episode 1:  When the going gets tough… MOVE!  Dr. Nii: All right, well thank you very much for joining us on the Doc’s Outside-the-Box podcast. You are our first guest — first victim, I guess. It's the inaugural episode, so I just wanted to thank you for joining us. I know you are in New Zealand, which is roughly 18 hours ...

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In medicine, this is the time when one season ends, and another begins. New doctors graduate medical school. They are excited and, at the same time scared, as they enter into residency training. Interns become residents. Senior residents celebrate moving into attending positions or look forward to subspecialty training in fellowship programs. It’s the excitement of completion combined with the uncertainty of charting a new course in medicine. Each new ...

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“Sorry, I’m running late … sorry, to keep you waiting.” How many times a day do I say that? Sometimes it is every time I walk into a patient’s room as if it is a normal greeting. Sometimes patients respond with: “Oh, you aren’t late” or “I haven’t been waiting long.” I can be so obsessed with not being late that I don’t realize I’m actually running on time! But ...

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I lost a friend this month. She was a surgeon; she was one of us. We lost her. So did her patients. All the ones she helped. The ones she saved. So did her hospital, her nurses, her techs. So did her family. All the love, coming to a screeching halt. Another friend lost. Another brilliant healer in medicine -- gone. Another one I will now refer to as “she was …” when I talk ...

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Physicians are notorious for being bad with money. Today we’re going to assign some blame for that phenomenon. Physician finances have three enemies, and we’re going to expose them today. 1. Financial professionals Enemy number one consists of many members of the financial industry. These “helpers” are often part of the problem. One of the biggest problems is commissioned salesmen masquerading as financial advisors. Although some of the these “advisors” ...

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The doctor-patient interaction is the absolute core of clinical medicine. Maybe I’ll go much further: it’s the core of health care in general. I always try to remember, whenever I’m ever feeling frustrated with the system, the crazy bureaucracy -- and of course, the debacle of our clunky electronic medical records and their data entry requirements -- to separate myself from all of that when I’m face-to-face with my patient ...

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Imagine, if you will, that you’re an anesthesiologist. You’ve been part of a successful practice for over 10 years. You can walk down your neighborhood street and run into mothers whose epidurals you’ve helped place. You’ve established a home, a community, and your children are in a great school system. One uneventful day, say Wednesday, you get an email from the hospital administrators announcing that there’s going to be a meeting ...

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I came across a letter I wrote to a patient while rummaging through some old files on my computer. I flashbacked to what triggered this: a response to a letter she had sent me, one that was, shall we say, extremely unflattering and quite scathing in the way she described me and our last encounter. From the letter’s tone, I sensed she held back on using more profane language to ...

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My father, recently retired, spent over 40 years in private practice. After dinner, he would sift through piles of paper charts and call patients with their lab results. As a grade schooler, what impressed me the most was that he knew many of his patient’s phone numbers by heart. Of course, this was in the days before HIPAA and caller ID, so scattered charts on the dining table and calling ...

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