Everybody gets nervous at the doctor’s office. Physicians ask all sorts of personal questions about what people eat, how much they drink, and how things are at home. Even questions that would seem completely harmless in another context — such as how work is going, or what hobbies a person enjoys — seem surrounded by hidden meaning and purpose. After all, who doesn’t want to “pass” their annual checkup? Part of ...

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Drivers are distracted klutzes and computers could obviously do better. Self-driving cars will make all of us safer on he road. Doctors have spotty knowledge and keep illegible records. EMRs with decision support will improve the quality of healthcare. The parallels are obvious. And so far the outcomes are disappointing on both fronts of our new war against human error. I remember vividly flunking my first driving test in Sweden. It was early ...

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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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I am not a doctor of finance.  I’m a medical doctor.  So when I enter an elderly patient’s home, I’m not expecting to do a wallet biopsy.  Whether they can pay me or not is of little consequence.  I do think, however, about whether they will be able to afford the care I prescribe.  Will they have enough to pay for that extra caregiver?  Is there cash to keep a roof over ...

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As medical professionals we often see people at their worst: battered and broken, bothered and in pain, no make-up, bad hair day, naked and too ill to even care about modesty. At those critical moments, in our patients' hour of desperation, they hand over their lives to us … and the lives of their family. All that they are -- they willingly place at our mercy. At times, burnout, and ...

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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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If one more person tells me to be sure to take care of myself, I'm going to bury my face in a pillow and scream. "Go for a walk, take a vacation," they advise. I know they're trying to help, but really? Giving me one more thing to do? Oh well, they're just doing the best they can. I moved my folks across the country, from Florida to Washington State, and into ...

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One of the great myths amongst residents is that once they become attendings, they’ll have so much more free time. I’ll never work this much again, they think. This is the most time-intensive phase of life, and everything after residency is easy in comparison. Unfortunately, they are usually wrong. Statistically, working about the same number of hours in residency and as an attending is the norm. In one study, attendings work 59.2 ...

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Quality of life matters. This straightforward assertion gets complicated when we discuss the treatment of depression. Depression is common, part of a family doctor's daily schedule; it can affect anyone, although certain groups are at higher risk. There have been many hypotheses as to why we as a species are susceptible to depression (and its frequent companion, anxiety), but in the day to day practice of medicine, those proposed etiologies end ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Chronic pain is a silent epidemic Chronic pain is a significant public health burden, but one that is not talked about enough. In 2011, the Institute of Medicine estimated that approximately 100 million Americans suffer from chronic pain. But chronic pain is not just ...

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