The cafeteria can tell you a lot about the hospital. Here’s how.

Physician
September 14, 2015

Hospital cafeterias are important places. Great progress has been made over the last few years in raising the standard of the food served (to both patients and staff!), with much more emphasis too on making the options healthier and nutritious.

Speaking as someone who has worked in several different hospitals, and with my own general interest in health care quality and improving the patient experience, it’s always very interesting to look …

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Can you fake empathy until it becomes real?

Physician
September 13, 2015

Studies show over and over again that empathy is the key to physician-patient communication and is directly related to patient satisfaction, adherence to medical treatment, lawsuits, and clinical outcomes. Yet despite its importance, many doctors still struggle with showing empathy.

The reality is that while most medical students start school with high levels of empathy, it doesn’t take long before that empathy is beaten out of us.  Studies show …

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How anatomy lab changed this medical student forever

Education
September 13, 2015

I’m supposed to speak at the body donor memorial in September. I told the organizers my speech was written. “Don’t worry,” I assured them. “I have it all in my head, just need to get it down on paper. I’m a writer; it’s my process.” But the truth is that I am struggling with what to say. I’ve tried to write it, but I just end up drinking a pot …

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The day I saw the humanity in medicine

Education
September 13, 2015

At the heart of American medicine is the concept of bedside manner, and with it the concern that doctors are cold and unemotional. Indeed, doctors are exposed to disease and misfortune on a daily basis. A patient who presents with stage IV metastatic stomach cancer is just one of the many hundreds or thousands of such patients that will walk through the hospital doors in the coming years. Quotidian exposure …

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6 reasons why doctors grieve differently

Physician
September 11, 2015

I’ve been thinking about this over the last ten and a half years since my soul mate had a cardiac arrest and died. He was 38 and as fit as a fiddle. I am a rural general practitioner in South Australia (family practitioner in American parlance). He left behind four kids (from his previous relationship), and me with a broken heart. We had been together a little over two years.

Western …

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Is your hospital a miserable place to work? Here are 14 clues.

Physician
September 10, 2015

Earlier this month I read a Wall Street Journal article about Zeynep Ton’s Good Jobs Index. Who is Zeynep Ton? She is a professor at the Massachusetts Institute of Technology’s Sloan School of Management who has ranked retailers on employee happiness. This was so positive. It was good to hear about businesses concerned about employee happiness and not just about profits and shareholders.

Two weeks later I was dismayed to …

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Discussing the side effects of medications: How can doctors do better?

Meds
September 9, 2015

While studying for a certification exam, I came across a question that stayed with me well after taking the practice test. The case discussed a patient who was prescribed antibiotics by his physician for a presumed bacterial illness and then returned the following week with an antibiotic-associated diarrheal infection. The test question then asked what could be concluded from this case. The answer: informed consent (i.e., patient permission for a …

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4 ways to improve the lives of doctors and their patients

Policy
September 8, 2015

Ask physicians across the country what problems they want solved, and they won’t hesitate to tell you. They worry about the growing health risks they observe in patients based on lifestyle choices, obesity and a variety of social factors that they feel powerless to change. Ask what they would modify if they had a magic wand, and they’ll point to the illogical, problematic and increasingly complex reimbursement schemes still favored …

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How can we measure the doctor-patient relationship?

Policy
September 6, 2015

Sixty years ago, before he became a controversial figure in the field of psychiatry, Dr. Thomas S. Szasz co-authored an article for the Archives of Internal Medicine (now JAMA Internal Medicine) on “The Basic Models of the Doctor-Patient Relationship,” which is well worth reading today, particularly for those who believe that patient empowerment/engagement is a novel and disruptive innovation of our digital times.

The paper is describing …

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Why physician burnout and work-life balance is a first-world problem

Physician
September 5, 2015

Did it ever occur to some of today’s physicians that many people work awfully hard and complain a lot less than they do about “burnout” and “work-life balance”?

Did it ever occur to them that “work-life balance” is the very definition of a first-world problem, unique to a very privileged class of highly educated people, most of whom are white?

Every day, I go to work and see the example of the …

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Kim Kardashian’s first trimester nausea: The truth behind Diclegis

Meds
September 2, 2015

It was only a matter of time before Kim Kardashian posted a picture on her Instagram account with a bottle of Diclegis, basically announcing her brand partnership with Duchesnay, the manufacturer of the prescription medication for nausea and vomiting in pregnancy. Duchesnay had been tweeting for ages that they were so relieved Kim had found help with Diclegis — so much so that I was wondering if Ms. …

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When doctors pass the buck: The ugly side of a shift-work mentality

Physician
September 1, 2015

“I’m just the night doc,” you said. You said it with emphasis as if that explained everything and dismissed your incompetence, your lack of compassion, your failure to care. Unfortunately my sister was “just the patient,” who lay suffering hours before her death and the RN was “just the nurse” withholding the morphine that the daytime doctor had ordered for air hunger and agitation. The nurse called you in to …

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A physician’s ode to nurses

Physician
September 1, 2015

A few weeks ago, after feeding my face with rich, dense chocolate cake brought by a truly awesome nurse (for no particular reason other than a warm and generous spirit), I walked back into a room to check on a post-cardiac arrest patient.

After surveying his vitals on the monitor, I turned my attention to two nurses and a pharmacist who were discussing the management of his six drips. He was …

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So doctor, who’s your boss?

Physician
August 31, 2015

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As a relatively young physician, I always enjoy my conversations with the older members of our profession, who’ve seen so much change over the last few decades. I’m fascinated with their stories about how different the medical world was when they were residents, how treatments were so novel, and how they used solid clinical skills to get to the diagnosis.

Those were the …

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A patient presents with painless diarrhea. What should you do next?

Conditions
August 29, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 67-year-old woman is evaluated for a 1-year history of loose stools. She reports approximately four episodes per day without abdominal pain. She has not had nausea, vomiting, weight loss, bright red blood per rectum, or melena.

On physical examination, temperature is 36.7 °C (98.1 °F), blood pressure is 115/85 mm Hg, pulse …

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The story of a boy who liked to draw

Physician
August 27, 2015

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There was once a little boy who loved to draw.  He would wake up every morning, pull out his box of colored pencils, and let his hands explore the promise of a pristine sheet of blank paper.  For him, the canvas was anything but empty,  images and ideas exploded out of his mind and magically appeared on the pages in front of …

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What doctors can learn from a professional photo shoot

Physician
August 26, 2015

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Have you ever had a professional photo shoot? I have had many, but not because I particularly enjoy being photographed. Actually, it is quite the contrary.

Photo shoots have always been a traumatic experience for me. You see, for some reason, likely as a creative form of cruel parenting punishment, my family of five siblings had a photo taken every year while growing up. …

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So you had a bad day: 3 reasons why doctors should have some perspective

Physician
August 25, 2015

Being a doctor is one of the most emotionally and physically demanding professions out there. The health care landscape may have changed a lot over the last decade, but the basic unavoidable grueling nature of medical practice has been the same for time immemorial. I remember reading a careers advice book when I was a teenager telling me just that being a doctor was “the most challenging of jobs,” and …

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