Paul Bergl, MD

Teaching doctors: Learning to learn in new ways

Paul Bergl, MD

Education

April 16, 2014

In my transition from pure learner (i.e., the med student role) to teacher-learner (i.e., the attending), I’ve actually found myself focusing more on the learner than the teacher part of my dual existence. Strong learning seems to be requisite to strong teaching, and I am realizing that succeeding on the next level requires some extra meta-cognition, that is, learning to learn in new ways.

Learning to unlearn

In med school, learners amass an …

Will resident autonomy disappear completely in the future?

Paul Bergl, MD

Education

February 18, 2014

Recently, our residency program had the excellent fortune of hosting Dr. Bob Wachter as a visiting speaker. Dr. Wachter is considered a pioneer in the hospitalist movement and has built his career around inpatient quality and safety. During lunch with Dr. Wachter, some of our residents, and hospitalist faculty, we discussed the topic of resident autonomy in the hospital.

In the glory days of residency, I imagine that house officers experienced …

Prevention, detection, and treatment of cancer has become more nuanced

Paul Bergl, MD

Conditions

January 17, 2014

At first glance, no diagnosis seems more terrible than cancer. Although it remains a huge killer in the developed world, cancer has also taken on new meanings in modern medicine. As an ordinary person, I certainly fear the word and would dread the diagnosis. Cancer. It has such a damning and unforgiving ring to it. After 3 years of residency in a tertiary referral center, where I’ve seen …

How can we encourage medical residents to truly choose wisely?

Paul Bergl, MD

Education

December 20, 2013

As Dr. David Green reported recently in NEJM Journal Watch, the American Society of Hematology is the latest society to comment on appropriate and cost-conscious care in the ABIM Choosing Wisely campaign. I’ve followed the Choosing Wisely campaign closely and have been using it on the wards and in clinic as academic ammunition. A specialist society’s public advice about showing restraint is an excellent means to challenge the dogma of our …

Doctors should hone their abilities to recognize visual patterns

Paul Bergl, MD

Education

December 10, 2013

Nothing puts more fear into the heart of an internist than a dermatologic chief complaint. And for good reason: we have very little exposure to the breadth of the field. To us, all rashes seem to be maculopapular, all bumps are pustules … or was that nodules?

It’s not that we internists don’t care about the skin or don’t appreciate its complexity. Rather, we simply haven’t seen enough bumps, rashes, and …

How technology will revolutionize medical training

Paul Bergl, MD

Education

December 3, 2013

Recently, I attended the annual AAMC meeting where the question, “What will medical education look like in 2033?” was asked in a session called “Lightyears Beyond Flexner.”

After this thought-provoking session, I too pondered academic medicine’s fate. I would like to share my reflections in this forum.

Without question, technology stood out as a major theme in this conference. And for good reason: clearly it is already permeating every corner of our …

Primary care suffers from guideline overload

Paul Bergl, MD

Education

November 21, 2013

In my 3 years of residency, the nearly universal resident response to outpatient continuity clinic was a disturbing, guttural groan. I recognize that many aspects of primary care drag down even the most enduring physicians. But I have also found primary care — particularly with a panel of high-risk and complex patients — to be a welcome challenge. I recently spoke with one of my institution’s main advocates for academic primary …

What’s the best way to keep up with medical literature?

Paul Bergl, MD

Education

October 23, 2013

As a resident, probably the most common piece of feedback one receives is, “Read more and expand your clinical knowledge base.” This critique is a standard and generic piece of feedback to encourage the younger generation to never quit in the endless pursuit of knowledge. As our erudite attendings know, medical knowledge always evolves and often reverses course. Thus, the trainee is reminded to establish the habit of keeping up …

How do we empower patients with information while not scaring them?

Paul Bergl, MD

Education

October 9, 2013

“What do you think, Doctor?”

For a novice physician, these worlds can quickly jolt a relatively straightforward conversation into a jumble of partially formed thoughts, suppositions, jargon, and (sometimes) incoherent ramblings. Even for simpler questions, the fumbling trainee does not have a convenient script that has been refined through years of recitation. Thus, many conversations that residents have with patients are truly occurring for the first time. And unfortunately, this novelty …

Does the amount of interns’ time spent in direct patient care matter?

Paul Bergl, MD

Education

September 25, 2013

Recently in NEJM Journal Watch General Medicine, Abigail Zuger reviewed an article from the Journal of General Internal Medicine in which researchers examined how medical interns spend their time. The results from this time motion study might be concerning but are not unexpected. The investigators found that interns on inpatient rotations spend only 12% of their time in direct patient care and spend only 8 minutes daily with each patient on their inpatient services. Dr. Zuger notes this …

Paul Bergl, MD

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