Health care in U.S. hospitals is suffering from three under-recognized conditions that I will refer to as “Metris,” “Severe Metris” and “Metric Shock.” Metris occurs when a health system begins to focus more on achieving certain metrics than on improvi…
I was on inpatient service and had already seen most of the patients on my list. I just had to see one more before I could call it a day and rush out just in time to take my daughter to her tennis lesson. I reviewed the patient’s chart to find out that…
In a moment of caffeine-depleted delirium, I volunteered to head the creation of a “notes committee” for my 80-member hospitalist group. I placed myself on a 72-hour hold and quickly established a group consensus: “Bloated notes are a huge proble…
An excerpt from Under the Collar: Frank Conversations about Healing that Harms: Simply Speaking. Hospitalist Nigel admitted elderly Ms. Mann who had developed dehydration after several days of unrelenting nausea and vomiting. Respecting patients’ priva…
“Go have a seat,” the receptionist at the imaging center told me, gesturing to the waiting room. It was a close, poorly ventilated space, and several of the chairs were already occupied. I turned back to the receptionist. ”I have a primary immune defic…
I have seen great leadership and bad leadership. As a leader, I have also made my share of mistakes, and I am sure I will make more. When I do, I will immediately take ownership of it, learn from it, and do all I can not to make the same mistake. Howev…
“Most residents are young, often in their mid to late 20s, having spent years ensconced in libraries, research labs, and classrooms learning pathophysiology and pharmacology. Upon graduation from medical school, they are now drafted to the front …
“It is not enough to say we are anti-racist; we have to modify our systems to recognize that we have placed individuals of color at risk of poorer outcomes. Lack of insurance, lack of finances, or even the presence of certain diagnoses may refle…
The old saying that says “practice makes perfect” is a basic rule taught to every resident starting their training. The follow-up questions that pose themselves: Is it true? How much time does it need to become perfect? What type of practice? Time was …
After entering Gate D at Fenway Park, John had his temperature taken and verified that he was symptom-free. As he rounded the corner, his friend heard him whisper through his mask, “I think this is real.” He was referring to the calming sounds of a str…
