I recently completed my internal medicine residency training. Three years, thousands of hours, thousands of patients, thousands of decisions. I certainly learned a lot from the past three years: everything from what “HFrEF” means and how to manage it…
I’ve always believed in looking the part as a physician. So much so that I even write about it! You may have read my piece that became widely circulated online, about why physicians should always dress to impress. The article generated quite a response…
When I was in medical school, I didn’t realize the potential data would have in health care. Back then I learned from 1000+ page hardcover textbooks and handwrote notes in paper medical records. Fast forward twenty years — data and analytics are …
We recently had a patient who arrived on our service in the intensive care unit after a complicated surgery. The surgery left him close to dying, and he was immediately put on life support and given heavy sedatives. Ventilators breathed for him. Specia…
A wonderful senior resident helped me understand the goal of rounding. Rounds should focus primarily on understanding the key problems and the diagnostic and therapeutic approaches to those problems. She suggested that some rounds spend too much time…
Our country is at risk of losing an iconic institution that has played a pivotal role in the history of medical education. A school, which has produced some of the boldest pioneers in medicine, could lose accreditation upon the opening of a new hospita…
“I am really uncomfortable and in pain,” said Elaine tearfully as I met her in the preoperative area for the first time. She had a very sad and difficult history, dealing with complications from childbirth nearly two years ago. She had developed a comm…
I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’…
Two of my local hospitals just invested 3 to 4 million dollars in preparation for an inspection of the facilities by the Joint Commission. The cost of the inspection runs in the $10 million dollar range after the preparation costs. The inspection is a …
“Admission diagnosis: causa socialis” In my training in Sweden, it was not unusual to admit patients to the hospital for social reasons: an elderly person who could no longer manage at home, a person whose social network fell apart, and so on. “Social …
