What is evidence? How do we gather evidence of patient harm? More importantly, what is the evidence that counts? A research paper dating back to 2004 suggests that besides research evidence, clinical and patient experiences, as well as contextual information also constitute evidence. However, the only currency of science is data collected through systematic and rigorous […]
Sepsis, the body’s self-destructive inflammatory response to severe infection, is the leading cause of death in U.S. hospitals, particularly among the elderly. It starts as mild sepsis, advances to severe sepsis, and all too frequently blossoms into septic shock. More than 1.5 million Americans get sepsis each year. More than 250,000 die of the illness. One […]
It was 5:27 p.m. on a Friday evening when the pager went off. “Ahh,” said the intern, “Three minutes before shift change, and the ER is paging for another admission!” I could see the dismay on his face as he dreaded the thought of staying late on yet another Friday night. I decided to take […]
The summer is an exciting time for fourth-year medical students. By this point in the year, many fourth-years have decided on a specialty to pursue, are traveling to new institutions for away rotations, and starting to work on their residency application via the Electronic Residency Application Service (ERAS). Since I was part of the inaugural […]
1. Our health care system is broken, and there isn’t going to be an easy way out. Costs are too high and our outcomes too poor. There’s a lot of finger-pointing in how we got to this point, but one thing is for certain — physicians must lead the way to a better system. The heart […]
1. Our health care system is broken, and there isn’t going to be an easy way out. Costs are too high and our outcomes too poor. There’s a lot of finger-pointing in how we got to this point, but one thing is for certain — physicians must lead the way to a better system. The heart […]
I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice. With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, […]
I have a fantastic leader as our chief. He develops a certain softness in his voice and demeanor when he has to sit down with me and share some concerns. It’s like he is on my side. It’s like he believes in me. He thinks this was an act, but this is not who I […]
I remember the fervor of my first day of internship: expecting a daunting yet exciting time lay ahead and I was finally going to be of some use to people. (And to my parents, relatives, and neighbors: “Oh, you’re finally a doctor.”) I felt like Tom Cruise on the airstrip of Miramar racing an F-14 […]
Walking through the dark construction zone of my now demolished kitchen, I made my way to the garage and out into the still, hot, humid July night. The air felt so thick, it was hard to breathe. At 1 a.m. I was headed to the hospital for a patient that just arrived in active labor. […]
