Mr. Smith was a sixty-eight-year-old man who came to the Veterans Affairs hospital where I was a medical student complaining of chest pain. “With chest pain, it’s all about the story,” my resident, the physician in charge of our team, said. We talked to him to find out what he was doing when it started, […]
With the transition to residency, I’ve spent a lot of time thinking about next steps in my career. I even did a self-reflection exercise for a class in which I listed out professional decisions that will come up in the next few years (including choices like fellowship selection, type of practice setting, whether to pursue […]
When we studied ward attending rounds, the thought process represented the top attribute that learners valued. Learners can learn facts from textbooks, but using those facts requires experience and role modeling. I have given many lectures on clinical reasoning, and I have attended many lectures on clinical reasoning. These lectures can entertain, but one lecture […]
“Better patient care” is the reason hospital and health systems usually give when they merge or acquire one another. Our research suggests that mergers and affiliations might, paradoxically, increase the risk of harm to patients in the short run. Improving the safety of patient care is possible during mergers and affiliations, but requires intentional efforts. […]
It’s that time of year again. The start of a new academic year, marked by the arrival of a brand-new class of interns starting out in their training. Clutching their freshly-minted medical degrees, they appear so ready, so anxious, so excited, so eager to learn. Now it’s our job to make sure they stay this […]
This one’s for the new interns. You’re excited, you’re about to start residency. You’re a doctor. No more short white coat. You’ve got the long white coat that you’ve been waiting for. You’ve arrived. But actually, there’s one more thing you need before you really feel like you look like a doctor. It might be […]
Putting physicians in charge of hospitals seems like a no-brainer, but it isn’t what usually happens. A study published in Academic Medicine states that only about four percent of hospitals in the United States are run by physician leaders, which represents a steep decline from 35 percent in 1935. In the most recent 2018 Becker’s […]
Fake news is a term that’s become notorious over the last couple of years. For notorious reasons perhaps. But there’s actually another serious arena where there is inadvertently an awful lot of “fake news” on a daily basis. And that is, well you guessed it: in health care throughout our nation’s hospitals and offices! Let me […]
Let’s say your loved one is at the end of life. She’s 84, with advanced cancer that is no longer treatable. A decision has been made to put her in hospice — which is a level of care more than an actual location. (Most hospice actually occurs at home.) The patient waxes in and out […]
Physicians on the front lines of health care today are sometimes described as going to battle. It’s an apt metaphor. Physicians, like combat soldiers, often face a profound and unrecognized threat to their well-being: moral injury. Moral injury is frequently mischaracterized. In combat veterans it is diagnosed as post-traumatic stress; among physicians it’s portrayed as […]
