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Last Build Date: Fri, 24 Nov 2017 16:00:13 PST


The lessons of Harry Potter and the Deathly Hallows

Fri, 24 Nov 2017 16:00:13 PST

Harry understood at last that he was not supposed to survive. His job was to walk calmly into Death’s welcoming arms … All those times he had thought that it was about to happen and escaped, he had never really thought of the thing itself: His will to live had always been so much stronger […]

The worst-case scenario question you must ask patients: even healthy ones

Fri, 24 Nov 2017 12:00:44 PST

The last few passengers filter in and buckle themselves up before takeoff. The emergency exit row is occupied by an elderly couple, and I am seated behind them. The flight attendant asks whether they are comfortable in those seats, given that they’d have to respond in the case of an emergency. “Not that I expect […]

4 problems with the Joint Commission

Fri, 24 Nov 2017 08:00:45 PST

I’m passionate about patient safety. In no small part because I was raised to be. My mom has a lot of letters behind her name (RN, BSN, MSN), and she’s dedicated her career to the field. Before I was accepted into medical school, I knew about “six sigma,” the “Swiss cheese model” and root-cause analysis. […]

3 reasons why health care costs are rising

Fri, 24 Nov 2017 04:00:02 PST

Following a relatively routine doctor appointment, I received my bill for over $1,000. I rubbed my eyes, hoping to find an overlooked decimal point. I didn’t. My experience is not unique. We have a problem in the U.S. We pay over $3 trillion annually for health care — about 18 percent of our GDP. No […]

I’ll never forget the eyes of a 6-year-old sexual assault victim

Thu, 23 Nov 2017 16:00:04 PST

Patsy loved playing bingo every Wednesday night. Her boyfriend of three years loved watching her daughter Jenna who was a tiny and pretty six-year-old her momma called “princess.” Even though they weren’t related, Jenna called Patsy’s boyfriend “Uncle Billy” at her mother’s behest. And Uncle Billy made Jenna shyer and quieter than she usually was. […]

A new approach to shared decision making

Thu, 23 Nov 2017 12:00:20 PST

If patient-centered care is the current winning game plan for health care, then shared decision making (SDM) is the secret weapon. But we physicians need a new way to approach it. SDM, as defined by the Society for Medical Decision Making, is “a collaborative process that allows patients and their providers to make health care […]

Prioritize primary care this open enrollment season

Thu, 23 Nov 2017 08:00:49 PST

This open enrollment season, patients will be considering their health care coverage for the coming year. To ensure they are fully utilizing their primary care benefits and building relationships with health care teams that will keep them healthy, we need to encourage them to connect with a primary care practice or medical home. A medical […]

The scourge of electronic health records

Thu, 23 Nov 2017 04:00:24 PST

Scourge: An instrument of punishment or criticism A cause of wide or great suffering Whip or lash — especially for torture Introduction They say you never forget your first time. I remember mine, vividly. If only I could erase the memory. I had high expectations and higher hopes, but what I got was disillusionment. I […]

The doctor-patient relationship is everything

Wed, 22 Nov 2017 16:00:49 PST

While doing my doctoral dissertation research at a clinic for kids with diabetes, I observed the attachment that some of them had to the physician faculty member who directed the clinic. I particularly remember one teenager who complained that this doctor “did not care” about her, as he sent “fake doctors” (residents) to take care […]

The case of a fish hook in the eye

Wed, 22 Nov 2017 12:00:25 PST

Triage Note: Fish hook in eye. No bleeding. Tetanus up to date. It’s a sunny weekend during cottage season. A young woman is rushed into the ER as she cups both hands over her left eye. She’s in shorts, and flip-flops, and she’s hyperventilating. Her friends follow, hands similarly cupped over their mouths. I read […]

The greatest gift a physician can give

Wed, 22 Nov 2017 10:00:41 PST

Yesterday I looked in the eyes of a mother and told her that her son was likely to die in the next six months, and I had no more ways to try to make his heart stronger. Her son is 36 years old, and a father of two boys. He was on the bed beside […]

The most frustrating things about being chronically ill 

Wed, 22 Nov 2017 08:00:13 PST

Healthy or not, everybody has his or her share of frustrations in life. The chronically ill don’t have a corner on that market! This piece focuses on frustrations that are unique to those with ongoing health issues. I’ve experienced all of them as a result of being chronically ill with a debilitating illness that settled […]

Physicians share same mission across cultures and countries

Wed, 22 Nov 2017 06:00:54 PST

A guest column by the American College of Physicians, exclusive to As part of my role in International Programs at the American College of Physicians (ACP), I have a unique opportunity to travel frequently and engage with internists around the world. In fact, I am writing this while almost 7,000 miles away from home, […]

Why are you in medicine?

Wed, 22 Nov 2017 04:00:22 PST

I was recently interviewed on a podcast and was asked the simple question, “Why are you in medicine?” In retrospect, that’s the exact question I silently ask myself in frustration and exhaustion a little bit too often while I’m in the hospital. In those moments I recognize that I feel burnt out. In those moments […]

These are the biggest medical issues of 2017

Tue, 21 Nov 2017 16:00:57 PST

Periodically we should reflect on what challenges face patients and physicians.  Over the past few days, I have worked on a list of the issues that concern me the most.  I welcome suggestions for expanding the list. 1. Diagnostic errors. All patient care requires that we make the proper diagnosis.  Too often we make errors.  […]