Talking About Physician Burnout, and Changing the System

With many difficult situations, the first step in solving a problem is in acknowledging it exists. After that, you can understand it and, hopefully, fix it. Our health care system now, as it functions in most academic medical centers and dollar-strapped hospitals, doesn’t give doctors much of a break, or slack, or “joy,” as…

The Checklist and Future Culture of Medicine

…Poka-yoke, a Japanese term for rendering a repetitive process mistake-proof, is familiar to some business students and corporate executives. This concept, that simple strategies can reduce errors during very complex processes, is not the kind of thing most doctors pick up in med school. Rather, it remains foreign.

An Ordinary Day

If there’s one obvious thing I didn’t learn until I was well into my forties it’s this:

Don’t let a day go by without doing something you feel good about.

This message is not unusual, cryptic or even interesting. It’s simple, really so trite you could find it in most any “how having cancer changed my life” book available in bookstores and on-line.

Why say it again? Everyone knows we should relax and enjoy sunny weekend days like this.

Because it’s a reminder to myself, as much as for some readers and maybe a few fledgling doctors out there. One of my…

Are Doctors Necessary?

Ten years ago, my colleagues and I squirmed in our swivel chairs when a few tech-savvy patients filed in bearing reams of articles they’d discovered, downloaded and printed for our perusal.

Some of us accepted these informational “gifts” warily, half-curious about what was out there and half-loathing the prospect of more reading. Quite a few complained about the changing informational dynamic between patients and their physicians, threatened by a perceived and perhaps real loss of control.

How a decade can make a difference. In 2008 over 140 million Americans…

How to Avoid Death in the ICU

It was sometime in April, 1988. I was putting a line in an old man with end-stage kidney disease, cancer (maybe), heart failure, bacteria in his blood and no consciousness. Prince was on the radio, loud, by his bedside. If you could call it that – the uncomfortable, curtained compartment didn’t seem like a good place for resting.

Why Medical Lessons?

One of the things I liked best about practicing medicine is that I was constantly learning.

Making rounds at seven in the morning on an oncology floor would be a chore if you didn’t get to examine and think and figure out what’s happening to a man with leukemia whose platelets are dangerously low, or whose lymphoma is responding to treatment but can’t take anymore medicine because of an intense, burn-like rash. You’d have to look stuff up, sort among clues

Doctors Don’t Tweet

I didn’t know much about social media until the summer of 2008. Then, I entered Columbia University’s Graduate School of Journalism as a new student and attended an optional lunch-time session on Facebook, Gmail and Twitter.

My kids used Facebook, so I knew about that. Still, I hesitated…

Dinner with my Family

Family gatherings centered on two things – food, and talk about medicine. We spoke of interesting cases (always nameless), challenging conditions and, even back then, the constraints of health care costs. My fiancé, now husband of over 20 years, couldn’t get over how debate over health care dominated our Rosh Hashanah and Thanksgiving feasts…

…when I learned I had breast cancer, I knew exactly what to do. The decisions, though difficult, were almost straightforward, buttressed by my knowledge and familiarity with the language of medicine…

Hello Readers!

Well, I went ahead and started this blog without a proper introduction. Why was I in such a hurry?

Because I think the media’s getting – and giving – the wrong message on breast cancer screening. When it comes to long, boring medical publications like those published this week in the Annals of Internal Medicine, perhaps it’s not the devil that’s in the details so much as are the facts.

More on that tomorrow –

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