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Tired Health Care Workers And Patient Safety: Tips To Avoid Fatigue

Health care facilities should take five steps to ensure staff aren’t becoming sleep fatigued, according to a Sentinel Event Alert from The Joint Commission.

Shift length and work schedules impact job performance, and in health care, that means patient safety, the alert stated. A study of 393 nurses over more than 5,300 shifts showed that nurses who work shifts of 12.5 hours or longer are three times more likely to make an error in patient care.

Furthermore, residents who work traditional schedules with recurrent 24-hour shifts:
–make 36 percent more serious preventable adverse events than individuals who work fewer than 16 consecutive hours,
–make five times as many serious diagnostic errors,
–have twice as many Read more »

*This blog post was originally published at ACP Hospitalist*

The Changing Priorities Of A New Generation Of Physicians

Doctors are, famously, workaholics. That’s just the way it’s been forever, at least as far back as my memory goes. You work crazy hours in residency, you graduate and work like a dog to establish your practice or to become a partner in your practice, and then you live out your career working long hours because there just aren’t enough hours in the day to do everything that needs to be done. I remember, growing up in the ’80s, that my friends whose parents were doctors were latchkey kids whose dad (usually the dad, then) was never at home when we were hanging out in the rec room playing Atari.

Yeah, Atari. Look it up, kids.

Not much had changed by the time I went to medical school. There was recognition of the fact that burnout was an issue — that divorces, alcohol abuse and suicides were more common among physicians than in other professions. The unspoken implication was that being a doctor was difficult and stressful, which increased the risk of these consequences of an over-burdened professional life. These stresses were accepted as part of the turf, as a necessary part of “being a doctor.” It wasn’t optional, and indeed, most physician teachers that addressed the matter chose to sublimate it into a mark of nobility. Being a physician was a calling and a duty, and a physician must gladly subordinate his or her own happiness and well-being to the service of their flock.

But things have changed, or at least a slow shift is in progress. Read more »

*This blog post was originally published at Movin' Meat*

Should Med Students Be Taught How To Maintain A Healthy Lifestyle?

Last week I wrote a simple post on eating yogurt with fresh fruit for lunch. It wasn’t until later that I realized why it’s a medical lesson.

It happens that yesterday morning I was up and out early. I saw a former colleague walking along the street. He’d gained weight, and walked slowly. I thought about how hard he works, and what a good doctor I know him to be. And yet any citizen or patient might size him up as heavy, maybe even unhealthy.

The problem is not that he’s uneducated or can’t afford nutritious foods. He knows fully about the health benefits of losing weight and exercise. The problem is the stress and long hours of a busy, conscientious physician’s lifestyle.

When I worked as a practicing doctor and researcher at the hospital, I rarely ate a nutritious breakfast or lunch. My morning meal, too often, consisted of Read more »

*This blog post was originally published at Medical Lessons*

Despite Her Demanding Work, This Nurse Is Glad She Never Threw In The Towel

Mark Lamers from Online Nursing Degrees.org contacted me for an interview. Mark, I’m flattered. People tell me that I give good interviews because I’m very opinionated. Mark asked some thought provoking questions and one of them really stood out. He asked me about something that I wrote on my blog a long time ago. The post read, “I was also taught that anyone willing to work long, hard hours could obtain the American Dream. I’m a nurse for life, which means I’m not going to retire. In other words, I’m going to die with my Nurse Mates on.” Mark asked, “At this point in your career, it is safe to say you’ve worked long hard hours as a compassionate caregiver. In retrospect, is that American Dream now your story? What would provide the happy ending? What were the necessary steps to get there?

Answer: Read more »

*This blog post was originally published at Nurse Ratched's Place*

Why Primary Care Doctors Leave

There’s little question that the workplace environment for doctors is deteriorating. Especially in primary care, where physicians are arguably needed the most.

That’s why is so disheartening to read this Newsweek essay from pediatrician Karen Li, explaining why she left the field. Much of her piece can be attributed to the bad old days of managed care, where doctors were frustrated by the bureaucratic impediments placed before them. Read more »

*This blog post was originally published at KevinMD.com*

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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