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Latest Posts

Working In Primary Care: Two New Surveys

Two new surveys take the temperature of the primary care working environment.

In the first, a collaboration between the Medical Group Management Association and the Association of Staff Physician Recruiters, recruiters took a median of six months to fill positions for internal medicine or family practice physicians, according to the In-House Recruitment Benchmarking Survey: 2010 Report Based on 2008 Data.

Among the findings:

— It cost less to recruit specialists, due to the economic downturn and a 30% rise in the use of Internet job boards as a primary recruitment method.

— It takes longer to fill a position in non-metropolitan areas, where the impact of the primary care shortage is greatest. Read more »

*This blog post was originally published at ACP Internist*

Descriptive Charting And The Physical Exam

Our relatively new electronic medical record (EMR) product has prompts and clicks for everything imaginable. One of them, which we can use during the physical exam, is the long list of “constitutional” findings that we perceive on generally looking over the patient.

They include things like: Obviously ill, comfortable, uncomfortable, pale, well-nourished, well-hydrated, well-dressed, alert, chronically ill, contracted, emaciated — and so on.

But these descriptors don’t always cut it. I mean, people are both amazing and annoying, so why not add a few more to the list? Read more »

*This blog post was originally published at*

A Significant Pediatric Moment

I hate pediatrics. People who don’t understand the life of surgery may think this means I don’t like children, but in fact the contrast is true.

Surgery is suffering and heartache. Surgery is pain and misery. It’s stuff children aren’t supposed to experience.

Children are supposed to be caught up in the joys of life. They’re supposed to play and smell the roses along life’s paths. Pain will come later, but childhood is supposed to be a sanctuary, albeit temporary from the harsh realities of life. And when life gets harsh, they may need to come to me.

I once spoke about a very special boy who crossed my path. His death still haunts me, but there was another incident which drove the wedge between myself and pediatric surgery forever. Read more »

*This blog post was originally published at other things amanzi*

The House Special

During the past several weeks, I have diagnosed several patients with novel H1N1 influenza infection with my diagnostic opinion occasionally backed by a positive flu swab. When my wife, an ER doctor, fell ill I suggested she had novel H1N1 infection and went on to advise some of my family, friends, and neighbors of the likelihood that they too had H1N1. Yet when it was my turn to suffer with fever, body aches, headache, sore throat, and malaise one word seemed best able to convey how I really felt: swine.

My symptoms began four days after having the H1N1 shot and almost immediately after putting my children to bed following a fun but rainy Halloween night. It would have been nice to blame the rain or the flu shot for my suffering but I knew better. Unable to sleep I found myself ruminating over an aphorism I first heard as a third year medical student, spoken by a man who lives in my heart as my mentor. Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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