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Awareness

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Why I Won’t Close My Practice to New Patients

Closing a medical practice to new patients is like cutting off the very top of a tree. It’s the beginning of the end. The top of the tree, the crown, is where the newest leaves are. It’s also the part that continues growing ever upward, at least until it reaches its maximal genetic height, depending on environmental factors like the availability of water and sunlight (both of which also depend on how many other trees are competing for them nearby). Read more...

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How Technology Helps, and Hurts, Healthcare

Robert was the picture of health. He had run eight marathons and finished countless 5K and 10K races. He tracked everything from sleep to food intake, logging his exercise parameters religiously. A seven minute mile was a routine workout for Robert. But over the course of a few days, he noticed that he felt more winded during his run. One morning, when he awoke and checked his heart rate variability (HRV), it revealed a unusual drop. His VO2 max had also fallen considerably. So Robert sent an email to his physician, sharing his data and concerns. His doctor was also a runner, and loved when his patients armed him with data that enabled him to treat them. Read more...

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Are Small Practices More Resilient Than We Think?

When I was in high school, a national hardware retailer opened a new franchise down the street from the mom-and-pop hardware store that had served my neighborhood for many years. Since the new store had the advantage of larger volumes and lower costs, it seemed to be only a matter of time before it drove its smaller competitor out of business, the way that big bookstore chains and fast-food restaurants had already vanquished theirs. But a funny thing happened on the way to the inevitable. By the time I left for college, the new hardware store had folded, and the mom-and-pop operation had moved into their former building. How did this small business manage to retain its customers and win new ones? The answer was quality of service. I remember visiting the mom-and-pop store when a classmate and I were working on a physics project. There, the owner himself happily held forth for several minutes on the advantages and disadvantages of various types of epoxy adhesive. It was a special and unique experience. Read more...

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Mindfulness at Work: Bringing Joy to the Practice of Medicine

Recent news stories have catapulted the value of providing “mindfulness” and the health community is paying attention. Clinically introduced by Dr. John Kabat-Zinn in 1979, Mindfulness Based Stress Reduction (MBSR) brings together mindfulness meditation, body scanning and simple yoga postures over an eight-week training program. Participants are taught that they can decrease their response to stress through “moment-to-moment, non-judgmental awareness.” Compelling research studies published in 2015 show MBSR is effective for veterans with PTSD, relief of depression and anxiety among patients with cancer, a better quality of life for individuals living with inflammatory bowel disease, treatment of insomnia, alleviation of depression in the elderly living in nursing homes, and decreasing chronic low back pain. Read more...

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Managing Your Online Reputation: What Every Doctor Needs to Know

About two years ago, I started noticing an uptick in posts and discussions on what role digital footprints and online reputation was going to play for physicians. We knew it was just a matter of time before the Internet would become a key component in how our patients found and interacted with us. Yet even…

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Why Medicine Needs Its Stories

I was at a dinner meeting for our hospital last week, and before everyone went in to sit at their tables and hear the evening’s speeches, there was some time for the usual networking over wine in the reception room. I got chatting with an established local primary care physician. A respected member of the hospital staff who has been in practice for over 30 years. He’s quite a presence and a great clinician, someone who still finds himself coming into the hospital to work on various administrative duties. I expect every hospital in the country has characters like him wandering around. Read more...

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Patient Honesty in the Exam Room: Doctors React to New Survey

To any physician, the fact that patients aren’t always entirely honest about their health concerns will come as no surprise. Health issues are tremendously personal, and we all know how challenging they can be to discuss. Yet the more detailed and accurate the doctor-patient relationship becomes, the better equipped both parties are for success. Read more...

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Changing Patient Feedback Forms Could Transform Healthcare

We’ve all seen them: those once paper but increasingly digital forms that enthusiastically request our feedback.Tell us how we’re doing, they cheerfully announce, or Help us improve! Some of us even send them out as part of our practices or health systems or educational programs. We also fill them out, both as regular citizens and as clinicians. Or we mean to. I certainly try to, with some exceptions. Recently, I deleted a survey from a hotel I stayed at for one night in a country I am unlikely to return to in this lifetime. I just didn’t care enough to bother. Read more...