Mea sententia...

Docs and their socks

Two weeks into my third year psychiatry clerkship at the University of Rochester, I was summoned to the Dean’s Office to meet with Dr. Orbison.

Speaking truth

“In a time of universal deceit, telling the truth is a revolutionary act.”

(George Orwell)

Nursemaid's elbow

One of the characteristics of a long medical career is the kaleidoscope of educational experiences one draws upon. This afternoon a three year old boy and his father benefitted from one of my early lessons, courtesy of Mary Mahotka, an x-ray tech in the Verona Family Practice Residency Clinic

EBM and P4P: Uniforms don't make the man

There is a push afoot to use evidence based medicine (EBM) to generate standards of care and then use pay-for-performance  (P4P) to Nudge people towards better behavior.

Why do we treat strep throats with antibiotics

Clinicians like making the diagnosis of strep (streptococcal) throat (and patients hate being told they have a viral sore throat) for the same reasons: a belief in the ability of antibiotics to shorten the illness and prevent serious complications That’s what we doctors were taught, and that’s what we’ve taught our patients. How justified is this belief?  Well, there are problems.

Technically speaking

With regard to the EHR:

(crappy process) + (technology) = (fast, expensive crap)

‘Nuff said. 


The impact of errors in medicine

Not all errors have negative consequences. Many go unnoticed. Occasionally they save lives.

Why I argue

I have been called argumentative, disputatious, a vexatious nuisance, oppositional, a disagreement looking for an opportunity, and far worse.

 With these descriptions, I would not argue. The folks who say these things are correct. But I wonder if they know why I like to argue?

Not to win. Not to prove a point. Not to sell a position. Not to convince.

Honor the heretics

In an organization – as in society – there is an important distinction between faith and religion. 

Faith is belief in the organization’s mission, supported and embodied in its values and long term goals. In a successful organization, faith is a common good, co-owned and held by the entire community.  Leadership doesn’t own or control faith, but functions as steward and guide, helping the community stay connected with (and by) their shared faith.

In praise of the PITA

You know who I mean. We've all had to work with (or around) the guy everyone calls the pain in the ass.

He is not the person you would choose to make the decision, but he is a person you definitely want in the room when the options are being explored.


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