Mea sententia...

Mea Sententia translates roughly as 'My Opinion' and has been my intermittent blog since 2011. Much of my writing is about medical issues, but my topics range through philosophy, behavioral and decision making, management, humor, and personal/family anecdotes.


Patient preferences

Dr. David Nash makes some very good points about  the importance of recognizing both the relevance and the lack of alignment with physician beliefs of patient preferences, commenting on a December 4, 2011 JAMA commentary by Dr. Allen Detsky.

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Entropy is relentless

“…it’s easier to add stuff than to take it away.  It brings to mind thesecond law of thermodynamics in physics, which (very loosely) says that a system will always develop greater disorder (or randomness, or “entropy”) unless work is done on that system.  Stated from a clinical point of view: unless we invest more time and energy in our patients, their care will become more scattered, disorganized, and chaotic.”

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Thought for today

"Vision is not enough. It must be combined with venture. It is not enough to stare up the steps. We must step up the stairs."

(Vaclav Havel)     

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The tip of the iceberg

During an interview in the post season, the franchise quarterback explained his success.

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Remember George Engel, MD

Our institution has recently started using NRC PIcker to collect patient feedback and grade clinical providers.  When I learned of this, I was anxious, defensive, offended and prepared to be angry at the prospect of being graded by data from some feedback form. I suspect my reaction is pretty common among providers. My discovery that the data includes some very useful material - and that I score well - has been a surprise, somewhat confusing, and led me to do some self-observation while with patients. 

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All mushrooms are edible, but some only once.  (Serbian proverb.)



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Wouldn't it be loverly?

For all my friends and colleagues at CMHC (with deepest apologies to Lerner and Lowe)…


All I want is a place somewhere,

Not locked down by Committee Chairs,

Where all who want can go to share,

Now wouldn't that be loverly?


Lots of documents for us to read.

Lots of communication, indeed.

Where creativity can breed.

Oh, wouldn't it be loverly?


Oh, so loverly as we all collaborate at will

We would never need to budge

For stuff that thrills like a sleeping pill.


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Listen to the patient

Sir William Osler famously said: “Listen to the patient. He is trying to tell you what ails him.”

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Thought for today

The German philosopher Hegel said, “We learn from history that we don’t learn from history.”

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Deciding to be a doctor

The process of becoming a physician is a long and gradual process. Scattered through this glacially slow and often painful process are episodes that are transformational in every sense of the word, experiences that impact what kind of physician one becomes. Or even, whether or not one becomes a physician. 

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