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Posts Tagged ‘patient care’

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February 11th, 2014

Do Quality Initiatives and the Patient Safety Movement Threaten Resident Autonomy?

Paul Bergl, M.D.

Recently, our residency program had the excellent fortune of hosting Dr. Bob Wachter as a visiting speaker. Dr. Wachter is considered a pioneer in the hospitalist movement and has built his career around inpatient quality and safety. During lunch with Dr. Wachter, some of our residents, and hospitalist faculty, we discussed the topic of resident […]


January 8th, 2014

Cancer 2014 — A Modern Spin on a Tragic Diagnosis

Paul Bergl, M.D.

At first glance, no diagnosis seems more terrible than cancer. Although it remains a huge killer in the developed world, cancer has also taken on new meanings in modern medicine. As an ordinary person, I certainly fear the word and would dread the diagnosis. Cancer. It has such a damning and unforgiving ring to it. After […]


December 11th, 2013

Making Value-Based Decisions About Ordering Tests

Paul Bergl, M.D.

As Dr. David Green reported this week in NEJM Journal Watch, the American Society of Hematology is the latest society to comment on appropriate and cost-conscious care in the ABIM Choosing Wisely campaign. I’ve followed the Choosing Wisely campaign closely and have been using it on the wards and in clinic as academic ammunition. A specialist society’s […]


November 7th, 2013

Is the Overwhelming “Primary Care To-Do List” Driving Talented Residents Away?

Paul Bergl, M.D.

In my 3 years of residency, the nearly universal resident response to outpatient continuity clinic was a disturbing, guttural groan. I recognize that many aspects of primary care drag down even the most enduring physicians. But I have also found primary care — particularly with a panel of high-risk and complex patients — to be a welcome […]


October 3rd, 2013

Choosing Words Wisely

Paul Bergl, M.D.

“What do you think, Doctor?” For a novice physician, these worlds can quickly jolt a relatively straightforward conversation into a jumble of partially formed thoughts, suppositions, jargon, and (sometimes) incoherent ramblings. Even for simpler questions, the fumbling trainee does not have a convenient script that has been refined through years of recitation. Thus, many conversations […]


September 27th, 2013

Duty Hour Reform Revisited

Akhil Narang, M.D.

 Discussions of resident duty hour reforms reached the point of ad nauseam a few years ago.  Everyone had their say – Program Directors (“In 2003 we instituted an 80-hour work week, in 2011 we switched to 16 hour shifts, what’s next – online residencies!?”), senior residents (“What? I have to write H&Ps again? I don’t […]


September 16th, 2013

Medical Interns – Not at the Bedside, but Not to Be Blamed

Paul Bergl, M.D.

This past week in NEJM Journal Watch General Medicine, Abigail Zuger reviewed an article from the Journal of General Internal Medicine by Lauren Block et al. in which researchers examined how medical interns spend their time. The results from this time motion study might be concerning but are not unexpected. The investigators found that interns […]


August 28th, 2013

Vaccination Against Pertussis – Is It Worth the Trouble?

Paul Bergl, M.D.

 “Four out of four!” exclaimed a proud PGY1 as she handed me the billing sheet for her last patient in continuity clinic. “Four out of four?” asked I. “Yes, I gave all of my patients their updated Tdap today,” she boasted. As her preceptor, I commended her for her commitment to routine health maintenance — you […]


August 13th, 2013

Broad Is Best? The Culture and Etiquette of Antibiotic Selection in the Training Environment

Paul Bergl, M.D.

Friends and colleagues, welcome to the new academic year! I am delighted to be a chief resident blogger for NEJM Journal Watch for the coming year. Without further ado, let’s discuss residents’ use of antibiotics. Antibiotic selection can either be one of the most anguishing or most mindless decisions that an internal medicine resident makes. […]


May 24th, 2013

The MICU Rotation — Oh, no!

Jonathan Schwartz

After a well-received post last week that focused on a commonly asked question I have fielded this year, I thought another common question would make for an excellent topic this week.  We’ll focus on the MICU rotation from the resident (and, potentially, the medical student) perspective. The MICU can be one of, if not the most, […]


Resident Bloggers Bergl and Narang

Akhil Narang, M.D.
Paul Bergl, M.D.

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