Internal medicine, American health care, and especially medical education

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On difficult patients

We must all make mistakes as we mature as physicians.  We should improve our interactive skills and our tolerance with experience and practice.

The expense of end of life care

I object to doing things that have virtually no chance of helping the patient, and significant chance of harming the patient further. 

My hopes for CER

I know many investigators who plan to apply for CER studies.  I hope they try to design unbiased studies.  I believe they will.

Teaching bedside manner

We (the universe of medical educators) have a responsibility to make bedside manner part of our everyday concerns.

Teaching bedside manner

We (the universe of medical educators) have a responsibility to make bedside manner part of our everyday concerns.

Hyperkalemia – why

A 53-year-old man, with a history of DM II, hypertension, depression and hepatitis C,  He is admitted for muscle cramps.

Why the man was jaundiced

What could cause such acute cellular destruction?  When I first heard this presentation at morning report I assumed viral hepatitis. 

A jaundiced man

Here is a puzzle for you to consider.  One of my residents told me that I needed to post more clnical problems.