medical education

The four-part closure statement

The four-part closure statement

When I'm working with trainees, many have ideas about starting clinical encounters but few have thought about conclusions.  When I was in grad school, a professor spoke with us about how our society doesn't end things well — we'd rather say “see you later” than “this...

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We have 15 minutes today

We have 15 minutes today

 We know that doctors of different types and stripes have different appointment lengths, and if you're working on an inpatient service you may not have a specific schedule.  Regardless of whether you have eight, fifteen or thirty minutes (like I do in my clinic for...

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Agenda setting for the doctor-patient clinical encounter

Agenda setting for the doctor-patient clinical encounter

Ask ‘What else?’ As doctors, there are few things more frustrating than attending a department or other meeting without a clear agenda, so it makes sense that we and our patients have the same expectation of why we are meeting and why we’re gathering and what we’re...

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Ninety Seconds

Ninety Seconds

A worsening doctor-patient communication problem Back in Medical school, we learned that doctors are quick to interrupt patients at the very start of the clinical encounter — my colleagues and I all committed to doing better.   Interestingly, that study from the 1980s...

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How to diagnose gender dysphoria. 

How to diagnose gender dysphoria. 

how do I know if my patient is transgender? In my practice I work with many medical students and residents who we train in part to provide gender affirming care. I frequently speak with colleagues who know I have a transgender-inclusive family practice and field many...

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How to Overcome a History of Medical Violence

How to Overcome a History of Medical Violence

We carry the burden of our patients’ past mistreatments. We know from history how doctors have participated in the medical violence brought upon Black people, transgender and queer community, and women--just to name a few. Think about the roles physicians played in...

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Resources for Physicians, Medical Students, Residents and International Medical Graduates (IMGs). Here we explore insights on complex patient care, family medicine in the context of the opioid crisis, transgender health, equity and social justice in healthcare.