Tag Archives: quality care

Medical Axioms: The Pithy Little Sayings That Reflect Deeper Knowledge

  I love axioms. Perhaps it is the result of hearing them from one of my earliest mentors in medical school. Or perhaps it is the result of advice given me by my journalist/English teacher mother who told me that everything you write can be improved by condensation. Whatever the underlying reason, I continue to […]

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nurse showing an elderly woman something on a tablet in office

Candid to the Bitter End: Indiscriminate Disclosures

  The physician’s obligation to tell the patient the full truth about his or her condition has become an established ethical principle, enabling patients’ autonomy, shared decision-making, and patient-centered care. However, indiscriminate application of this obligation may at times be harmful to the patient, contradicting the old Hippocratic imperative of “first do no harm” (“Primum […]

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American Journal of Medicine Editor Joseph Alpert

Please Say Thank You

I frequently get letters from readers regarding one of my editorials or commentaries. Editorials and commentaries in The American Journal of Medicine (AJM) are expressions of opinion by the author of the piece. Of course, most observations in the Journal deal with medical topics, although occasionally they will stray into remarks about life in general or current events. As […]

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young female doctor examines x-ray

A Depressing Diagnostic Error

To the Editor: A 52-year-old woman with diabetes presented to the hospital with acute onset of right flank pain, in the setting of profound lower extremity weakness and cachexia with a 30-lb unintentional weight loss over the past 6 months. She was diagnosed with ascending pyelonephritis and treated with empiric antibiotics. On hospital day 2, […]

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The Frequency of Unnecessary Testing in Hospitalized Patients

Testing is an important part of medicine across all specialties and settings. As a result, the volume of testing is enormous, with an estimated 4-5 billion tests performed in the United States each year.1 Unnecessary laboratory testing and diagnostic imaging is believed to be common. Studies looking at testing of patients have found 40%-60% of tests […]

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