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Health professional wellness hierarchy.

Beyond Burnout: A Physician Wellness Hierarchy Designed to Prioritize Interventions at the Systems Level

Burnout has been implicated in higher physician turnover, reduced patient satisfaction, and worsened safety, but understanding the degree of burnout in a given physician or team does not direct leaders to solutions. The model proposed integrates a long list of variables that may ameliorate burnout into a prioritized, easy-to-understand hierarchy. Modified from Maslow’s hierarchy, the […]

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Young Adults and Adverse Childhood Events: A Potent Measure of Cardiovascular Risk

  While cardiovascular disease is the leading cause of death, its determinants include unhealthy behaviors and clinical risk factors and are recognized as the “actual causes” of death. Risk likely accumulates over the life course, and adverse childhood experiences may increase the risk of “actual causes” of death. The objectives of the study are to […]

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Building Trust in the Profession: What Can We Learn from Choosing Wisely?

  The Choosing Wisely campaign sought to prompt physician–patient conversations about unnecessary care. At its 2012 launch, physicians and patients felt uncomfortable about “denying” even unnecessary or potentially harmful care. Opponents of the Affordable Care Act raised fears of rationing and death panels. Physicians and patients had long mistrusted the motives of third parties, including […]

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The Rise of Documentation and the Destruction of Modern Medicine

The doctor–patient relationship has remained a central theme in the art of medicine since Hippocrates. Investing time into this relationship ensures trust and communication between both parties during a patient’s most vulnerable moments. Unfortunately, however, it seems as if the doctor–patient interaction has been gradually declining over time. The widespread implementation and dissemination of the […]

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Team-Based Primary Care for the Multimorbid Patient: Matching Complexity With Complexity

Complex, multimorbid patients are individuals within whom multiple chronic diagnoses (usually, more than two)1intersect additional complications—diminished function, cognitive impairment, homelessness, or substance abuse, for example. As many as one third of patients are multimorbid, with correlates of socioeconomic deprivation, increasing health services utilization, and mental health comorbidity.2 The growing scope and scale of care for complex, […]

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Annals of Communication: ’Giving a Patient a Diagnosis‘ and Other Idioms in Development

Communication is at the heart of the medical enterprise. We doctors share our research and our interpretations of that research in words. We use words to learn about the concerns of our patients and record our impressions, our findings, and our plans; words to share with patients and families what we have discovered, how we […]

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