Perspective
Stanford Medicine 25 Blog
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How the ‘Privilege of Physicianhood’ Inspires Best-Selling Author Abraham Verghese
Verghese embodies Stanford Medicine 25’s ideals of channeling humanity & empathy in patient interactions, and this interest in the human story is part of his magic as an author. A closer look at his philosophy on writing reveals important lessons for physicians and medical learners!…
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Honoring Breast Cancer Awareness Month Through Physical Exam Knowledge
Each fall, Breast Cancer Awareness Month aims to promote education about the disease that impacts roughly one in eight women. In this post, we’ve outlined useful information and key resources to help physicians identify signs of breast cancer and other abnormalities at the patient bedside.
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Stanford Medicine 25’s Resources to Help Physicians Promote Skin Health
Skin health is always a relevant topic in the clinical setting, but it’s particularly worthwhile to revisit after the summer season, during which many people are exposed to high levels of sun damage.
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Healing: A Journey, Not a Destination
Although healing and curing are often used interchangeably, we think of these two terms in different ways and believe the distinction is important when it comes to our outlook on patient care and bedside medicine.
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Confusion & Unsteady Gait: This Physical Exam Tells You Why
Discover why a 70-year-old man is experiencing confusion, difficulty walking, and urinary incontinence. This physical exam reveals Normal Pressure Hydrocephalus (NPH) as the cause.
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Books On Bedside Medicine
We’ve put together a list of reading material for those who are passionate about bedside medicine. We believe they all include a variety of timeless lessons to help you bring better care to patients.
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Stanford 25 Perspectives: Featuring Maja Artandi, MD
Dr. Maja Artandi shares her journey into medicine, emphasizing the importance of bedside skills in building trust and accurate diagnosis.
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The Resurgence of Bedside Teaching During the Pandemic
Authored by Danielle Miller of the Stanford School of Medicine, “Not Quite Bedside” Teaching During the COVID-19 Pandemic examines the teaching of bedside medicine in the midst of the pandemic.
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Using Acting to Connect with Patients in the COVID-19 Era
In addition to clinical training, medical students at the University of Delaware also participate in a “healthcare theater” to develop communication skills that help them build trust and personal connection with patients.
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Teaching Empathy in Medical Education
In addition to physical exam skills, we believe instruction on empathy is an essential aspect of physician training, but it’s often overlooked in medical school curriculum.
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The Presence 5 for Racial Justice: Promoting Anti-Racism in Clinical Interactions
Stanford Medicine 25’s Donna Zulman, Abraham Verghese and their Stanford Medicine colleagues evolved the Presence 5 practices into The Presence 5 for Racial Justice to address a longstanding history of racial bias in medicine.
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Abraham Verghese Asks: Why Are We Doing This Teaching?
We teach bedside medicine. We emphasize the importance of the physical exam and how it can help care for your patient and also create an environment where the person you are caring for develops trust. We have taught this now for over 6 years (when the Stanford Medicine 25 was first created). But sometimes it’s important to ask why. In a recent blog post, “Will the Healing Touch Go Out the Door With the Stethoscope?”, we look at the how some think that ultrasound is replacing any need for a stethoscope...
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Will the Healing Touch Go Out the Door With the Stethoscope?
We teach bedside medicine. We emphasize the importance of the physical exam and how it can help care for your patient and also create an environment where the person you are caring for develops trust. We have taught this now for over 6 years (when the Stanford Medicine 25 was first created). But sometimes it’s important to ask why. In a recent blog post, “Will the Healing Touch Go Out the Door With the Stethoscope?”, we look at the how some think that ultrasound is replacing any need for a stethoscope...
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Every Patient Has a Story Worth Hearing
Earlier this year, Canadian newspaper The Globe and Mail commemorated the anniversary of the death of neurologist Oliver Sacks by taking a look at his legacy. The piece, by author Norman Doidge, aptly reminds us that “the world’s most famous neurologist believed that every patient had a story worth hearing.” And indeed, his work proves...
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What will bedside manner look like for new data-driven physicians?
Earlier this year, Managed Care magazine published a cover story on young doctors. Praising them for their ability to collaborate, their openness to measurement and consciousness related to cost-effective care, the article advanced the idea that these “newly minted” physicians are just what health care needs. However, it had one main question: “How well will...
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An Image For A Day
This interesting image raises all sorts of questions. What was Frida trying to say? Was it a comment about presence or about lack thereof? Was it a way of sanctifying the doctor? We know he operated on her many times and she thought he had saved her life. What does this evoke for you? What other observations might you make as an art critic and medical person?…
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Slow Medicine And Fast Medicine
As we watch medicine unfold, there is a lovely debate emerging around slow versus fast medicine. It would seem that emphasis on the bedside falls very much in the category of the former.
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The Internet: The Elephant in the Examination Room
Peter Conrad, a sociologist at Brandeis University, spoke of the rise and fall of the medical authority in the doctor patient office encounter in his many scholarly articles. With the internet becoming the “elephant in the doctor’s office,” the dynamic of medical authority has certainly changed…
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Interview with Dr. Eric Topol (editor-in-chief of Medscape)
The editor-in-chief of Medscape, Dr. Eric Topol, visited Stanford to sit down and do an interview with our Dr. Vergese for the Medscape One-on-One online video series.
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What Can Doctors Learn from Narrative Medicine?
Patient-centered care is an important aspect of the National Strategy for Quality Improvement on Health Care. As such, healthcare institutions are strongly focusing on the patient-physician relationship and the patient experience.
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The Flipped Patient
Many of us in the Program in Bedside Medicine are deeply involved in the medical students pre-clerkship curriculum. Each week the students interview hospitalized patients, perform physical exams, give presentations, followed by a written H&P note. These students enter the patient room with only pen and paper, as they have not yet gained access to the Electronic Health Record (EHR). By the end of the year, our students are able to obtain medical history from patients with complex medical problems on their own and able to communicate their findings concisely and effectively.
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Clinical Medicine Article by Dr. Andy Elder
A member of our Stanford 25 team, Dr. Andy Elder, recently published his thoughts about his visiting professorship to Stanford last year.
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Teaching Humility at the Bedside
Humility is an underappreciated skill in a time of global budgets, evidenced based approaches, and cost-containment. The bright, well-read, talented medical students who may lack humility are not uncommon.
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Artificial Intelligence and the Gift of Physician Time
In a new book Eric Topol explores his belief that AI will go beyond enhancing diagnoses and treatments and “transform almost everything that doctors do.”…
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Four Physicians Describe the Synergy Between Technology and Bedside Medicine
Four physicians (Abraham Verghese, Eric Topol, Christopher Maiona and Caesar Djavaherian) are outlining similar solutions that leverage technology to nurture the doctor-patient relationship.
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The Art and Science of Patient Care
In a perspective piece published in Wiley Online Library, author Robert Truog conveys the importance of the physical exam, writing that “from the beginning, touching has been integral to doctoring.”…
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Bedside Teaching is a Powerful Learning Tool in the ICU
An analysis by Christopher Cheney in HealthLeaders discusses the importance of teaching at the bedside in the ICU--it's a challenging and unique environment due to “the medical complexity of the patients [and] the time pressure.”…
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Learning from the Bedside at the 5th Annual Stanford 25 Bedside Teaching Symposium
Abraham Verghese, MD, MACP, connected his talk at Stanford 25’s 5th Annual Bedside Teaching Symposium to a larger theme: the importance of working, teaching, and learning at the bedside.
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The Physical Exam Remains an Effective Tool for Physicians
A new study published in the Annals of Family Medicine highlights the necessity of the physical exam in medicine concluding that “it not only contributes diagnostic information but is a therapeutic intervention in and of itself.”…
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Compassion: A Powerful Tool for Improving Patient Outcomes
The release of Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference has ignited a conversation on the relationship between physician compassion and patient outcomes.
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A Diagnosis of Nelson's Syndrome
At age 15, Gillian noticed changes in her body that did not feel typical of a young adolescent woman.
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How AI Can Improve the EHR and Bedside Medicine
In a recent JAMA Network Viewpoint feature, Stanford Medicine 25’s Abraham Verghese and Sonoo Thadaney readily endorse artificial intelligence (AI) in medicine, describing its promise as “undeniable.” But they also emphasize an overlooked opportunity, specifically how AI can “help clinicians deliver better and more humanistic care.”…
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Physicians Can Protect the Human Connection in Medicine
In an episode of Medscape’s “Medicine and the Machine,” Stanford Medicine 25’s Abraham Verghese and Deep Medicine author Eric Topol explain that doctors must come together as advocates for the human connection in medicine.
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Humanizing the EHR
In a recent CLOSLER feature, Jeffery Millstein of Penn Medicine reinforces a sentiment frequently shared by Stanford Medicine 25, writing that “the clinically excellent clinician makes an effort to know each patient’s unique story, moving beyond the confines of the content within the [electronic health record] EHR.”…
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Telehealth Tips to Preserve Key Aspects of Patient Care
To ensure that doctors are able to properly care for and connect with their patients via video, Stanford Medicine professors and faculty have developed guidance and best practices for conducting telehealth visits.
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Five Practices to Strengthen the Physician-Patient Relationship
A new study authored by Stanford Medicine 25’s Donna Zulman and Abraham Verghese shares five practices they say can “enhance physician presence and meaningful connection with patients in the clinical encounter.”…
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Conversation About Bedside Medicine Gains Momentum
Abraham Verghese’s passion for patient care and physician wellbeing is contagious. It’s also attracting national attention, as with this recent Medscape article: Abraham Verghese: ‘Revolution’ Starts at Bedside.
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Can Improv Help Doctors Connect With Patients?
Writing for The Atlantic last summer, Anu Atluru, MD, lamented the depersonalization that can happen in medical training and offered an alternative to the current script. It was improv.
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Abraham Verghese Interviews Jerome Kassirer on New Book
In a career that spans more than five decades, Jerome P. Kassirer, M.D. has been an acclaimed kidney specialist, clinical researcher, administrator, author, creator of new medical disciplines and, during the decade of the 1990s, editor-in-chief of the prestigious New England Journal of Medicine.
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Artificial Intelligence as a Partner in Patient Care
Abraham Verghese and fellow Department of Medicine faculty Nigam Shah and Robert Harrington have authored an opinion piece on humanism and artificial intelligence which insists that “the two cultures – computer and the physician – must work together.”…
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The Tradition of Daily Bedside Clinical Care
Brian Garibaldi, co-president of the Society of Bedside Medicine and contributor to Stanford Bedside Teaching Symposium, and his colleagues at Johns Hopkins University (JHU) are reinvigorating beside medicine in the university’s residency training program.
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UMKC Case Highlights the Importance of a Thorough Physical Exam
A recent case presented by the Department of Internal Medicine at the University of Missouri Kansas City (UMKC) demonstrates the importance of physical exam skills and provides a clear example that lack of thorough history and complete physical exam can lead to diagnostic errors.
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Empathy and the Physical Exam Remain Essential Components of Medicine
A recent article in Quartz says that while machine-learning technology is becoming more “pervasive in the health system,” empathy may be becoming obsolete… even though “it’s one of the reasons why people trust doctors."…
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Register Now for the 4th Annual Bedside Teaching Symposium
This year, the 4th annual Stanford 25 Bedside Teaching Symposium will take place on September 7 and 8, 2018. Registration is now open!…
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The Benefits of Bringing Doctors Back to the Bedside
The first two episodes of a new podcast from Johns Hopkins Medicine focus on “bringing doctors back to the bedside,” and both feature members of the Society of Bedside Medicine, where Stanford Medicine 25’s Abraham Verghese serves as an Advisory Council member.
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Physical Exam Can Sort Out - And Treat - Common Type of Vertigo
Some older patients with dizziness undergo thousands of dollars of tests that often turn up nothing. Others are told it’s just a part of aging. But with the most common kind of vertigo, there’s actually an easy fix.
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Medical Students Recognize Importance of Bedside Manner
Truly caring for the patient begins at the bedside with observation, examination and connection. An article in In Training – “Why is Bedside Manner Important” – describes the value of taking time to engage with patients at the bedside because a “chart can only reveal so much.”…
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Finding Joy in Physical Exam Skills
In an interview with hospitalist, Twitter personality and “Incident Report” host Zubin Damania, Abraham Verghese discusses the movement to bring physicians back to the bedside.
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How Technology May Lead to Greater Human Connection at the Bedside
Could the machine be the catalyst that brings us back to the bedside? It may sound counter-intuitive, but it’s one theory Stanford Medicine 25’s John Kugler shared in this Medscape interview.
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Journal Dedicates Entire Issue to “Enduring Value” of Bedside Medicine
The latest issue of Medical Clinics of North America focuses entirely on a topic very important to us at Stanford Medicine 25 – the physical examination. The issue “explores the enduring value of the clinical encounter” and contains 14 articles related to bedside medicine and the physical exam.
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Bedside Medicine Training Helps Both New and Established Physicians
A recent blog post on the Daily Nurse highlights the different ways nursing students, medical students and residents are being taught good bedside manner. This training builds clinicians’ communications skills and offers real-life experience.
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Compassion, Patience and Bedside Manner Improve Patient Satisfaction
A study from Healthgrades and Medical Group Management Association (MGMA) analyzed seven million patient reviews and comments about health care providers. This Patient Sentiment Report found that over 52 percent of patients stated that they wanted their doctor to have at least one of the following qualities: compassion, comfort, patience, personality and bedside manner.
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AI is Doing More to Help Keep Doctors at the Bedside
Prompted by the release of Sense.ly’s “Molly,” a new artificial intelligence (AI)-powered avatar, a Forbes article examined “how humans and machines can work together to improve and transform” health care.
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As Prices Drop, Point-of-Care Ultrasound May Spark Evolution of Physical Exam
In a commentary for JAMA Cardiology, John Kugler writes, “The ‘wow’ factor is powerful with the latest generation of pocket ultrasound machines.
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The Miracle of a Patient’s Recovery
If it was a movie script, you wouldn’t believe it. A 28-year-old woman has a miscarriage while on vacation in Mexico. When she goes to the doctor, a nightmare begins. She ends up spending the next five years in and out of hospitals. At one point, she’s told she’s going to die. She takes chemotherapy, sees a naturopath, sees doctors in her native Ukiah and at Stanford, even goes to Philadelphia and Boston to see experts on the disease. They all agree that nothing can be done.
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Technology Doesn’t Have to Be the Antithesis of Humanity
In a commentary for Modern Healthcare, North Carolina physician Chris DeRienzo asks a question that we’ve also been exploring with great interest and passion: “Could technology actually return some humanity to healthcare?” DeRienzo believes it can, and we agree, of course.
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Abraham Verghese Shares Story of the EHR’s Negative Consequences With Broader Audience
In a recent feature piece for The New York Times, Abraham Verghese, MD, MACP addresses “the threat that electronic health records (EHRs) and machine learning pose to physicians’ clinical judgment – and their well-being.”…
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Using Riddles as Medical Teaching Tools
In a recent article in The American Journal of Medicine (AMjMED), Stanford Medicine 25’s Abraham Verghese advocates for riddles as a teaching tactic.
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An Emphasis on the Bedside May Prevent Physician Burnout
Physician burnout is a very real job hazard. However, according to a 2016 article in Consumer Affairs, “being present and mindful” with patients may be able to prevent burnout.
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What Stands in the Way of Bedside Teaching?
An opinion piece from The BMJ made the rounds a while ago on Twitter. The column, provocatively titled “The death of bedside teaching,” originally appeared in December 2016, but the points made by physician Mark Mikhail continue to reverberate. Is bedside teaching really dying?…
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Teaching the “Intangibles” of Medicine
An editorial on Healio.com highlights the importance of “intangibles” in medicine, primarily the connection between patient and provider. In the commentary, Leonard H. Calabrese, a rheumatologist and course director at the Cleveland Clinic Lerner College of Medicine, shares concern that empathy and mindfulness are pieces of medicine “we know very little about.”…
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AI to Complement – Not Compete With –Physicians’ Diagnostic Skills
It was big news earlier this summer. As reported by Forbes, “This AI Just Beat Human Doctors On A Clinical Exam.” The story unfolded on a stage in London where Babylon Health demonstrated its artificial intelligence software.
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Using Art to Teach the Human Side of Medicine
In Spokane’s Providence Internal Medicine Residency rotation, students and residents study more than patient charts. Each morning, reports The Spokesman-Review, they also gather to chat briefly about a painting, image, piece of music or poem that one of them has brought in for discussion.
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The Basics vs. Technology Debate: When They Work Together, Everyone Wins
A recent discussion on Medscape between two physicians posed the question, “Are Physicians--Let's Face It--Getting Clinically Lazy?” This bold question has prompted many responses from clinicians that has become an ongoing conversation on “The Basics Versus Technology: Which Wins?”…
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Why the Physical Exam Remains Valuable in Patient Care
Although today’s climate has forced physicians to rethink the physical exam, Hyman notes that “not all is lost with the emergence of telehealth” as virtual visits lend themselves to new avenues for patient connection.
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Dr. Verghese’s Rules for the Bedside Exam
Abraham Verghese says he’s learned key lessons at the patient bedside over the course of his career, all of which can be applied to enhance physical exam skills and foster the physician-patient connection.
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Bringing Human Connection to the Forefront of Medicine in a Technological Era
At Stanford Medicine 25, we believe human connection plays a critical role in patient care. But as the medical world becomes increasingly reliant on technology, how can we keep this approach in focus?…
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Through a Patient’s Eyes: Physicians Reflect on Personal Illness
A few recently published articles shed light on how physicians’ own experiences with illness offered lessons on the importance of humanity, connection and comfort.
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Communication Strategies to Help Physicians Lead Meaningful Patient Conversations
Let’s take a closer look at how physicians can transition into substantive discussions through simple yet effective communication strategies that encourage conversation, transparency and partnership.
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Bringing Tidings of Comfort and Joy to the Patient Bedside
The ability to conjure feelings of comfort and joy plays an important role at the patient bedside, especially during difficult times.
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How Physicians Go Above and Beyond to Promote Patient Healing
Simple acts like holding a patient’s hand or offering a warm blanket can elevate the patient experience in immeasurable ways.
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How to Address Monumental Patient Conversations
At some point, every physician will need to share difficult news with a patient. We provide tips and resources to aid physicians as they help patients process bad news.
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The Importance of Cultural Competence in Bedside Medicine
Providing quality care at the bedside relies not only on a physician’s medical knowledge, technical skills and compassionate demeanor, but also on respect for a patient’s cultural, racial and ethnic background.
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Combat Physician Burnout with the Joy of Bedside Medicine
Ongoing research has shed light on various tactics to prevent and address physician burnout, including rediscovering the joys of bedside medicine.
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Promoting Inclusive Care at the Patient Bedside
Creating a clinical environment that is inclusive, welcoming and comfortable for individuals of all backgrounds is an important component of the patient experience.
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Janet Tillman's Life as SP and GTA
In her roles as a standardized patient (SP) and gynecological teaching associate (GTA), Janet Tillman has helped medical students learn how to conduct exams as well as master other basic skills including patient interaction, diagnoses, and more.
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The Significance of Small Gestures at the Patient Bedside
Textbooks rightly emphasize the importance of diagnostic and treatment skills, but we also believe it’s vital not to lose sight of the big impact that small gestures can have.
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Balancing Technology and Human Connection in Patient Care
As the broad-reaching capabilities of Artificial Intelligence (AI) gain momentum, we see enormous potential to advance human health. However, as we look forward to this progress, we also believe it's more important than ever to preserve the physical exam and humanistic aspects of medicine.
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Stanford 25 Perspectives: Featuring Michelle Chiu, MD
Dr. Michelle Chiu shares her journey into medicine, emphasizing the importance of bedside skills.
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Five Tips to Enhance Patient Communication at the Bedside
Discover five essential tips to improve patient communication at the bedside, fostering stronger connections and better health outcomes.