Pauline W. Chen: A Surgeon's Reflections

Where Have All the Doctors Gone?

For awhile now, I've been reading about the crisis in primary care. I've been concerned about the predictions of a shortage of primary care physicians, but I've always had this sense that there might be time to address the problem.

Recently, however, I read the results of a survey of some 12,000 physicians, most of whom are in primary care. I no longer believe we have the luxury of time. In fact, I worry that even the best of health care reform efforts will be doomed to failure unless we begin to take steps immediately to address the situation.

I write about the survey and the primary care crisis in this week's "Doctor and Patient" column. Tara Parker-Pope blogs about it in "Well," where you can leave a comment.

Does More Sleep Make for Better Doctors?

This Tuesday, the Institute of Medicine released its report on resident duty hours limits. It's an impressive work and an important step for the medical profession; but like our best attempts at cure, it comes with strings attached.

I hope you will take a moment to read this week's "Doctor and Patient" column and to leave your thoughts on the "Well" blog.

Too Much Information

In the doctor-patient relationship, is there such a thing as "T.M.I.," too much information? In this week's "Doctor and Patient" column, I write about the research done on physician self-disclosure.  It turns out that sometimes, even a little information can be too much.

What are your experiences with physician self-disclosure? Tara Parker-Pope writes about the topic on her "Well" blog, where I hope you will leave a comment about your experiences.

Confronting the Racial Barriers Between Doctors and Patients

Like most people in this country, last Tuesday I stayed up too late watching the election returns and was moved when it became clear that Barack Obama was going to be our next president. But his election also made me think more about racial barriers, especially those in medicine.

In this week's "Doctor and Patient" column, I examine racial disparities in medicine and biases that affect all of us in some way. Tara Parker-Pope writes about my column on her "Well" blog, where I hope you will post a comment.

A Positive Approach to Doctors in Training

Internship was a challenge, but those challenges helped to make me a careful and conscientious doctor. Nonetheless, I sometimes wonder if the negative reinforcement that marked my early clinical training was necessary.

In this week's column, I write about positive reinforcement for doctors in training. I interview Dr. Darcy Reed about her recent paper in the Journal of the American Medical Association titled, "Behaviors of Highly Professional Resident Physicians."

I hope you will join in on the discussion on Tara Parker-Pope's "Well" blog.