Clinical monitoring of our patients—have we lost the art?

The sedentary (r)evolution: Have we lost our metabolic flexibility?

During the course of evolution, up until the agricultural revolution, environmental fluctuations forced the human species to develop a flexible metabolism in order to adapt its energy needs to various climate, seasonal and vegetation conditions. Metabolic flexibility safeguarded human survival independent of food availability. In modern times, humans switched their primal lifestyle towards a co...

Customer satisfaction versus patient safety: have we lost our way?

The maturing science of the causes and consequences of boarding of admitted patients demonstrates unequivocally the dangers the patient may face when entering a crowded emergency department (ED). 1 Even the demonstration of increased mortality rates associated with crowding 2,3 has not compelled the hospital industry as a whole to implement policies and procedures to ameliorate crowding. Howeve...

Systems Engineering: Have we lost our Competitive Edge

Recent media reports include several large systems engineering failures. These failures are especially alarming given that they span different sectors (i.e., shipbuilding and space systems), and are not isolated to one firm. Therefore we need to ask: Have we lost our systems engineering competitive edge? What can the systems engineering discipline do to correct the apparent discrepancies that a...

Lost art of argumentation

In training to be physicians, medical students occasionally try their hand at structured debates over popular topics in medicine. These debating exercises highlight an important issue for physicians: we may be known for our smarts, but we are not always known for our stellar communication skills. Much of our job is made easier by the implicit trust patients irrevocably afford us, but what happe...

Prognostication: medicine's lost art.