Spending six months at a world-renowned hospital institution has been an incredibly insightful and uplifting experience for me. As part of the Master'...

Now, nearly 30 years later, thoughts of Edith and her psychosis, her time with me (and my time with her) on an inpatient psychiatric unit, my attempts to understand her and care for her, have affected my work today. I struggle with this question: How can we do better?

I got into the health care field to save lives, and the last thing I planned on doing was to chair a committee and study process improvement. In the beginning, I asked myself how all of that ancillary activity could have anything to do with my mission and calling.

I have come to realize that in order to experience the rich and rewarding life I seek, there has to be a balance between discipline and passion. My dogged determination to hunker down and plow through any situation often meant that I ignored or missed opportunities for joy in my life.

As our health care system moves from compensating providers on the basis of quantity of care to quality of care, it's very important to measure hospital performance. But a key limitation for that measurement is patient selection.

Here are a few important and often unrecognized considerations that patients and their families should be aware of when discussing code status with their health care team.

Although I continue to believe that these professional qualities are paramount to excellent patient care, I am finding that other, less-obvious proficiencies are also required. Ironically, these skills that I have in mind involve a field what we as physicians know least about: business.