screen-shot-2016-08-16-at-5-08-11-pm Donald Trump is talking about Hillary Clinton’s health as are two doctors who have never evaluated Clinton. This attention on Clinton has renewed some interest in the letter Donald Trump released last year from his personal physician. Many outlets have picked it apart, but I want to tell you as a doctor exactly how bad it is. I would never write ...

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During my first rotation of intern year, we took care of a woman who walked into the hospital with a kidney stone and never walked out. 52 years old, diabetic but otherwise healthy, she had been vacationing in Vermont with her son and extended family when she became sick with high fevers. When her symptoms didn’t improve, her son rushed her to our emergency room where an imaging scan revealed ...

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I graduated medical school in 1995. I believe in a single-payer health system. I am about championing for my patients. I left a salaried position in academic medicine to go an underserved area of rural Maine and start a practice. This is the letter I wrote to the CEO of a large health insurance company recently. Dear Mr. CEO, My name is Cathleen Greenberg London. I am a family medicine physician who ...

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The science we conduct often reflects the society we live in. One phenomenon of current society is the rise of the reality television show. Participants are promised instant media fame without having to struggle through acting school. I worry that this has rubbed off on some of the studies we now conduct. Sir Richard Doll and Austin Hill, the architects of modern epidemiology, realized that it was hard for epidemiology ...

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"Z" and "S" were both hesitant skeptics from the start. Earlier this year, they’d signed up for an entrepreneurial class I taught. Z was a first-year medical student with a dream of having millions. S was his blonde-haired, model-type wife; ex-ballerina-come-cancer-survivor who wanted to help people with similar experiences. Before the course, she’d contemplated taking out even more debt in student loans so she could go into physical therapy.  After the course, ...

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Years ago on Cape Cod, my kids and I stumbled across a man who had spent the day creating a sand sculpture of a mermaid. It was an impressive piece of art. “How long did it take you to make it?” we asked. While I can’t recall his precise words, the response was something like “25 years and 7 hours.” I’m sure my astute readers will get his point. We are transfixed ...

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2:15 a.m., July 2, 1981. Its 83 degrees outside in a loud, humid Chicago night, but here the scrubbed air is chilled, dry, while white tiles reflect the occasional nurse, who appear and vanish, and the rhythmic sighs of the machines, gasping somewhere down empty halls, are occasionally interrupted by a frantic chime. My first night in the unit and my first patient’s chart.  Papers spill from the accidentally opened binder ...

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Living in the fine city of Boston, I am fortunate enough to be located right in the middle of a medical hub. A place that’s full of exciting new research, developments, and ideas. Working at the front line of hospital care, also with a keen interest in quality improvement, patient experience, and technology, I frequently attend social and professional healthcare networking events around the city. While doing this, I’ve gotten to ...

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“Get well soon!” That’s a common saying. All of us have heard it. But what if you have an illness that you won’t ever get better from? The most horrible part of having a chronic illness is that it’s forever, or for a very long time. Unless your personal miracle comes, your illness will always be with you. There isn’t an end in sight. There’s just adjusting to the pain, the tiredness, ...

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To my younger self, I remember how excited you were when you finally settled on medicine as the thing that you wanted to do as a career in your junior year of college. I remember all the questions you had about what the process entailed since no one in your family had undertaken this journey before. I even remember some of the doubts you had when you thought about how long ...

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Many recent articles, blogs, and presentations have focused on what American health care lacks and what additional skills health care professionals should adopt to “fix” our “broken” system. Third-party payers and health care organizations tend to promote the need for quality improvement and economic measures, while clinicians grapple with their transition to less-autonomous employees, noting increased job dissatisfaction and conflicts regarding administration and reimbursements. The theme that American health care ...

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A.J. Smith, a pseudonym of course, walked into my office today, unhappily.  Most of her topical medications for acne caused too much irritation.  The ones that didn’t, weren’t working.  The doxycycline caused photosensitivity in the past.  But her friend’s dermatologist gave her isotretinoin, better known as Accutane, and she completely cleared.  As such, that’s what my patient demanded.  There was only one problem.  The degree of her acne didn’t warrant ...

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The federal government has been trying to control the health of citizens for nearly a century, increasingly separating patients and their physicians. WWII wage controls firmly established health insurance as an employee “benefit” in lieu of salary.  This gave the employer power to choose coverage based on its needs, not the employee’s: the first degree of separation. Since WWII, government has imposed a multitude of programs that add degrees of separation: Medicare, ...

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I was home free: in my final year of medical school, with one last rotation to finish. I had matched into a residency in obstetrics. The tsunami of stress that loomed over the past year -- choosing a specialty, interviewing all over the country, waiting for the life-altering but fickle match -- had passed. I knew where I was going and what I was doing. Our end-of-the-year show was fast approaching. ...

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It’s Friday afternoon at 4 p.m., and Mr. Anderson walks into my endoscopy suite as the last patient of the day. He’s a 65-year-old publicly-insured male who presents for a screening colonoscopy. He’s 20 minutes late, because he went to registration in the surgery department. He is convinced “looking for cancer” requires surgery. In triage, the nurses learn that he has held his Coumadin for five days as personally instructed by ...

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Sometimes, the loudest sounds I hear in the emergency department are laughter. It may seem irresponsible. It may seem discordant. It may seem callous. To me, it is the sound of survival. It is the sound of resiliency. It is the sound of making it through the day. My father was at work when he suddenly became cold, clammy, and collapsed to the ground unresponsive. His staff did the right thing ...

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As first year came to an end, we were asked to reflect on our experiences thus far. The multitude of tests and memorized facts, anatomy dissections, and patient interactions flooded my mind. Shockingly, it was not the difficulty of the first year of medical school that I will remember the most, rather the jaded comments from physicians and students that attempted to cloud my perspective of medicine. “Medicine is different now. ...

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I knew it was bad when she couldn’t tell me her name. I watched her face fill with frustration as a word she had uttered countless times over eight decades somehow got lost between her brain and her lips. It was 2 a.m. and I was on call as the surgical resident. I had been told that a patient with bladder cancer was being transferred from another hospital, and, as these ...

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As the health care landscape in America continues to change after the enactment of the Affordable Care Act, we are seeing an even more diverse group of patients seeking care across the nation. As rapidly as these demographics are changing, however, there is still progress to be made in diversity of health care providers who treat these patients. For instance, although 13 percent of Americans are of African descent,
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Quality measures began as tools to quantify the health care process, using outcomes, patient perceptions, and organizational structures associated with the provision of high-quality health care. Overall, the goals should focus on delivery of care that is effective, safe, efficient, and equitable.  Did you notice a particular word missing?  Yes, I missed the word physician too, because they have been left out of the conversation entirely. Measuring quality health care by ...

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