The invitation was unexpected. Although I would attend the conference as a relatively new member of the community, I knew I was making inroads, so I accepted without hesitation. The prospect of meeting well-established players in the field at dinner with the planning committee was exciting. And, I was equally looking forward to spending more time with a fellow newbie who had already been tapped as a rising star the ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is seen for follow-up evaluation of Parkinson disease, which was diagnosed 10 years ago. Although his symptoms initially were well controlled with medications, he has experienced increasing fluctuations in motor symptoms, specifically tremor at rest and slowness, within the past 3 years. Medications are ...

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This year, I stood on the curb at the 2017 Halifax Pride Parade and watched high-energy floats pass by. Leading the parade was the indigenous float. The vibrant trans youth float warmed my heart. The prime minister waved and called out “Happy Pride!” to the spectators. It was a stream of enthusiastic faces, song, dance, and brightly colored banners. I love pride. It’s is a special time for a lot of ...

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In a recent Vox interview, Senator Brian Schatz (D-Hawaii) announced his plans to allow individuals without insurance to buy Medicaid coverage. As a family doctor caring for patients on Medicaid in Senator Schatz’s home state, I cannot support such a plan. Medicare continues to be run by the federal government. In contrast, Medicaid programs are run by states. The trend in recent decades is for ...

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As I sit in the exam room waiting for my first patient of the afternoon, the phone rings. It rings four more times before I realize that Amanda Ringwald, our eighty-year-old receptionist, hasn't come back from taking a rare lunch break. I pick up the phone and say, "VA Hospital. Marianna Crane." Oops, I'm not back at the VA anymore. "Senior Clinic," I quickly add. "Hello, my friend." The familiar voice makes my ...

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Saturday nights on my couch are usually late and peaceful. But my old friend, civil unrest, crept into my reprieve. Do I do one more "to-do task?" Or do I or continue my aimless net surfing? But it's not exactly aimless now. I'd just stumbled across an online article: "When You are the Friend of a Physician Suicide." The physician-author's narrative about his friend's death and the reader's posts, mostly from ...

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I am not the first physician blogger to write about the difficulties of prior authorizations, denials, and appeals, but recent occurrences in my own practice have been so convoluted that I feel they must be shared. The nonsensical denials would almost cause one to laugh, if not for the reality that each denial represents potential delay in care for the patient and redundant work for the physician. That's work that expands ...

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One way to fight burnout is to have a passion outside of medicine, or another passion within medicine.  The work I do with KevinMD is what is preventing me from becoming a burned out, physician statistic.

"The doctors who did this should be hanged." It's a statement the came at me with a bang. It stood out in its thread, in the accusatory way of old courtroom scenes of black and white movies, where the heroine dramatically screams out at the jury, seated wide-eyed in their box nearby. But it was merely a response to a Facebook post on the topic of the opioid epidemic, typed in nonchalantly, ...

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Twenty years ago, Congress made a commitment to its children when it created the Children’s Health Insurance Program, recognizing working parents who earned too much to qualify for Medicaid still couldn’t afford health insurance for their kids. For pediatricians who remember, the practice landscape was a great deal different then. So many children were uninsured that pediatric emergency rooms were filled with children who needed routine school physicals and regular ...

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It’s 8:45 p.m. in rural Chiapas, Mexico. A cool blanket wraps around the previously warm day in the small farming town of Honduras. With a syringe of medicine in his front pocket pasante, Dr. Ivan Martinez does a steady jog up a steep hill to see about a patient’s chronic pain. Nestled in the Sierra Madre Mountains, there are few flat places. At the door, he’s immediately and warmly greeted by multiple ...

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Devastating. That alone cannot fully describe the extent of the destruction of property, the displacement of tens of thousands of residents, the injuries and loss of life in the wake of Hurricanes Harvey and Irma. As Americans, our hearts ache for those affected by the flooding. As a medical student, former international development worker in Afghanistan and EMT in South Africa, I also lay awake thinking about the many infectious ...

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As I approach the end of my medical school training, I want to take a moment to reflect upon the invaluable education that my classmates -- novices in medicine but rich in life experiences -- have provided. Nearly all of us identified with the common struggle of medical school: late night study sessions, difficult days, and the general balancing act of focusing on work as well as our own wellness. All ...

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A pediatrician husband recently wrote here in KevinMD about the stark differences in assumptions about work-life balance for men and women, in "What does your husband think of you being a surgeon?"  Then I came across another article on Medscape by a male cardiologist, whose wife is also a physician, entitled, "The gender gap in cardiology is embarrassing." Both men’s wives delayed their medical training, and ...

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No one needs to know the value of multitasking more than a physician. At any point in time, we have to juggle a myriad of tasks and obligations. As a younger physician, I was able to recall multiple requests and obligations without writing them down. As I have grown older and the memory is starting to fade, I find it necessary to ...

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It’s that time of year again, the dreaded, yet exciting, residency application season. Year after year, we have learned that securing a residency position extends beyond competitive scores. It involves planning, networking and putting your best foot forward to prove you are the perfect “match” for a program. To avoid having shock and stress of an unexpected scramble, we wanted to share five tips, which extend beyond some of the ...

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We humans can’t help but shove as much as possible into one minute, one hour, one day. We’re rewarded for doing it, too. Society says that the more you check off your list, the more productive you are. And by default, then, the more productive you are, the more successful you are. So, we rush. We search for ways to skip steps and still get the same result. We fill ...

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There is a 4,300-strong grassroots movement known as “Save Our Hospital” gaining notoriety in Albert Lea, Minnesota. This story is symptomatic of the fact that hospital consolidation has slowly become a national pastime. With declining revenue under the Affordable Care Act, mergers increased by 70 percent, leaving small communities scrambling for health care access. The latest casualty in the “hospital-consolidation-for-sport” trend is Albert Lea, a small ...

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Most parents have been deeply distressed by the rising violence and streams of hate as a keynote in our national discourse. For a constructive response, I encourage parents to write to their school administrators and partner with the adults in their children’s community to stem the tide of vitriol that has engulfed our views on race, religion, and the study of history in our everyday lives. Here is an edited ...

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We tend to like threes. Hendriasis, in Greek — one through three, is a figure of speech used for emphasis in which three words are used to express one idea. For example: Veni vidi, vici. Location, location, location. Or one of the anthems of my youth — sex drugs and rock n' roll. Monty Hall had three doors on "Let’s Make a Deal." Even Uncle Junior, the patriarch in the “Sopranos,” ...

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