Dear health insurance company, Let me set the scene for you.  It was a sunny August afternoon.  A young college woman with stars in her eyes and dreams of being a dentist came to my office.  She drove an hour to see me and would leave the next day for college. She was reasonably requesting that her implantable birth control be changed out so as to avoid pregnancy during her educational career.   ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man is admitted to the hospital for evaluation of substernal chest pain. His medical history is significant for type 2 diabetes mellitus, coronary artery disease, hypertension, and hyperlipidemia. He manages his diabetes as an outpatient with diet, exercise, and metformin. His other medications are aspirin, metoprolol, atorvastatin, and sublingual ...

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In 1978, the Institute of Medicine published A Manpower Policy for Primary Health Care: Report of a Study where they defined primary care as “integrated, accessible services by clinicians accountable for addressing a majority of heath care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” The four main features of “good” primary care based on this definition are: 1. First-contact access for new medical ...

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When I was 17 years old, I insisted that my father, a pulmonologist, join Physicians for Social Responsibility. I had just read about the organization in my history class, and I was feeling increasingly hopeless that I would live to see my 30s if the world continued its march toward nuclear Armageddon. My father refused to even have the discussion. I’ll get to why he refused in a minute, but first, a bit of ...

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The new school year is just around the corner (or maybe it’s already started where you live). Either way, here are a few quick tips to make sure you start the year off right: 1. Sleep is key: Poor or insufficient sleep can have significant effects on school performance. Many of us (myself included) let our children stay up later during the summer months. But as school starts back, it’s important ...

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"I graduated this July and took the QE (written general surgery boards) on July 19th. I got my results today, and I failed. Not only did I fail but my score placed me in the 5th percentile. Needless to say, I'm disappointed. You hear stories about CE (oral exam) failure but never about QE failure. I never blew the ABSITE out of the water (50, 29, 20, 34, ...

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We all want this sometimes, don’t we?  We want the things in our daily lives that bug us the most, like long lines at the DMV, to just go away.  But how often does that really happen? As the senior staff person for ACP’s governmental affairs team in Washington, DC, I often hear from exasperated physicians who want ACP to just make things they don’t like go away, whether it's MACRA ...

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A colleague of mine was recently questioning her capabilities having lost yet another patient who had arrived nearly lifeless after being shot.  She was despondent over the nation’s overall complacency about our gun violence epidemic giving her far too many opportunities to fail or succeed as a trauma surgeon. Truthfully, neither quick, decisive action nor expert surgical skill was enough to repair that much damage. Not in the hands of any trauma surgeon. As ...

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Left to our own devices, most of us physicians try our best to provide high-quality care to our patients. But almost none of us provide perfect care to all of our patients all of the time. In fact, many of us get so caught up in our busy clinic schedules we occasionally forget to, say, order mammograms for women overdue for such tests, or we don’t get around to weaning ...

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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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