A fairly recent article in the Journal of Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students. It is sobering because it describes the potential harm that can come from it — harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless quest to explain everything. "Overdiagnosis" is the term the authors ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old woman is evaluated in the emergency department for several hours of altered mental status. She is from out-of-state and is visiting with relatives. One of her young relatives was recently ill with gastrointestinal symptoms. The patient developed anorexia 3 days ago and vomiting 2 days ago. She has been ...

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Dr. Tom Price may become the first medical doctor to lead the U.S. Department of Health and Human Services in 24 years. One might think that having completed medical school and practiced orthopedic surgery before entering politics might give him some extra insight into what works and what doesn't in medicine. But judging by a letter to then-HHS Secretary Kathleen Sebelius that he signed in 2011 objecting to the ...

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A concussion is a brain injury. A mild one, yes, but one that can lead to longstanding symptoms. What you do after a concussion, immediately and in the weeks that follow, can make a big difference in how your child recovers. Though it’s a mild injury -- there’s nothing to see on a CT, X-ray, or MRI -- the effects of a concussion can be significant and uncomfortable for a child ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a 6-month history of worsening exertional dyspnea. He has a history of severe COPD diagnosed 4 years ago and previously had minimal exertional symptoms. However, he now notes shortness of breath when walking short distances that is limiting his activity level. He does not have ...

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I want you to know about colds, and integrity. Every day I see a hand full of colds. Viral upper respiratory infections. Bronchitis. Coughing, sneezing, congestion, fever. You come to me because you are miserable, and I appreciate that you trust my advice. I want you to know that I can commiserate with you. I don’t want you to feel miserable either. Truthfully, as odd as this sounds, I wish could find ...

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One evening this past week, after my wife finished feeding our 5-week-old daughter, I took over baby duty. I sat her up on my lap and gave her a few thumps on the back. Not hard enough to hurt, obviously, but just to make her burp. She didn’t burp. So I gave her a couple more gentle-but-firm whacks, still without a result. And then I remembered the phone call I got a ...

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I know why I sometimes eat too many brownies. They taste great! The same goes, of course, for a whole slew of desserts -- I love me my strawberry rhubarb pie, and I never say no to a ginger snap. And while a touch of dessert is often a fine way to top off dinner, many of us get in trouble when we gorge on desserts. So how can we get ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 45-year-old man is evaluated for right-sided chest discomfort and cough of 2 weeks' duration. His chest discomfort is described as a vague, painful sensation on the right. The cough occasionally produces a small amount of sputum; he reports no hemoptysis or shortness of breath. He has felt feverish with mild ...

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I recently read a book by Dr. Barbara Natterson-Horowitz a UCLA cardiologist who also happens to be a consultant for the Los Angeles Zoo. In her book Zoobiquity, Dr. Natterson-Horowitz demystified the story of HIV (Human Immunodeficiency Virus) transmission from monkeys in West and Central Africa to humans. Most physicians today, including me, have a limited knowledge of zoonosis (the science surrounding bugs that can be from animals to humans) ...

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