Why does the universe have conscious beings? The physical and biological laws of nature do not seem to explain the existence of conscious creatures such as humans. Neuroscience has done well to explain many of our behaviors, illnesses and medical therapies based on purely physical and observable rules. But no one has ever measured consciousness. And yet it appears fundamental to whether my patient will recover from their disease. After 15 ...

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In medicine, there exists a dangerous condition that affects millions of Americans each year but is woefully underdiagnosed. It affects how long we live and how much we pay for health care. It impacts the way doctors treat us and care for us. Yet, many health care providers are reluctant to acknowledge that this condition exists. That condition is bias in medicine. We know that bias and discrimination kill. In politics, the ...

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An excerpt from Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery. Near my office, there’s a breakfast-and-lunch joint where strangers sit down at shared tables. When Joseph, an attorney ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 29-year-old woman is evaluated for a 5-day history of nodules over her lower extremities. She reports that she regularly visits a local spa that uses whirlpool footbaths during her pedicure procedures; she always shaves her legs with a razor before these visits. Medical history is unremarkable, ...

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Sometimes It’s important to know the news behind the news: the comments and the cautions that don’t get into the article that the public gets to read. It’s the sort of thing that keeps me up at night: trying to convey the reality, while realizing what most people want to hear is the hope. That’s the problem I have with a story posted on a major news network website ...

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4.9 million — yes, million — people are diagnosed with skin cancer every year in the United States. It costs an estimated $8.1 billion —with a “B — to treat those skin cancers, according to the Centers for Disease Control (CDC). Do I have your attention? I hope so. The problem is we don’t have enough attention. There is no other way to ...

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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 evaluated for new-onset ascites with lower-extremity edema. Symptoms have increased gradually over the past 4 weeks. He has consumed three alcoholic beverages per day for many years. His medical history is notable for coronary artery bypass graft surgery 8 months ago and dyslipidemia. His medications are low-dose ...

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Part of a series. The percentage of the population that will be “elderly” is rising fairly dramatically. In 1900 only four percent of the population was over 65 and only one percent over 75. By 1950 it was eight and three percent, respectively. By 2000 it was thirteen and five percent, and now it’s about fourteen and six percent. By 2030 it will be substantially more again. There are many ...

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Being a radiologist, I rarely speak to patients, but I was asked to counsel Mrs. Patel (not her real name), who was worried about the risks of radiation from cardiac calcium CT scan. Because of her risk factors for atherosclerosis, her cardiologist wanted her to take statins for primary prevention, but she was reluctant to start statins. They eventually reached a truce. If she had even a speck of calcium ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 44-year-old woman is evaluated for a 2-month history of a painless right neck mass. Medical history is unremarkable, and she takes no medications. She is a lifelong nonsmoker. On physical examination, vital signs are normal. A 5-cm right anterior neck mass is palpated. The remainder of the examination is unremarkable. An initial ...

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