Cold, sterile and well … clinical. Three words that neatly describe hospitals as many of us know them. In books, on TV and in movies, we see and experience hospitals as impersonal, solemn and sterile institutions — designed only to treat disease. Interestingly enough, while our society has begun shifting away from thinking of health as just the treatment of disease, our hospitals fail to reflect these changes. This is particularly ...

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Patient psychology is increasingly recognized as an important contributor to health outcomes. What patients believe about their health and their providers can significantly affect their initiative and their adherence. It is important to recognize that factors that appear to be unrelated to medical care can influence feelings about that care, as well as outcomes. The reason this occurs is that the brain is not designed to parse out each element of ...

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I was rotating through an infectious disease elective at an outside hospital during my fourth year of medical school when I encountered a startling situation. We were called to evaluate a patient who was suffering from an infection called Haemophilus influenzae. Now, I knew that most children were vaccinated against this pathogen, so I was surprised by the consult. I was working on a team with three others: one attending, one ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old woman is evaluated after laboratory study results show an HbA1c value of 9.1%. Her HbA1c goal is less than 7% because she has high function, long life expectancy, few comorbidities, good support, health literacy, and access to care. Medical history is significant for morbid obesity, ...

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When health officials learned that the 2015 measles outbreak was caused by clusters of unvaccinated children, Americans once more wanted to understand why some parents do not vaccinate their children. In our highly polarized culture, media commentators and even academics began to connect opposition to vaccination to either the left or right of politics. So a question arises: Who is more likely to be opposed to vaccination, liberals or conservatives? As ...

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Words matter. At some point, we all may have casually tossed a psychiatric adjective to describe a situation or person. There is usually no malicious intent behind the use of these colloquialisms. However, during these strange and unprecedented political times, psychiatric terms seem to be thrown around more so by those trying to paint a picture of current prominent figures. A late-night show host referred to someone as “being off ...

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I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity. Epidemiologists debate ...

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I bought a pocket ultrasound in 2011, determined to learn how to perform and interpret ultrasound at the bedside and thus transform my internal medicine practice. I bought it new, and it cost over $8,000. That was a staggering amount of money to spend on something I knew very little about. In 2015 after having performed many thousand ultrasound exams with my little GE Vscan with the phased array transducer, ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 58-year-old man undergoes follow-up evaluation for cancer of the ascending colon diagnosed 3 weeks ago. Colonoscopy at that time revealed a fungating mass in the ascending colon. Biopsy revealed adenocarcinoma, and additional studies showed no evidence of metastatic disease. Right hemicolectomy was performed. The pathology report ...

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For many, American football is a beautiful game that is simple to enjoy but complex to master. Choreographed with a mixture of artistry and brutality, it features the occasional “big hit” or bone-jarring tackle, forcing a fumble and turning the tide of the game. But with this part of football comes justified concern about the long-term health effects of engaging in this type of activity over time, concerns that abound in ...

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