I grew up most of my life avoiding doctors and hospital visits. I never fancied getting shots or blood draws as a child, and without health insurance; I didn’t have much of a choice.  This lack of access is what drew me to volunteer at the county hospital I was born at. Every Wednesday morning, I would report to the pediatric asthma allergy clinic at San Francisco General Hospital. Most ...

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The letters are usually four pages long and begin by saying that my patient has received a temporary supply of the medication I prescribed. Next, there are general paragraphs about how the drug either isn’t on their formulary or the quantity exceeds the plan limits. None of these letters contains a reference to an online formulary physicians can access to compare covered alternatives. Then there are several cumbersome explanations about the appeal ...

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The flu season has really gotten into gear now with 46 of our 50 states reporting widespread influenza activity as of January 3, 2015. Influenza is a virus that infects the respiratory tract, causing sore throat, runny nose, fever, and cough. Rarely people with the flu will have nausea, vomiting and diarrhea, but this is not "stomach flu" which is a term some of us use to describe any one ...

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The power of placebos has long been known. People who believe that they are taking an effective drug frequently feel better. In fact, prior to the discovery of penicillin, it is likely that the placebo effect accounted for much of the benefit of medical care. A study published in the journal Neurology makes an interesting connection between the magnitude of the placebo effect and the medication’s perceived price. The study enrolled 12 ...

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“Twilight! She has to have twilight,” insisted the adult daughter of my frail, 85-year-old patient. “She can’t have general anesthesia. She hasn’t been cleared for general anesthesia!” We were in the preoperative area of my hospital, where my patient -- brightly alert, with a colorful headband and bright red lipstick -- was about to undergo surgery. Her skin had broken down on both legs due to poor circulation in her veins, ...

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As the Centers for Disease Control and Prevention (CDC) reported that people who received this season's influenza vaccine were only 23 percent less likely to be diagnosed with influenza than unvaccinated persons, CDC director Tom Frieden was publicly urging high-risk patients and their physicians to use antiviral medications to prevent complications and disease transmission:

People who are sick with flu, if they're very sick in the hospital or if they have ...

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Parents are appropriately expressing concern about the safety of Miralax®, a commonly used stool softener in kids, after a recent New York Times article exposed a potential association with long-term use of the drug and undesired behavioral side effects. As the article explains, the FDA has awarded a research grant to a team at the Children’s Hospital of Philadelphia (CHOP) to directly address these concerns. Miralax® has been used ...

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The measles outbreak from Disneyland is a potent reminder of a) how infectious measles actually is; and, b) what happens when people don’t vaccinate. However, despite a mountain of evidence that vaccination is safe and does not cause autism or immune dysfunction or really anything terrible at all people still refuse. I live in a county that is on the leading edge of this scientific ignorance, but we are not alone ...

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Spend less.  Live better.  Except, she didn’t have that long to live.  Maybe ten days ... probably not. Thirty-three years old, an illegal Mexican migrant worker, she was diagnosed in an emergency room with an aggressive stomach cancer two years ago, and she had been fighting for her life ever since.  Multiple rounds of chemo administered through our community medical clinic had not worked. And now, here she was in my ICU, ...

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Headlines still appear about the vaccine “controversy.” However, there really isn’t one is there? Vaccines hold no controversy in the arenas of science, public health records, and medical schools across the country. In fact, the use of vaccines is considered standard of care. All mainstream religions uphold their immense value and even make them a part of their humanitarian relief programs. So, what is happening? I am a physician and a ...

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