The discovery of antibiotics is one of the most significant medical achievements of the 20th century. In the 1920s Alexander Fleming pioneered the discovery and use of penicillin, winning the Nobel Prize in Physiology and Medicine for his work. Other pioneers built upon his success and scientific research to pave the way for even more antibiotic development. The ability to fight infections has ultimately resulted in longer life spans and ...

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It was like watching the news footage of shoppers trampling each other to get through the doors of a Filene's Basement sale or witnessing people standing outside all night for the new iPhone even though it isn't a sale and it will be made in mass production for months or years to come.  I am talking about seeing people line up in the dark of pre-dawn to get their fingers ...

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The other day at an interdisciplinary rounds meeting at the hospital, one of our nurses who is also an emergency medical technician mentioned that in Britain injured patients receive tranexamic acid before arriving at the hospital because it reduces death from bleeding. "What's that?" I said. I kind of barely remembered hearing this medication's name associated with the treatment of a rare disease, but not treatment of trauma. So I was guessing ...

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What an amazing time to be a champion of new health care delivery models.  Three megatrends are driving change at a pace that I only wished for 20 years ago. Back then, I first had the insight that care could be improved, in some instances, if we separate doctor and patient in time and space. The first trend is provider reimbursement reform.For provider organizations going at risk with their payers, these are nerve-wracking ...

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The evening news is filled with fatal car crashes and shootings. But drug overdoses kill nearly 40,000 people a year, accounting for more deaths than vehicular accidents or homicides. Drug overdoses are on the rise in America, fueled largely by prescription meds. Reversing the course of this epidemic will require some dramatic changes. The facts Drug overdose rates climbed more than 100 percent between 1990 and 2012. But what most people don’t recognize ...

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Opioids are a family of pain medications chemically related to opium and heroin. They include morphine, fentanyl, codeine, hydromorphone and others. Opioids have unique properties that make them both indispensable for pain management and extremely dangerous. Unlike virtually any other family of medications, opioids have no maximum effective dose. If any dose, no matter how high, is ineffective at controlling pain, a higher dose can give more pain relief. Most other ...

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On February 18, 2014 the Food and Drug Administration indicated their consideration to allow pharmaceutical companies to shorten the list of possible side effects seen by millions everyday and night in pharmaceutical ads and commercials. In recent years, citizens -- patients and consumers -- have been bombarded with numerous and lengthy televised commercials in which pharmaceutical companies push their medicinal wares. It's called "direct-to-consumer" advertising (DTC). Such DTC efforts work for detergents, ...

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Despite representing only 4% of the world’s population, the United States accounted for almost 35% ($326 billion) of the global market for pharmaceutical drugs in 2012. Not surprisingly, the pharmaceutical industry’s business practices, considerable marketing budgets, and substantial profits are hotly debated as part of virtually every health policy discussion. But before addressing the possibility of transcendent evil in that industry, we should pose a more mundane yet critical question: ...

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Now that medical marijuana is legal in Massachusetts and licenses have been awarded for the first twenty dispensaries across the state, you'd guess that my practice is busily preparing to meet the demands of patients seeking marijuana prescriptions for several debilitating conditions including chemotherapy-related nausea and AIDS-related weight loss. You'd guess wrong. Since Massachusetts voters approved legalization of marijuana in 2012 I've received no special training (required for physicians to certify patients as ...

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The death penalty has been in the news lately, what with a "botched" execution in Ohio, using a 2 drug method that Louisiana has also recently adopted for it's administration of the death penalty. These changes come on the heels of a new tactic by death penalty opponents: getting European countries to ban their pharmaceutical manufacturers from exporting drugs that may be used to execute people.  These bans were partially responsible for ...

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