An active 61 year female, who has been in my practice for 30 years, developed strange aches and pains and abdominal symptoms.  My evaluation turned up nothing. I then asked for help at the University of Miami rheumatology and gastroenterology divisions. With the help of a brilliant local gastroenterologist and rheumatologist, and after a trip to Johns Hopkins Medical Center and the Mayo Clinic, collagenous ...

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"How to Haggle With Your Doctor" was the title of a recent Business section column in the New York Times.  This is one of many similar directives to the public in magazines, TV and Websites urging us to lower the high price of our health care by going  mano a mano with our physicians about the price of tests they recommend and the drugs they prescribe.  Such articles provide simple, ...

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by Dennis Grace I recently received a message from the Center for Connected Health.  I must admit the opening of the letter really put me off. It asked:

How do you solve the puzzle of patient compliance?
I responded to the gentleman who sent the invitation with:
Well, you might start by calling it something less offensive. Patient compliance? The phrase assumes “patient” as direct object rather than subject of participatory medicine. We ...

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The approval of dabigatran (Pradaxa) has been long awaited in the cardiology community. Although just about everyone agrees that a good alternative to warfarin is highly desirable, there are many remaining questions about the drug as it prepares to enter the marketplace. Here are a few questions raised by electrophysiologist John Mandrola on his blog:

by Danielle Leach, MPA "A true friend walks in when everyone else walks out." I read that on a magnet on my friend’s refrigerator recently and the simple power of that saying brought me to tears. I have learned that lesson of true friends since my son’s diagnosis of cancer in 2007. Anyone who has faced a serious illness as a patient or a caregiver knows that you quickly learn who your ...

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Every once in awhile amidst the weekly deluge of medical articles comes a show-stopper that has the potential to change the way we practice. Rarer yet is the article that not only changes how we practice, but calls into question why we do what we do. This recent article from the New England Journal of Medicine is just such an article. Before you bolt, let me simplify it for you.

Here’s the ...

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You are a new parent. Your infant is gassy, fussy, spitty, and does not sleep much. In other words your infant is a normal baby. You are stressed, and like any good parent, you want to fix what "ails" your infant. As you stroll down the baby aisle at the grocery store, you see labels that tout words like gentle, comfort, and restful. Formula manufacturers are brilliant. They know their ...

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There has been an irresistible urge for people — doctors, public health officers, politicians, journalists, the usual pundits — to compare adherence to HIV treatment in resource-rich vs. resource-limited setting. I suspect this is because the whole issue got off to a famously bad start in 2001, when then-head of  the U.S. Agency for International Development (USAID) Andrew Natsios said in an interview with the Boston Globe that Africans,

don’t know what Western time ...

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Childhood obesity is a problem. It is a function of the foods children eat both at home and at school. The people responsible for feeding children are parents not advertisers. Running the line that it is all to do with advertising allows adults to run a "Johnny told me to" line, which would not be accepted as an excuse from a child. It is not about blaming parents. It is about ...

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by Eileen M.K. Bobek, MD The year after I finished my emergency medicine residency, I had all four of my wisdom teeth pulled. Afterwards, I looked as if I had taken several punches to my face. My jaw was swollen, my skin a cornucopia of muddied blues, purples, greens, yellows and reds. If people didn't know better, I told my husband with a laugh, they might think that I'd ...

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