Several years ago, I spoke at Baylor College of Medicine in Houston, where Michael DeBakey, the legendary heart surgeon, was master of the universe for nearly half a century. I heard lots of DeBakey stories during my visit, but one in particular really stuck with me. “A few years back,” someone told me in a voice of hushed reverence usually reserved for descriptions of flawless beach days and single ...

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PLoS Medicine recently published an article commenting on an earlier study exploring the link between social networking and mortality. The result speaks for itself: "the degree of mortality risk associated with lack of social relationships is similar to that which exists for more widely publicized risk factors, such as smoking." You read that right, according to this study which examined over 300,000 participants in a meta-analysis, social relationships are ...

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Raghav Govindarajan, ACP Associate Member, a neurology resident at the Cleveland Clinic Florida, told us about a case he saw in India that has important lessons for clinicians everywhere. The patient was a 65-year-old man who presented with chronic symptoms of burning discomfort and weakness in his left leg. His symptoms had started about seven years prior and he had been told that he had “neuritis.” He reported that he had ...

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A guest column by the American Medical Association, exclusive to KevinMD.com. As the nation’s largest physician organization, the American Medical Association (AMA) is uniquely positioned to help physicians thrive in medical practice throughout the stages of their careers. Because the AMA is led by physicians, we understand the many demands and rigors physicians face as they work to provide high-quality patient care, and we are proud to support  physicians in their ...

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Ten years ago, I wrote the Pew Internet Project’s first report on the impact of the internet on health care, calling it “The Online Health Care Revolution.” Back then, the idea that people were searching online for health information was revolutionary. All of a sudden, regular people had access to medical information that had always been locked up and out of reach. Ten years later, I am ready to declare ...

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Are patients better off than they were ten years ago? Just over a decade ago the Institute of Medicine (IOM) released its celebrated report on patient safety, To Err is Human.  Many credit that report, which was released with great fanfare, with launching the patient safety movement.  So it's appropriate to assess the movement's impact eleven years later.  How did we do? On November 25 the New England Journal of Medicine published ...

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by Steve Sanders, DO “What am I going to do now Doc?” asked Mike, a down on his luck, 29 year–old recently unemployed truck driver, as he handed me his hospital bill. Mike was seen at our local emergency department on a Friday evening with complaints of indigestion. Earlier that day he and his wife Susan celebrated their second anniversary by splitting a store bought pepperoni pizza. ...

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Recently, I had a patient visiting me for the first time. He basically a "syndrome X" type of guy: middle-aged, overweight, high cholesterol, high blood pressure. He's not the most personally careful individual, with a history of domestic altercation, some prison time. Almost goes without saying he drinks too much and smokes cigarettes. Well, he wanted his cholesterol medication restarted since he has just now started receiving "insurance", MassHealth, Massachusetts' state ...

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I have been genuinely blessed by my career in medicine. When I started medical school, I was living through a very rocky time, dealing with severe, at times suicidal depression.  I was working through an outpatient alcohol and drug rehabilitation program, and I was about 40 pounds overweight.  I had grown up with a very negative and fatalistic attitude toward life which resulted in chronic misery and a number of personal ...

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We are no longer surprised when a patient is asked if they take their blood pressure medicines every day, and we are told "it depends." Yes, it can be amusing to hear how one member of a couple decides that they know more than their physician, and makes decisions based on home blood pressure measurements. Sample quotes may include “she thinks she is a doctor”, or “I decide what to give ...

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