How informed are doctors? The answer is not obvious. Doctors know enormous amounts of data and have years of clinical experience. Many have solid science backgrounds and some conduct research keeping them at the top of their field.  Most rely on published studies to make their decisions on which products to use. However, only a small percentage of all published studies are level 1 studies: the studies with data that is ...

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There will are lots of things I hope improve in our health care system in 2015, but I’ll just mention one wish today. My wish is that the worthless wellness programs that have sprung up all over corporate America will fade away. I have criticized these programs in the past, but more ammo has come to light. A recent article in Employee Benefit News lists seven factors explaining how wellness programs are ...

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shutterstock_197629736 You are human and fallible. - Charlotte Bronte, Jane Eyre Alas, the frailty is to blame, not me -- for such as we are made of, such we be … - William Shakespeare, Twelfth Night Sha-doo-bee, Shattered … - Mick Jagger, “Shattered”, The Rolling Stones, Some Girls (1978) The image of the surgeon is synonymous with strength. Surgeons are stereotypically charismatic, commanding, confident, even arrogant. Strong minds, strong bodies, strong wills. Leaders, especially ...

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I am a doctor today because of Dr. J.W. Epstein, my pediatrician in Cleveland in the 1950s. An immigrant from the Nazi terror in Europe (it was family lore that he had escaped the Holocaust), he had trained in Vienna and spoke English with a Germanic accent. His house calls are etched permanently in my memory. His visits were heralded by a fury of activity, led by my mother. “The ...

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shutterstock_216030211 Dr. Heathcliff Huxtable.  Black America’s favorite physician is under fire.  Multiple allegations have surfaced and re-surfaced accusing Bill Cosby of various insidious perpetrations.  This blog is not intended to persecute or defend Mr. Cosby, but rather to highlight something to minority physicians that can be easily overlooked. Ask any black male physician under age 40 to name five black doctors who inspired ...

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I assumed many things that morning.  For instance, I thought it was likely that Ronald's fatigue was from lung cancer that had metastasized to the liver.  Or that he decided to stay in his room in the nursing facility because the decision to elect hospice had finally taken its toll. I was sure that he was both physically and emotionally spent.  I reasoned that I wouldn't want to get out ...

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0121_davidson-620x411 In 1994, I was working at my first radiation oncology job in San Diego at Grossmont Hospital when I came into work to hear disturbing news.  One of my colleagues in medical oncology, a compassionate man known for his gentle nature, had stayed late at the cancer center the evening before to finish up paperwork.  With his back to his ever ...

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The world of health care has made tremendous progress in the last several years in raising the quality and safety of clinical medicine. Despite this, the discharge process (when patients are discharged from hospital) is still fraught with potential pitfalls and opportunities for things to "slip through the net." If you ask most patients who are discharged -- particularly the elderly with multiple medical problems -- they will tell you that ...

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In the academic world, there is an unspoken rule under which faculty, residents, and fellows collectively live and work. Educational programs are to be separate from industry and its financial stronghold. I understand the rule and its application in certain scenarios and clinical departments. But I would like to challenge it within my specialty of orthopedic surgery. As I finish up residency and look ahead to fellowship, I am constantly thinking about ...

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shutterstock_245379106 It’s no secret that medicine has become a highly specialized business. While generalists used to be in charge of most patient care 50 years ago, we have now splintered into extraordinarily granular specialties. Each organ system has its own specialty (e.g., gastroenterology, cardiology), and now parts of systems have their own experts (hepatologists, cardiac electrophysiologists)  Even ophthalmologists have subspecialized into groups ...

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