A grandfather-father-husband-salesman-cook-gardener-hiker-gentleman, adored by many, is struck down by cancer.  His disease is particularly horrible, spreading quickly though his body causing damage not only to bone and organ, but to sinew and nerve. He suffers terrible pain for weeks, relieved poorly with inadequate doses of inferior medications, thrashing in misery witnessed by his kin, always at the bedside, ages seven to seventy.  Finally, uncomfortable and agitated until the end, he ...

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We know that physicians (and their pens/keyboards) are some of the main drivers in health care spending. But which ones are the biggest offenders? A recent study from the nonprofit RAND Corporation asked this question and found that newer doctors tend to run up higher health care bills for their patients than their more seasoned colleagues. The study, published in Health Affairs earlier this month, looked ...

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Ask your toddler to do the chores If you ask for a spoon in my house, you may expect to be directed towards a drawer of neatly nestled stacks of stainless. Instead, you will likely find this a tangled mess of silver and plastic in no apparent order. I used to be bothered by a such a disorganized silverware drawer, but that was years ago. I have let go of ...

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Why are physicians burning out? Too many emotional extremes My patient was brought by EMS after a respiratory, and subsequent cardiac, arrest. She could not be intubated in the field, and I did so on her arrival. We actually restored some circulation, albeit not much. Over the course of an hour, despite our best efforts, she became blue again, with lividity pooling in her flanks. I ...

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Doctors should return phone calls because it is the right thing to do My veterinarian answers my phone calls.  The other day I called her office to ask for a renewal of the pain medication for my little dog Jack.  He has been blind and deaf for over a year, but now his rear end is going and he is falling a lot and having a hard time getting up. When I asked for ...

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A war is brewing in the House of Medicine.  It's a war of philosophy based on how we physicians approach our patients--the people who come to us to be cared for and to be cared about.  The people who come as patients to the physician as healer, a healer who also has a wealth of scientific knowledge which can be used to stamp out disease and bring long, healthy lives ...

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My advice to a new generation of doctors “There’s no passion to be found playing small, in settling for a life that is less than the one you are capable of living.” -Nelson Mandela Amidst the chaos of our noisy world, it’s hard to know where to begin a new career as a healthcare professional who’s about to inherit an American disaster called healthcare. And it’s likely that in a few ...

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I can always count on Mr. Wonderful to come up with a timely subject for my blog.  Today’s quotable is, “Dear G-d, I have a problem.  My problem is me!” Some days it feels like I spend half my time trying to convince patients that they need to change their ways in order to get healthy.  I often spend the other half of my time treating the effects of their bad ...

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As a primary care doctor, my days are busy. Seeing patient after patient, I try to provide the most patient-centric, evidence based care that I can. But if I read anything about healthcare reform, it will tell me that 80-85% of the patients I see can be seen by a nurse practitioner or a physician’s assistant. So why did I train for an extra 3-4 years as a doctor, incur ...

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One of medicine’s ethical traditions is to relieve suffering whenever possible. I believe in this, and try to treat all of my patients as I myself would want to be treated under similar circumstances. My dilemma is, even after practicing medicine for over 30 years, the definition of a “suffering patient” has become a moving target. On the one hand, I hear arguments primarily from governmental agencies that presume to “advocate for ...

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