DECAFfinalresize-640x480 Pancakesresize-640x480 Health insurance is complex. Eating out is easy -- unless you were to involve your health insurance company. If you hired a third party to pay your restaurant bill, you’d pay twice as much, wait 2 weeks for a table, and have 7 minutes to eat. I shared my restaurant analogy on a LinkedIn ...

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A major debate taking place in the hospital medicine community over the last several years concerns the way in which we cohort patients on the medical floors. The traditional way is to have patients belonging to each doctor scattered across the hospital on several different floors. This is in contrast to designing a geographical system where all the patients for any one doctor are located on a single floor. On the ...

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It was January 1, 2000, and I was an intern in emergency medicine at the University of Arkansas for Medical Sciences. I had gone to sleep the night before listening to celebratory fireworks and congratulating myself for surviving Y2K.  Now I was walking into the emergency department of our large, level 1 trauma center where I was furthering my medical training.  Like most urban ERs, this one was a busy place ...

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shutterstock_89942932 Today’s article follows the money trail to expose a different form of bias: the kind that takes place when doctors own their own diagnostic and therapeutic equipment. For people living with cancer, this kind of bias can have a particularly painful impact. Radiation therapy brings out medical bias In the United States, cancer is the second most common cause of death, killing nearly 600,000 ...

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Sometimes my day is like a book.  The first chapter may begin in the darkness of a self imposed corner as a phone call is made.  A voice, full with the thickness of slumber, answers unexpectedly. "I think today is the day." No matter how many years I have been discussing death I still find myself using poor euphemisms.  The bane of medical school teaching, I often struggle with the directness.  "Your mother ...

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shutterstock_209618260 We are, I trust, all but universally familiar with the knee-jerk, or patellar, reflex. A doctor taps the patellar tendon with a rubber mallet, and our leg kicks forward in response. The reaction is famously unthinking. In fact, it is literally so. What makes a reflex a reflex is that the brain is substantially uninvolved. The stretch of a tendon by the mallet ...

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I see nearly 100 patients a week.  Of these, easily 35% are overweight and 15-20% are obese with a BMI greater than 30.  I live in New Orleans, Louisiana, which along with Mississippi has the highest rate of hypertension, diabetes mellitus, arthritis, and other diseases commonly associated with obesity.  There are many explanations for the obesity academic in America but certainly poor nutrition and lack of exercise are at the ...

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I got the following email a few weeks ago (details changed for confidentiality reasons):

Dear Sir, I read about your unique practice online.   I have an 91-year-old ambulatory father who will not go to a doctor.  He definitely is not well and this is the only way I can get him the attention he needs.   He is adamant about not wanting medical interventions, however he still needs to be seen ...

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shutterstock_51253324 So much in medicine and in life is done out of habit.   We do stuff simply because that’s the way we always did it.  Repetition leads to the belief that we are doing the right thing. In this country, we traditionally eat three meals each day.  Why not four or two? We prefer soft drinks to be served iced cold.  I’ve never tried ...

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shutterstock_130004912 Welcome to college, young people! It’s an amazing time in your lives. These years will impact your life dramatically if you use them well. So, to help you along the way, allow me to give you some wisdom. First and foremost, get some wisdom. You are bright and capable, otherwise you probably wouldn’t be in college in the first place. But for all ...

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