I was driving home from a night shift and the scorching sound of Texas guitars flamed out of my car speakers.  The group ZZ Top was old, but the song was new.  It went like this, “25 lighters on my dresser, yessir.  You know I gotsta get paid.” Mostly, I was shocked that any members of the band ZZ Top were still alive, let alone putting out new music that was actually ...

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The New York Times recently had an important and provocative piece, "Overtreatment Is Taking a Harmful Toll." The title is a bit misleading. The article focuses more on overtesting. We test too much and we treat too much. The article, while mostly accurate, does not really explain the reasons for the problem. Unless we can accept and understand the underlying reasons for these problems, we cannot successful correct these problems. Let ...

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Facing the difficult issues when it comes to high quality cancer careIt has been a long slog since we started our war on cancer here in the United States in 1971. At times I am not certain that this has been so much of a war as opposed to a series of skirmishes that occasionally have produced incredible moments of optimism. But there have been a fair share of frustrations ...

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I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. -Hippocratic Oath While Hippocrates recognized early on that medicine was complicated enough to necessitate specialists, medicine has advanced far beyond what he could have ever predicted.  I practice medicine in a world of specialists who have received training so that they might specialize ...

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When I write from my clinical experience as a behavioral pediatrician, I am careful to change identifying information to protect the privacy of my patients. It is rather freeing, therefore, to write  about characters in a novel. Left Neglected by Lisa Genova, who is also a neuroscientist (perhaps she took the story from some real cases) offers some important insights into this complex subject. The story revolves around Sarah, a 37-year-old mother of three ...

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Bill M. is a 22-year old college student who has had asthma and diabetes since he was a child. He comes in with trouble breathing because he has no primary care doctor and is out of his inhalers. While he’s in the ER, he also says that his diabetes hasn’t been followed for years, and now his blood sugars are out of control and he has new problems with his ...

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One of the joys of being a physician is learning the patients' histories. A joy, you say? Isn't taking the history simply part of the doctoring routine? You've all been there. When did the pain start? What made it worse? Did it move around or stay in one place? I agree that inquiries like these are not intrinsically joyful, but this is not my meaning here. I refer to history here in the conventional ...

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What if Hurricane Sandy came to your city? A guest post by the American College of Chest Physicians, exclusive to KevinMD.com. In light of Hurricane Sandy’s impact upon the east coast, and subsequent effect on the area’s healthcare delivery systems, many physicians and healthcare professionals are likely considering how they would respond if disaster were to strike their community. From the decision making process and preparation for ...

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As both the private and public sector aggressively shift healthcare incentives from a “do more, bill more” to a value and outcome based model, healthcare providers ignore patients role in driving outcomes at their own peril. It is generally understood that patients forget 80-90% of what they are told at the doctor’s office. As incentives no longer reward outcome over activity, this is a disaster financially for health professionals. This ...

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Recognize and manage physician stress and burnoutA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. "The tragedy of man is what dies inside himself while he still lives." - Albert Schweitzer Statistically speaking When is the last day you truly remember feeling peace, happiness and a deep sense of well being? If you cannot answer this question, you are not alone among ...

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