As the world speeds up we tend to assume that newer must be better. In some instances it is but when it comes to health, less so than one might expect. The other tendency is to overlook simple solutions and go to complicated, and often expensive ones. In medical practice there is one step even before considering what to do with a given problem and that is whether there is a ...

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Traditionally, the patient chart stayed in the doctors office and rarely did a patient get a glimpse of anything in the record.  Photocopying the chart is expensive and no physician would let a chart leave her office because the record must be held safely for a minimum of 7 years.   Now more and more offices are doing away with clunky paper charts and electronic medical records are becoming the ...

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I admittedly snorted out loud when I read a New York Times article recently regarding increased physician distraction due to electronic devices, especially with the advent of the smartphone with its emails, text messages, calls, and other alerts that ping intermittently throughout a typical work day. There is no question that electronic devices distract physicians as the article pointed out. But that's like complaining about a leaky faucet when there's a flooded basement ...

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Recently, I presented Family Medicine Grand Rounds at Georgetown University School of Medicine on resolving conflicts between screening guidelines. During the question and answer session, Department Chair James Welsh, MD asked how evidence from carefully conducted clinical trials can possibly overcome powerful emotional stories of "saved lives." I answered that evidence-based medicine's supporters must fight anecdotes with anecdotes. For every person who believes his or her life was extended by a ...

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It all started while out to dinner with a couple of my fellow Brigham/Massachusetts General Hospital OB/Gyn residents. We were discussing our favorite old TV shows and one fellow resident's love of The Price Is Right with Bob Barker. After talking about the game show, a light bulb went off in my head and I thought, "Why can't we play The Price is Right with hospital charges to our patients?" With ...

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An oncologists deal with fateRecently, a very dear friend learned that her breast cancer (diagnosed in 2010) had spread to her brain. Despite my many years as an oncologist, having faced questions from my own patients about "Why me?", "What did I do to deserve this?"—questions I am fully aware have no answer—I found myself asking the same questions, expressing the same anguish: "Why ...

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When Dr. Timothy Malia of Fairport, New York, runs behind schedule, he passes out five-dollar bills to everyone in the waiting room. And when Dr. Cyrus Peikari of Dallas, Texas canceled his appointments for a family emergency, he gave each patient 50 bucks for the inconvenience. Most doctors apologize. Few offer cash. Others get creative: Dr. Gwen Hanson of Bellevue, Washington gives out Starbucks cards; Dr. Sharon McCoy George of Irvine, ...

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It is obvious to those who know me that I am an avid anti-smoker and work hard to help those afflicted with a tobacco addiction break their habit. Knowing your shortcomings is an important part of being successful. One of my short comings is not knowing when to quit. When it comes to helping smokers stop smoking, I am a zealot. Today, I went to work on one of my smokers, ...

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You know Mr. Miller? I adjusted the phone on my ear as I slipped out of bed and snuck into the bathroom. I tiptoed across the floor and winced as the old hardwood started to creek beneath my feet. I craned my head and listened for signs of stirring children. Remembering the resident holding on the line, I whispered into the cell. Yeah. What about him? He had a choleycystectomy this morning. I waited ...

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To just what age do you expect to live? You haven't thought about it? I bet you have. Would you like to live as long as Methuselah? Television's "Today Show" antes up centenarians to celebrate from time to time. There are about 70,000 American outliers past the age of 100. But that's out of a population of some 311,000,000 people. The most sensible place I know to read about this conundrum of ...

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