There was some good news recently about teens and driving: according to the Centers for Disease Control (CDC), the number of teens who report drinking and driving has come down by half in the past decade from two in ten to one in ten. While that really is good--great--news, it doesn't change the fact that motor vehicle crashes are the leading cause of death for US teens. In 2010,  every day ...

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Metastatic (stage IV) colon cancer and lung cancer are fatal incurable illnesses. That doesn’t just mean they are life-threatening. A fatal incurable illness is one which has zero survivors. You don’t know anyone who had metastatic colon or lung cancer who survived and is no longer ill. Chemotherapy is still occasionally used in such cases and sometimes can prolong life by a few months. Chemotherapy might also help temporarily alleviate some ...

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I had lunch with my old college roommate last week. She’s a new grandmother and was telling me about her daughter who lives in another state.  Her daughter is self pay because she and her husband own a restaurant and have opted out of insurance due to the cost.  She received her hospital bill in the mail and she was surprised at the cost of some of the items.  As ...

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On a recent Saturday morning, I took my problems to a bar.  The bar was on Boston’s Boylston Street at the end of a row of pubs.  Years ago, during orientation week of medical school, my classmates and I had worked our way methodically down that row. The bar I headed to on this particular day was the Apple Store Genius Bar.  The “bouncer,” a man with skinny arms and a ...

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I have watched more offices over the past few years close their phones and front desk during the lunch hour. If you close your office for an hour at lunchtime, what message are you sending your patients?  You are declaring that serving your patients takes a back seat to serving yourself and your employees.  Closing your phone lines at lunchtime means that you are creating missed opportunities for a vital ...

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Inappropriate care requests: The role of health care professionalsA guest column by the American College of Physicians, exclusive to KevinMD.com. How to reduce the cost of medical care while improving quality is the focus of several initiatives, including the American College of Physicians’ High Value Care initiative, the ABIM Foundation’s Choosing Wisely campaign, and Consumer Reports’ Consumer Health Choices. The common message is that we ...

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Why I decided to opt out of Medicare as a provider There’s a lake in Northern Arizona where I jog. I call it “my” lake. It used to be filled to the brim, a playground for ducks, geese, Monarch butterflies, rabbits and squirrels. Over the years when I’d jog in the cold mornings, my lake dried away from drought, measured by bathtub rings on the boulders which surrounded it. Today, rust-colored grass ...

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When a medical student sees you, consider it your lucky day Medical students rotate through the clinic I work at. I love it. It brings me back to those days. Sure, it reminds me how old I am, but also reminds me of the incredible impact patients have in directing the course of our career paths. We all have those memories. Our first delivery. Our first code. The first time we had to ...

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It is nearly impossible to ignore the need for clear thinking, confident and “in control” leaders. And whether in Congress or in a physician’s office, medical school department or hospital administrative suite, women leaders are notably absent. And while recent research tells us that women aspire to be leaders, the barriers to achieving this nebulous goal are enormous. So whose fault is it anyway?   I say both the women and the ...

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An excerpt from Pet Goats and Pap Smears. Both my parents are physicians. They are never home much because they work all the time. With no reliable child care, Dad takes me to work. The morgue is my favorite spot. It’s like our secret clubhouse. Nobody ever bothers us there. Entering the morgue, Dad opens the stainless-steel doors to the cooler and says, “Good morning! Is anyone home?” Then ...

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