“Yeah, Doc, I drink. I drink a lot. Some nights I drink a case of beer and a half pint. Can’t sleep if I don’t drink. Relaxes me. Pure and simple. Numbs me up like novocaine.” A toothless grin. “It’s the feeling of floating away. I don’t know, I just keep coming back to it. Stuff goes in, feel a little flushed, a little rush, then I go somewhere else, you know? ...

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If you are interested in patient safety and medical errors and haven't read the story in the Texas Observer about a spectacularly incompetent neurosurgeon, you should. It is long but worth it. It will make you cringe. The story includes many details about operations done poorly and patients suffering paralysis and death at the hands of Dr. Christopher D. Duntsch. The Texas Medical Board is over-worked, slow to act and ...

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The word "doctor" derives from the Latin verb docere: to teach and, as a doctor, I do often offer instruction. But when a woman in her eighties comes in for her annual physical and tells me she's still dancing, mowing her own lawn, and helping out herolder neighbors, I have no illusions about which of the two of us should be doing the teaching. Particularly since reading this lovely feature story about Ethel Weiss, ...

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Talking with an insurance doctor, who denied a vertebroplasty for my patient with a spontaneous compression fracture, I started thinking about the dilemma of defining what a doctor-patient relationship is. A couple of years ago a local doctor with a dwindling private practice joined an Internet medical site that promoted drugs like Viagra and offered online consultations with physicians who prescribed the medications when they felt it was appropriate. The state ...

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Now that Labor Day has come and gone,  I’ve thought about the months ahead and the major challenges I’ll face. 1. Mergers and acquisitions. Health care in the US is not a system of care, it’s a disconnected collection of hospitals, clinics, pharmacies, labs, and imaging centers.  As the Affordable Care Act rolls out, many accountable care organizations are realizing that the only way to survive is to create “systemness” through mergers, ...

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jayz Do you know who Jay-Z is? If not, chances are your kids do. Jay-Z is one of the most successful rap artists of all time, and has parlayed that success into a career in fashion, merchandising, his own line of vodka, as well as an ownership stake in the NBA’s New Jersey Nets franchise that he recently sold to begin a new career ...

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As a pathologist, I am one step removed from the patient. This is comforting for the most part. I render my diagnosis and another clinician communicates it to the patient. It is best this way -- I have no treatment options in my own doctor toolbox to give meaning to the words I communicate. I learned this the hard way -- in fellowship training. Once I was doing a fine needle ...

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Many of us find ourselves responding recently to a shocking news story about a Michigan oncologist who may have violated the primary charge to clinicians: First, do no harm. The federal government is charging Farid Fata, MD, with multiple counts of fraud for intentionally misdiagnosing patients with cancer to justify billing Medicare for unnecessary scans and chemotherapy. The case will be sorted out in federal court over the coming months and ...

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In 2008, the state legislature of Washington passed what was called the Death with Dignity Act, a law that legalized physician assisted suicide.  Under the law, terminally ill patients (predicted to have less than six months to live) can request prescriptions for lethal medications from their physicians, under a series of safeguards:  multiple requests for example, determination of competency, and the like.  Then, if the patients so choose, they ...

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We gastroenterologists are regularly summoned to bring light into dark places. We are the enlightened ones who illuminate anatomical shadows. Sure, we have tunnel vision, but we like to believe that we can think broadly and creatively as well. We are the scope doctors. We are commonly consulted by primary care physicians and hospitalists to perform colonoscopies, upper endoscopies (EGDs) of the esophagus and stomach and other gastrointestinal delights. We deliver a ...

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