“What is the term we use to describe the cells that help us diagnose papillary thyroid cancer?” the attending pathologist asked a room full of residents at a noon didactic. “Orphan Annie Eyes,” they nearly all responded at once. “And does anyone here know who Orphan Annie was?” he asked next. It is something memorized by every medical student -- the papillary thyroid carcinoma cells with cleared out nuclei are called “Orphan Annie ...

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When I was pregnant with my first child, I worked full time as a physician in the emergency department.  I worked mostly 9-hour shifts, but some 12-hour shifts as well. Days, evenings, nights, holidays and weekends were divided up amongst the entire group of physicians. I worked my share of those shifts as well. I have worked in the ER while pregnant twice now, and while I am proud to be ...

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You all have prostates. Seriously.  But let me explain further to those people who simply can not fathom as to how a woman could dare ask for maternity leave and expect her other team members to “pick up her slack, because she chose to get pregnant.”  (Yep, check the comments section on my last post. Pretty entertaining, in fact!) Life happens to everyone. If my profession as a trauma surgeon has ...

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I sit at my desk in a cubicle with high ceilings and an open entryway.  It is dark except for the somewhat eerie glow of light emitted by CRT monitors.  With concentration and some sense of urgency, I methodically plow through the queue of studies to be interpreted.  Some are marked STAT, some not.  I address the former first. Our ER is a busy one.  Many cases come from that department.  ...

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Last year, I retired from full-time practice and moved to a new area. At about the same time, my wife was diagnosed with breast cancer, and because she was in good health prior, she had relatively little contact with the health care system as a patient. Before our move she worked as a part-time school nurse, so we were able to share provider horror stories from different perspectives. Since we moved ...

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It would appear that I was a much more efficient cardiologist 20 years ago at age 50.  I had my share of the “worried well” -- patients with non-cardiac chest pains, benign palpitations, innocent murmurs and normal variation EKGs.  In most cases, a focused cardiac history and physical followed by some words of reassurance resolved the problem. For those with more serious cardiac problems, a battery of tests such as echocardiograms, ...

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Another workday comes to an end. 11 a.m. rolls around and freedom from the hospital beckons after another 24-hour call is finished. In the span of the preceding day, it is likely that numerous important decisions had to be made with the expectation that all of your mental faculties would be used, irrespective of what time of day it was or how much sleep was obtained. It is a day ...

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My 66-year-old professional athletic patient had a history of a scar tissue related small bowel obstruction seven years ago related to a previous appendectomy. He now had similar symptoms with cramping, lower abdominal pain, and some nausea. Since his office was next door to his longtime friend and gastroenterologist, he called over there. He was given an appointment with the junior partner since his buddy was out of town. Thirty years ...

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For the moment, I still take almost all insurances in my practice. And as long as I see enough patients (i.e., as long as the phone rings) I’m doing OK. I’ve been billing electronically with a free clearinghouse for about five years now, and things are pretty good. Over all these years, I’ve only dropped one insurance company. It covered a fair number of patients, including many of my ...

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I’ve read several articles recently reporting on a shortage of geriatricians. The writers have some clear misunderstandings of who actually cares for our elderly and where they come from. Susan Jaffe writing for Kaiser Health News stated that the American Geriatrics Society (AGS) estimates that the nation will require 30,000 geriatricians by 2030 to serve our aging population. This is probably true, what the AGS believes. She goes on ...

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