The state legislature in Florida decided it is legal and appropriate for pharmacists and pharmacies to begin administering vaccines against multiple diseases.  Their list of adult vaccines includes seasonal flu shots, Pneumovax (pneumonia vaccine) and Zostavax (vaccine to prevent shingles).  The rationale of the legislature is that access to doctors to receive these preventive vaccines is limited and difficult. By refusing to administer vaccines in their office because it is time ...

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The other night, a patient gave me a piece of his mind. Mr. Q was a middle-aged man debilitated by days of nausea, vomiting and intractable belly pain. That morning, his wife finally convinced him to get medical attention and drove him to our emergency department. On arrival, he sat in a cubicle in the waiting room and explained his story to a triage doctor: how he was doing well ...

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“This note was produced using [mega-brand] medical dictation software. While every effort has been made to insure accuracy, errors may still exist.” Really? What kind of doctor would admit in a medical chart to being too lazy or incompetent to produce an accurate record? A lot of them.  Dictations are easy to read if you are willing to confound legibility and accuracy.  Dictation software is relatively cheap, and with the continued profusion ...

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Millions of Americans believe in the practice. Government reformers believe in it. Doctors too. Heck, even I, an accused therapeutic nihilist, tracked down a poor soul who agreed to be my primary care doctor. Call it old-fashioned, but I wanted my own doc, and I wanted yearly “checkups.” No procedure—not even AF ablation–is as good as prevention. Taking your body in for routine checks and scheduled maintenance makes perfect sense. Call such a notion–obvious. But ...

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Did you know that urine pregnancy tests are routinely performed on all females before every surgery? No exceptions. The Children’s Hospital in Buffalo tests 9 years and above. Don’t know if a parent or a patient has a right to refuse the test, but I do know that the anesthesiologist will refuse to give anesthesia, except for a life-threatening emergency. I have never paid much attention to these tests. The nurses ...

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There are so many changes in medicine these days, but it takes a bit of time away from the keyboard to appreciate them. So glued have I become to looking at computer screens, it's been hard to pull my head from them any more.  Doctors lives are spent staring at these damn screens now.  I wonder how many of my youngest colleagues know how to start an IV, a foley, place a central ...

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Cancer survivors are truly remarkable peopleDavid Sampson, who is a colleague of mine here at the American Cancer Society, recently sent me a blog written by a woman well known in the breast cancer community who days previously had been diagnosed with recurrence of her breast cancer. The blog has captivated me, perhaps more so now that I have been facing some of my own ...

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Medicine, like law, the military, and many other professions, has its own language--a kind of verbal secret handshake by which its members recognize one another and close ranks against outsiders. Sometimes, the use of technical terms, abbreviations, and other forms of jargon can impair patients' understanding of their medical care. This article discusses the extent to which clinicians overestimate patients' "health literacy"--with potentially dangerous results. But sometimes, medical lingo has ...

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People often ask how old my son is when we are out and about. When he proudly says, “Two!”, the most common response is a smile to him ... and a knowing glance to me. This is often accompanied by, “Oooh, the terrible twos!” I’m here today to stand in the defense of two-year-olds. Sure, they have their share of tantrums and the transition from infant to preschooler is sometimes a ...

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We live in an age of patient empowerment.  Medical students are now routinely taught that the “right choice” often depends on patient preferences—on how an individual patient weighs the pros and cons of her treatment alternatives.  That means medical decisions depend, more than ever, on good communication. Physicians need to help patients understand their choices so that they can partner with their patients in discovering the best alternatives, ones personalized ...

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