Charlotte Scott had an eye for madness—for just the right amount of madness. As a booker for The Springer Show, her job was to find—and forgive me if I’m getting too technical here—minor nut jobs, the kind of people who were just unbalanced enough to make for entertaining T.V. but not so wacky that they would pull an Uzi out on the audience. I learned about Scott while reading Jon Ronson’s ...

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There are times when it is necessary to step up to the plate and go the extra mile on behalf of your patients.  There is no job description for doing this and there is no manual that gives you instructions on what action you need to take on behalf of your patients.  However, when you have the opportunity to do the right thing, at the right time and for the ...

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It’s natural: when you see someone doing something you long to do, you automatically search for reasons to justify why they’re doing it and you’re not. Maybe they had encouraging supportive parents and yours belittled you. Maybe they got their start at a younger age and it’s probably too late for you now. Maybe they got a great education, or were blessed with more opportunities in life. My coaching clients won’t ...

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The recent New York City law restricting portion sizes of sugary beverages offered in restaurants has stirred much controversy among policy makers, scientists, the media and consumers. Opponents support the freedom of choice in selecting beverage portions and contend there is insufficient evidence that legislation will change behavior or body weight. Proponents contend that something should be done to reduce the ever-expanding receptacles in which sugar-laden beverages ...

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She was in her late thirties when her medical oncologist asked me to see her.  Five years before, one of our community surgeons had removed part of her colon for cancer.  She also had a recognized, single metastatic tumor in her liver at the time of that original surgery. The contemporary standard of practice was to treat for a prescribed period of time with chemotherapy and then re-evaluate for the appearance ...

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A lot of people, many of them medical students, think that rural doctors don’t get to see many interesting cases. The opposite is true; if you are the only doctor within a wide radius, people will come to you for help, rather than try to pick the appropriate out-of-town specialist to diagnose their problem. In this state with widespread physician shortages most specialists won’t even see self-referred patients. Sir William Osler wrote: ...

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When I clicked on the “View Your Exam Results” link on the American Board of Anesthesiology website, I thought something rashly exuberant would engulf me. I thought that everyone in the lunch room would turn suddenly, throw their reheated pasta and cafeteria sandwiches high aloft with glee and balloons would gush from the cracks between the fluorescent lights on the ceiling as the whole world burst into song. But instead, there ...

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I’ve written about trying to communicate acuity to families. Maybe that needs to be expanded to encompass the same to other physicians. To be fair I’m sure some of this, perhaps much of it, rests solely on my shoulders. Recognizing that I’m still going to make an accusation that talking life and death with families and patients is a skill not fostered in many providers. More accurately ...

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It is a very odd thing that most doctors, especially ones who really love what they do, provide advice and sometimes treatment to family members and good friends. It is also held to be true that this is a bad practice. How do we reconcile this? In 1847 the AMA published its first "code of medical ethics" which covered many subjects and, though short, is dense and diatribe-like. It seemed to ...

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Doctors don't like to go to doctors. I suppose we might see it as a failure or more likely it is pure intellectual arrogance. Whatever the reason, there can be no excuses when you need to get an insurance examination form filled out. One way of taking the edge off it is possibly to try to use your conversational skills to awe the poor general practitioner forced to see a ...

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