Cancer is a dreadful disease. Just dreadful.  Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the  end of their lives. I believe a large part of their difficulty stems from the ridiculously ...

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One of my most vivid memories of medical school was during my internal medicine rotation, when it had become apparent to me that, despite spending my pre-clinical years studying complex pathophysiology and pharmacology, and the fine art of history-taking and the physical exam, the actual clinical work seemed to be more like a numbers game.  I felt like I was always responding to a data point:  a blood pressure reading, ...

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The instruments were indicating to the two co-pilots at the controls of the Airbus that they needed to pull back on the stick. They held back on the stick for 54 seconds. This is the position they were in when the Air France jet plunged into the cold water of the Atlantic killing everyone on board. The fix? Recognizing that a protocol or guideline might be giving them wrong instructions, seeing that there ...

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How is a doctor allowed to mess around with body parts he doesn't understand? If doctors were required to understand everything we touched we wouldn’t be able to touch you at all! The human body is still a deep mystery. Doctors understand more than most people, but what we know is still a vague approximation. Just because our educated guesses often work out well doesn’t mean we have any idea what’s actually ...

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Evidence-based medicine and health insurers generally focus on what’s medically necessary, not what’s epidemiologically relevant, not what soothes the mind of the bereaved or of the physician grieved and mystified by the loss of a patient. Once, the autopsy was a venerated tool for medical advancement and humility. An invaluable means of learning one’s own limitations and the extraordinary diversity in nature and human physiology, it has now become an unreimbursed ...

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What exactly is the difference between a child psychologist and child psychiatrist?  The two terms are frequently mistakenly interchanged, but the requirements for the two are considerably different. To become a child psychologist, many programs require that you get an undergraduate degree in psychology, although some graduate programs will only require that you take the prerequisite sciences courses (biology, physical and social sciences, statistics, mathematics, etc.) before applying for the graduate ...

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The investigations about the Penn State sex abuse scandal are still unfolding. Revealing the truth is up to justicia now. Meanwhile we can learn an important lesson about professionalism. It seems to me as if a few very powerful people put the Penn State brand above children and covered up the raping of young boys within the Penn State facilities. I assume that several people at the top of the Penn ...

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There was a bit of excitement on Twitter recently with a number of tweets about a paper published in the Annals of Family Medicine which shows that uninsured patients are being released from  hospitals significantly sooner than insured patients. The numbers don’t lie. From the abstract: "Across all hospital types, the mean length of stay … was significantly shorter for individuals without insurance (2.77 days) than for those with either private ...

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"Superior doctors prevent the disease. Mediocre doctors treat the disease before evident. Inferior doctors treat the full-blown disease." -Huang Dee Nai-Chan 2600 BC; 1st Chinese Medical Text. Not only does my work in integrative medicine have me on the front lines of big pharma-created "syndromes", like chronic fatigue, fibromyalgia and irritable bowel (these are real for patients, but are not formal syndromes), but I get to see the worst of our sickcare system. I ...

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In my new role as one of the directors of an internal medicine training program, I help select new interns out of medical school for the three year training stint of residency. At the end of residency, many graduates go on to subspecialty fellowships, another two to four year period of intensive training in fields like cardiology, nephrology, critical care etc. For those that don’t choose a subspecialty, one choice remains: traditional ...

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