"I’m sorry, Doctor, but we can’t have you give that talk; you have a conflict of interest since you’ve been paid to do research on that medicine." "Well, Senator, it’s a conflict of interest for a doctor to sell those crutches in his office." "It is the opinion of this newspaper that physicians should declare to each patient any ownership interest they might have in a surgery center so that the ...

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The notion that dying is a right seems nonsensical to argue:  death is given to all of us equally without the need of anyone’s sanction.  The right to die well, on the other hand—well, that’s another matter entirely.  A good death is, in many cases, something our fellow human beings have great power to grant or deny, and is therefore, sadly, a right for which we must indeed fight. The ...

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Spin Class. For the uninitiated, this involves a dark studio in a gym, rows of stationary bikes, and a pounding beat, heavy on the volume and bass. The instructor out at the front cajoles and drives you through spurts of speed and tests your endurance with simulated mountain climbs. Some instructors are better motivators than others. One, I remember, stretched belief a little in trying to make us feel we were ...

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"I'm not a doctor, but I play one on TV." It seems that everybody wants either to be a doctor or to play doctor. There are "doctoring" nurse practitioners who some derogatorily call noctors; there are RNs who get a PhD, and are thus Doctors of Philosophy; and then there are those new DNPs, Doctors of Nursing Practice. Of course, there are Doctors of Pharmacy, Doctors of Chiropractic, Doctors of Podiatry, ...

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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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