A patient calls or emails me with a problem.  I talk with them over the course of a few days, using whatever form of communication works best.  Eventually, they need to come to the office to be seen – either for something needing to be done in-person (examination, procedure, or lab test), or because of the advantages of face-to-face communication.  At the visit, I not only deal with one problem, ...

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Faith and reason entered my medical universe recently. A patient underwent surgery to resect a colon cancer. The tumor had metastasized to the lymph nodes, an unfavorable prognostic event. The surgeon entered the room and advised the patient that her survival is likely limited to 1-2 years. The patient and her husband were devastated. The distraught husband spent the next 24 hours sobbing in a painful and despondent state. He related ...

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She was 19 and hung herself from a tree in her backyard. You have the crumpled note that says goodbye. Her mother collapsed when you told her she had died. Her father wept into his hands. A chill crept up your spine. You hug your daughter extra close at home. Could that man be dying of cancer? He looks so young. His kids are so young, his wife so wounded and ...

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shutterstock_120318682 We have come a long way in medicine, treating serious illnesses and preventing life-threatening diseases. As a hospital-based physician, I treat various severe diseases every day throughout the ICU, medical, and surgical floors. On a normal day, I roll at a fast pace -- admitting, treating and, discharging patients has become fairly routine for me. On any given day, we have an ...

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Last week a woman told me that she had a miscarriage in her bathroom. She was terrified. She didn’t know what to do. So she flushed it down the toilet. A miscarriage is the spontaneous expulsion of a fetus from the womb before it is able to survive on its own. One in five pregnancies ends in miscarriage. Many women don’t know they are miscarrying. Those who know usually suffer grief ...

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The notion that doctors can be replaced by technology has sparked a series of brawls between doctors and technologists over the last couple of years. Today, both sides continue to throw punches in the press and online. As health care technologies become more sophisticated, the opportunity to automate medical decisions becomes more seductive. Yet, physicians are unwilling to throw in the towel. They point to the importance of human interaction and ...

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burnout To the literal-minded, burning out is the fate of light bulbs and matches.  But whether you read the popular press or medical journals today, you’re likely to find writers who are deeply concerned about physician burnout. What defines physician burnout, and who exactly is suffering from it?  Is burnout an actual clinical syndrome, a slang term connoting fatigue and boredom, or a hazy ...

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the view Jenny McCarthy is officially joining The View. “Do I have opinions?” one reporter asked. Yup. My concerns center around Jenny McCarthy’s past willingness to trade-in her experience for expertise. That is, she widely shared her theories and anecdotes about her son’s experience with learning challenges and falsely placed blame on vaccines for his then-diagnosed autism. I will not discount her private experience. What I discount ...

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During a recent visit to Dublin I was saw a neon sign in a pharmacy which read: "Doctor present." I was, first, amused by the wording. Dublin, home of George Bernard Shaw and Yeats and Joyce (and storytellers and bards in every pub) is a city with a deep and natural love of language--where even pharmacy signs are poetry. But, next, I got to thinking. Am I "present" in my practice, even ...

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trash-can There are lots of generalized complaints out there about insurance companies increasing physician workloads without additional compensation. I thought I would share a specific instance of this so everyone else can get an idea of what we’re up against. I received the following mailing:

We want you to screen our members for cancer.  Please do these things:
  • Call the member to discuss colorectal, skin, and prostate ...

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