My mother is my role model and my inspiration for what I do every day. She was diagnosed with breast cancer when she was in her forties, and fought it courageously for seven years until she passed away in 2010. There are so many stories I can tell about my mother and her battle with cancer. Let me start with just one. Whenever she’d go to her oncologist, she would go ...

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Facing advanced cancer, who among us wouldn’t look to our oncologist for expert advice on whether another round of chemotherapy makes sense?  But do you know what your oncologist cares about, and can you be sure her recommendations map onto your own treatment preferences? A recent study lead by Michael Kozminski (I was senior author) shows that American oncologists downplay the value of treatments that improve quality of life, ...

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Burnout is a constant threat for physicians. Research consistently shows an average of 1 in 3 doctors suffering from symptomatic burnout on any given office day. In my work with over stressed and burned out doctors, I have found that most of us work way too hard being the superhero to our staff, patients and families -- and don’t have any fun at all. It doesn’t have to be ...

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Here’s a little story from the early days of my first job as a chairman of surgery. Shortly after I assumed the role of surgical chairman in a community teaching hospital at the ripe old age of 40 and having absolutely no administrative experience, I visited a mentor of mine whom I had known since I was a medical student. He had been serving in a similar role at a larger ...

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A recent article, "Burned Out Nurses Linked to More Infections," addresses an important issue that is often overlooked and ignored. Let’s be brutally honest, without an appropriate nursing workforce, our entire healthcare system would collapse.  As our healthcare system continues to shift to a business and profit model, both nurse and physician burnout will only increase. Decisions to “cut corners” by not providing adequate nursing staff are made on a daily ...

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A recent case from Dayton, OH highlights the tangled mess of emergency department specialty coverage, federal law, and out-of-network insurance benefits.  When these interact, patients, doctors, insurers and hospitals can be left frustrated and perplexed. Here’s a brief summary. A 6-year old boy suffered a fingertip injury and the emergency staff called the covering plastic surgeon, who repaired the injury.  The surgeon, who does not participate with insurance, submitted a bill ...

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AMA works to reduce administrative burden for physiciansA guest column by the American Medical Association, exclusive to KevinMD.com. Since the American Medical Association launched our National Health Insurer Report Card in 2008, there has been noticeable progress by health insurers in response to the AMA's call to improve the accuracy, efficiency and transparency of their claims processing. The AMA has been working constructively with insurers, and as a result ...

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Mr. Omer had once held a position of social prominence, a moral influence on the lives of individuals and communities.  Until one year ago. A construction accident changed everything. He suffered injuries that left him in control of only one side of his body and his mind functioning as a 5-year old child. Most recently, he had resided in an extended rehabilitation nursing facility, until yesterday. When the nurse tried to arouse ...

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Encouraging patients to be more engaged, may also encourage more people to go beyond assertive to demanding care unsupported by good clinical judgment. Of course, physicians worry that saying “no” to a patient increases their risk of being disliked, dismissed, or even sued for medical malpractice. Greater transparency in health care means patients are more aware of options for screening, testing, procedures, and medications—often via direct advertising or public service campaigns. ...

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On a recent afternoon, Hansel Tookes stood on a sidewalk in downtown Miami, peering into a thicket of scraggly weeds. "I found a bunch over here," he said, edging toward an overpass. A small orange plastic cap came into sight, and next to it two slender insulin syringes, with the needles exposed. Scattered about were tiny plastic zipper bags -- evidence that the needles had been used to inject heroin ...

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