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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shutterstock_74641645 When I was a med student, the thing I loved most about primary care was continuity of care. I loved feeling like I had a sense of my patients’ lives, of the intimate details of their day to day, of their fears and dreams. I thought that this connectedness was all I needed to have a successful career as a primary care ...

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Guantanamo detainees on a hunger strike are now being strapped into chairs and gagged as doctors push a feeding tube through their nose into the back of their throat and into their stomach as often as twice a day. It’s a disturbing new practice, but one we must examine in full as we consider whether Guantanamo reflects American values. Anyone who has had a nasogastric tube placed through their throat while ...

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Nothing seems to please a fly so much as to be taken for a currant; and if it can be baked in a cake and palmed off on the unwary, it dies happy. -Mark Twain Returning to clinic after time off for a summer break, I worry I’m like a fly hiding among the black currants hoping to eventually become part of the currant cake.  Just maybe no one will notice I don’t ...

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The Mayo Clinic Proceedings came out with a study that shows that many of the treatments that doctors once swore by are useless or worse. The New York Times did a piece on it and the commentary contained a great deal of doctor-bashing.  So of course I opened my big mouth and pointed this doctor hatred out.  The comment I got back was this:  "It’s not hatred, it’s fear." Wow.  If people ...

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I remember a time when many physicians, especially residents in various specialties, would moonlight in small emergency departments. They viewed it as a convenient way to supplement their low salaries. Some of them were excellent doctors. Sadly, quite a few were not qualified and caused more harm than good. I did the same thing, although I was a second- and third-year emergency medicine resident at the time. Indeed, the money came ...

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