The baby boomers, the largest generation in American history, are now almost all in the last third of their lives (if average life expectancy is 78). They have spent the previous, early and middle thirds of their lives transforming cultural ideas, expectations and practices (e.g with the civil rights movement, environmental movement and women’s movement, etc). The question now is, “Will the baby boomers also transform our cultural ideas, expectations, and ...

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Dr. Anthony Youn, a plastic surgeon practicing in Detroit places most of the blame for long office waiting times at the feet of the patients themselves. He comes up with three general categories; patients who arrive late for their appointments, emergencies that require the physician to leave the office, and “oh by-the-way” scenarios: "Here is a typical scenario: It’s the end of a 10-minute office visit, scheduled as a ...

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As all of us know, there is a long, long tradition in our culture of disciplining or punishing children using physical means. “Spare the rod and spoil the child,” as the old saying goes.  That explicit wording, by the way, does not come from the Bible, as most people think. Rather, it comes from a seventeenth century satirical poem by Samuel Butler. Still, The belief that punishment requires ...

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For 19 years since residency, I have worked in one facility and one facility only.  I have paced its halls and touched its walls, known every crack and heard every sound.  I have seen life and death, laughed and cried there.  And yet, I began to have a wandering eye… Actually, I needed a little more immediate cash.  I began to flirt with ... locums! So, after some phone calls, some furtive, ...

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Breastfeeding and sex share something in common and it isn’t just breasts. It’s the apparently irresistible urge of some people to force their personal beliefs on other people. The stated desire of lactivists, like those promoting the Latch On NYC breastfeeding program, to “protect” breastfeeding bears an uncomfortable resemblance to the stated desire of religious fundamentalists to “protect” virginity from the “dangers” of premarital sex, or to “protect” marriage from the ...

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Medicine has gone down Alice in Wonderland’s rabbit hole. Looking at the size of practices today, it seems like some of them have taken red pills and the rest have taken blue ones: most of them are getting bigger and bigger and bigger, while some are getting smaller and smaller. As the giant practices gobble up their competition to become ever more gargantuan, others are shrinking down into micropractices. Everyone has ...

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I am so glad that I’m only a partially conflicted, semi-neurotic, intermittently confused middle-aged psychiatrist. It would be so much harder to be a young guy, just coming out of residency, trying to decide what to do and how and where to do it. The stress! When I finished training, career paths were relatively easy to research, vet, and decide upon. You could go into private practice, in a group or ...

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I felt a woman’s uterus without her permission. How this happened, and why I thought I had done the right thing at the time, tells us something important about medical education and shows us why doctor/patient interactions often play out like conversations between earthlings and aliens. To understand my inappropriate actions, you need to know something about the physical exams that we physicians conduct on our patients. More specifically, about the ...

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It turns out that the practice of medicine is just common sense.  If someone has fallen and their hip hurts, it is probably related.   If someone does not have an infection, do not give an antibiotic.  Exercise and good food are, well, good for you.  If it is not broken, do not fix it. Usually, patients understand this basic idea.  The best chance of becoming and staying healthy is the simplest ...

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As an emergency physician, I tend to work on the other side of preventive care services. I see what happens when women don’t know about safer sex and birth control, and end up with complications from sexually transmitted infections. I see what happens when women do not get routine screening for cervical cancer and struggle with life-threatening cancer. I see what happens with out-of-control hypertension and diabetes, and the heart attacks and strokes that ...

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