As a doctor, I appreciate that I am at an advantage when I seek medical care. Knowing terminology and basic medical principles helps a lot. In addition, when you’ve been practicing medicine for a while you get a feeling from how a doctor discusses options if the care seems valid or if a second opinion is in order. Other things I look for are board certification and a doctor ...

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Let's set aside for the moment the question of whether it's appropriate to talk about gun control in the wake of the shootings in Aurora, Colorado (though I can't think of a more appropriate time to talk about it). And let's not consider whether it makes sense that it's legal to buy thousands of rounds of ammunition on-line in the U.S, without any background check (though could it, really?) And ...

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If you pay attention at all to news about medicine, you must have heard about the tragic death of a 12-year old boy who was seen and discharged from the emergency department of the prestigious New York University Medical Center. He had developed sepsis from what appears to have been a small cut and the diagnosis was missed. When he eventually returned to the ED and was admitted, it ...

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I am a physician and guns are a disease I feel guilty about the killings in Colorado.  As a doctor, those horrid events are a personal failure.  I have spent a career fighting illness, often investing hundreds of hours in a single cancer case, yet in minutes, a dozen people vanish and 58 are grievously wounded.  Another 32,000 will die this year from gunshots, over 76,000 will be crippled and ...

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Too often I see both generalist physicians and subspecialists failing to fall back on the basic principles of a careful history and physical and then understand what specific tests to order. One can blame academe somewhat.  Too many subspecialty consults in academic centers end with a laundry list of tests, excluding almost anything that could ever be part of the differential diagnosis. One can blame the payment system.  The generalist physician, rather ...

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30 day hospital re-admission rates. It's a statistic that keeps hospital administrators up at night. Whether you agree or disagree with the use of this statistic as a quality and reimbursement metric, if it creates change, reduces hospital re-admissions and improves patient care, then in theory I support it. I'm reminded of Mrs G. She is emblematic of today's chronic disease patient. She was admitted to our hospital for a congestive heart ...

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Patients are increasingly demanding, and understandably so, that since they pay for their medical tests, they should receive results directly and immediately without waiting for physician review or interpretation.  Recent articles in the lay press about this issue are accompanied by scores of online patient comments insisting that physician reporting and interpretation is too often unreasonably delayed, often inaccurate, or just plain unhelpful, so why bother waiting at all? Dr. Google ...

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I recently followed a brief spat on Twitter between a journalist and a doctor.  It did not go further than a few irritable tweets, but I had to agree with the doctor’s point of view. The journalist had written an article about the death of a South African shack fire victim, admitted to hospital with 100% burns, and the contrast in perceived care he received compared to that of a ...

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"I gave at the office." I am an American taxpayer just like most of you, the audience. My tax dollars, and yours, fund the great majority of health-related research in the United States, mostly through the National Institutes of Health. Thus, I, and you, the taxpayers, own the results of that NIH funded research. We paid for it. Then, why, for goodness sake, do I, the owner, or my physician, another owner, have ...

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Steve is lying almost flat in the hospital room, an IV attached to his arm.  I am happy to see he is more comfortable, last night’s crisis has passed.  He smiles as I enter and walk to his side.  I touch his hand as I sit down on the pressed clean blanket.  And then … a shrill loud wail breaks the silence … lights flash above his bed … fear ...

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