Imagine this scenario. A young child is playing in the yard when her pet dog bites her face. Bleeding, the child is rushed to the ER and the doctor offers to suture up the child's face. A parent will probably ask for a plastic surgeon to suture the face instead of the emergency room doctor. As such, the plastic surgeon is called in and sutures up the face beautifully. The child and family ...

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Many recent conversations in the advancing world of health care delivery have integrated the term "disruption." At first glance, this is perhaps quite jarring and counter-intuitive to the mind of the forward or progressive thinker. It is ever the more uncomfortable to the medical mind that is trained to carry on in the face of adversity, through exhaustion, and despite resistance. Paradigmatically, the medical world has recently been presented with ...

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And issue of Newsweek quotes me as saying, “A lot of our weight-loss recommendations are unethical because we shouldn’t be saying lose weight when there is no chance people will keep it off.“ This quote appears in the context of a lengthy article by Daniel Heimpel that examines whether or not the obesity epidemic is being oversold. While I personally do not think that the obesity epidemic is being oversold, I do ...

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I am a devoted fan of Zumba, specifically as it is taught by my wonderful teacher, who has a dedicated following. She has been out for the past month, home with a newborn and two year old. Last week, she came with her baby to try to take the class, now being taught by a substitute, also a regular member of her class. "I need this for my mental heath, " ...

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It was another day in the intensive care unit. The night was clean and calm, ventilators beeping their expected  melody, and the laborers of medicine went about their night shifts uneventfully, including me sitting with the obnoxious admission pager attached to my hip. The smoothness of it all shattered when the beeper started screaming - I picked up the phone and soon the emergency room physician was on the line. "We ...

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As you may know, I left Maine to come to Virginia to work in an urgent care center.  It was not how I pictured myself when I trained to be a family doctor 18 years ago but the world has changed. I like my present job fine and there isn’t a bunch of suits looking over my shoulder all day.  That being said, I want to share my thoughts about the ...

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We’re not going for sympathy here. Doctors as a whole enjoy less sympathy than many other professional groups (members of Congress enjoy the least, I would think), and that’s probably appropriate. They have high incomes and many prerogatives and rank highly in esteem polls as individuals, if not as a group. It’s not where they are that is causing the grieving, it is where they are coming from. Let’s deal with ...

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Dr. Atul Gawande has written a much-ballyhooed essay in the New Yorker, entitled "Big Med." His piece proposes The Cheesecake Factory as a model for healthcare. For me, a physician, Dr. Gawande's message left a bad taste in my mouth. The Cheesecake Factory succeeds because of standardization and efficiencies, with complete control over purchasing and production. What recipes work become menu items throughout the chain. What recipes don't work are ...

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The most common complaint about physicians on the Internet is, “They didn’t listen to me.” You were sitting in the office and the doctor was physically present in the room, but they weren’t all there. Even worse is when the doctor doesn’t try to understand what you are going through. Sometimes it can seem like they didn’t even care. Most of us take for granted that we are the center of the ...

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All American physicians should be members of the American Medical Association (AMA). And, while they are at it, they should also be members of their county, state, and principal specialty societies. Why? Because they are the only games in town, and both security and safety are top Maslow imperatives. The only real political power any physician has is the individual power of persuasion and participation (or not) and the power of a ...

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