The year is 2012. A 58-year-old veteran Family Physician who has just finished a day with more human heartaches than clinical triumphs settles down among the pillows with his wife in front of his MacBook to watch a movie, delivered wirelessly over the Internet: "The year is 1969. A 62-year-old veteran general practitioner who has just seen his health threaten to fail him, speaks passionately to a group of doctors about ...

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Does your doctor have something on the wall that starts with “American Board of ... "? The terms “board certified” and “board eligible” are confusing to people not in the medical profession. It doesn’t help that more than a few doctors blur the distinctions to their own benefit. This post gives you a brief rundown on what’s at stake in the distinctions. The first thing to understand is that anybody who has ...

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Recently our department of medicine grand rounds was on the subject of asthma.  It began with a clinical vignette about a child with asthma, lasting three minutes, and, was followed by 47 more of intracellular cascades.  The talk was like many others this year, and the speaker, who was introduced as a physician scientist, lived up to the part. As someone who works in an academic hospital, I know many physician-scientists.  ...

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What do you think is the physician-view of an "ideal patient"? Well, as physicians, though we would like to think of caring for an ideal patient, we have to face the reality that this would rarely happen. You see, the ideal patient would be one who, first of all, bears many of the views and goals of the physician. As physicians, we really can't believe that we will be so lucky. ...

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Does it really make sense for a neurosurgeon to be quoted in a news story about a new treatment for diabetes or prevention of obesity? Some news reporters think so, leaving primary care physicians frustrated at the media’s lack of understanding about the wide range of expertise they practice on a daily basis. In both news and entertainment media, seeking out and representing primary care expertise seems to be the ...

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"Great interview, darling, but there’s one question you didn’t quite answer." My wife is my best coach. She thought the question about a busy orthopedic surgeon not having time to relate to his patients deserved a better response. My interviewer, a psychiatrist, said he once accompanied a surgeon friend on his Saturday morning round of post-op cases. On the drive home, he challenged his friend with the observation that many of the ...

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Those who know and work with me have heard me state without hesitation that it’s morally wrong to do CPR on 90-year old great grandmas. So, it was with great relief that I read the “Do Not Offer CPR” option in a recent JAMA article urging a revision of our present approach to the use of CPR for those who are unarguably at the end of life. This is a change ...

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Always remember why you are a doctorI was recently asked to speak at hematology-oncology Grand Rounds at Rhode Island Hospital. Instead of my usual topics on gynecologic cancers or sexual health, my colleague, MaryAnn Fenton, had asked me to speak to them about promotion in academics. I was both touched and taken aback that I was now in a position to give that kind of advice. ...

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“Cheers!” “To good health,” my girlfriend and I toasted in the living room of our apartment joined by my parents on speakerphone. It had been 12 years since my last radiation treatment—my last treatment for Hodgkin’s Lymphoma. Tonight was the anniversary of my remission, and in the case of Hodgkin’s—a cancer with an exceedingly low relapse rate—tonight was my anniversary of being cured. I kissed my girlfriend goodbye and tread the dark ...

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Pretty much everyone chats up shared decision making these days. And that is good.  It seems intuitive that people (patients) who are knowledgeable about their condition and buy in and/or help to shape the treatment plan are more likely to follow it. Here is an example from my seatmate on today’s flight from SFO to our nation’s capitol. Her son, let’s call him Alex, is a teen with cystic fibrosis (CF). ...

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