The only religion that my patients see me practice is medicine When I was the director of undergraduate medical education for OB/GYN at a Midwestern university (a state school), it came to my attention that a medical student was refusing to have anything to do with contraception as it was against her religion. So I spoke with her. I explained that over the course of her career she would undoubtedly see people from ...

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There is a broad consensus among healthcare policy wonks that the 800 pound gorilla in the healthcare cost debate is that a big chunk of the medical care we provide — some say as much as a third — does not help. It may even make things worse for patients.  Aside from the ethical issue of doing things that don’t help, and may hurt, this useless and dangerous care is ...

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The Surgeon had been handicapped by a burr in the plantar aspect of his left foot.  All summer it had been causing discomfort on jogs, during soccer games, and,eventually, even just walking barefoot across the hardwood floors in the morning.  There was something lodged in the thick skin of the strikeplate of his foot--- a splinter, a piece of glass, whatever the hell--- and it was really starting to cramp ...

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Moving from paper death certificates to an online process called the Washington State Electronic Death Registry System, or EDRS. Sounds like a simple 21st century process that should make the process of completing a death certificate faster and easier right?  Oh, the government designed the system.  Oops. I’ve been so frustrated by the unintended consequences of a new state governmental process for completing death certificates. Beginning in early 2012 Washington state started ...

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We had one of each in our house: one baby that we let cry for periods of time to self-soothe and one where I simply couldn’t bear to hear the crying in quite the same way. You’d think it would have been just the same for both of our boys, but it wasn’t. Clearly I wasn’t the same parent each time around. There are many things that go into the equation ...

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Probably the hardest part of making the change from a traditional to a direct-care practice is the effect it has on relationships.  I am only taking a maximum of 1000 patients (less at the start) and will be no longer accepting insurance.  These changes make it impossible for me to continue in a doctor-patient relationship with most of my patients. For some, this transition will be more hassle than anything.  Some people ...

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I vividly remember the first day my medical school classmates and I met our cadavers in the anatomy lab. Large body bags lay on metal tables that had been bolted to the floor. I remember the sheer size of the bags best. No doubt existed in my mind that dead human bodies indeed lay within them. And yet part of me couldn’t quite grasp that I was actually going to ...

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I wouldn't call myself a palliative care expert.  I kind of happened into the job.  The nursing home had a need, and the local hospice/palliative care program didn't have the available staff.  I had always been good at handling end of life and pain issues, so I stepped up.  Of course, there are finer points that I could have learned in a fellowship program.  I don't want to pretend that my ...

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Charlotte Scott had an eye for madness—for just the right amount of madness. As a booker for The Springer Show, her job was to find—and forgive me if I’m getting too technical here—minor nut jobs, the kind of people who were just unbalanced enough to make for entertaining T.V. but not so wacky that they would pull an Uzi out on the audience. I learned about Scott while reading Jon Ronson’s ...

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There are times when it is necessary to step up to the plate and go the extra mile on behalf of your patients.  There is no job description for doing this and there is no manual that gives you instructions on what action you need to take on behalf of your patients.  However, when you have the opportunity to do the right thing, at the right time and for the ...

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