Most of us will not have the opportunity to just die of “old age” or to simply fall to sleep one night never to wake again. Most often, we develop an illness which causes our death. These have changed markedly over the years. For the pioneers, accidents, infections, childbirth were times and causes of great likelihood of death. A century ago, infections were the leading causes of death. Today, we ...

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When I see patients in the office, I try to guess their occupations from their demeanor and mannerisms. Salesmen are the easiest to ID. In general, they are gregarious males with manly handshakes. They laugh loudly and like to tell jokes. Teachers are more reserved and often give their narrative in a logical and chronological order, as would be expected. Another clue that the patient is an educator is that ...

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Full disclosure. I have 4 board certifications and dutifully do all of the required reading, continuing medical education (CME) and recertification exams to maintain my status (I am board certified in OB/GYN in both the US and Canada as well as board certified in pain medicine by both the American Board of Pain Medicine, ABPM, and the American Board of Physical Medicine and Rehabilitation). I would never go to a non-board ...

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I had an unexpected gift this week: a not-so-sick sick day with my 5 year-old. And it really couldn’t have come at a better time. We’ve never had a sick day like this before and he’s off to Kindergarten in September so the days were running out for preschool stolen-away sick leave. In the past when he’s been ill he’s been well enough for me to head off to clinic or work ...

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An article in the New York Times sheds a little light in a dark corner of medicine, the world of workers’ compensation. In particular, it highlights a world of doctors that dispense drugs in their offices, which improves both patient satisfaction and profits. Though fraudulent insurance claims are always easy headline-grabbers, the real world of workers’ comp is complex and not always so tailor-made for sound bites. Add to this ...

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The practice of medicine has changed enormously in just the last few years.  While the upcoming implementation of the Affordable Care Act promises even further—and more dramatic—change, one topic which has received little popular attention is the question of exactly who provides medical services.  Throughout medicine, physicians (i.e., those with MD or DO degrees) are being replaced by others, whenever possible, in an attempt to cut costs and improve access ...

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Recently a physician reporter for the New York Times, Elisabeth Rosenthal, argued in the cover article of the Sunday Review that routine physicals are in many ways pointless, and perhaps even dangerous. In the article, entitled “Let’s Not Get Physicals,” Dr. Rosenthal goes on to point out that many routine tests performed during physicals -- EKG’s, pap smears and blood work, are unnecessary. In my opinion, Dr. Rosenthal’s front page ...

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I was talking to some new friends over lunch recently, at the nationally renowned Hominy Cafe, in Charleston, SC. Any place with a Fried Green Tomato BLT, and Shrimp and Grits for breakfast, has my vote! To the point: my question to these esteemed emergency medicine educators was this: "Do you ever have irrational fears about the people you love, because of what you do?" The answer was a resounding "absolutely!" Like me, ...

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The ACA passed and is already in trouble. The Republicans are up in arms, calling the ACA an overreach of a totalitarian governmental regime. The Democrats are defending it, promoting its cost-saving measures as a progressive step forward for America. To say the rhetoric has heated would be an understatement. I’m not here to debate politics though. In the run up to the Supreme Court’s ruling on the ACA and the ...

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Too often, bedbugs prevent cost-effective and quality health care – both literally and figuratively. In the literal sense, consider the case of an elderly woman we’ll call Mary. A frequent visitor to emergency rooms in Northern Colorado, Mary has a long list of medical and behavioral health problems. Recently, a pilot project implemented by the North Colorado Health Alliance brings together a team of providers representing different walks of the health care ...

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