If you're a fan of star surgeon overachiever Atul Gawande, then reading his New Yorker article "Big Med" is a must. The rest of us skeptics should still use the article to signal our health care adroitness by knowingly referring to the "Cheesecake Factory" in our policy medical meetings, conferences, PowerPoints and bloggery. What he wrote Dr. Gawande uses the successful restaurant chain to extract lessons and draw health system parallels, ultimately ...

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Once again, legislators are meddling into healthcare. This time, it’s in my own home state, where Governor Cuomo has just signed a bill requiring radiologists to notify women when their normal mammogram also shows that they have dense breasts. In such cases, the following text must be included in the lay summary mammogram report given to the patient: “Your mammogram shows that your breast tissue is dense. Dense breast tissue ...

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Many elderly patients get admitted to the hospital with profound weakness due to their acute and chronic medical conditions. Many of them will leave the hospital with profound weakness from their acute and chronic medical conditions (and unfortunately without a palliative care consult). In many situations, these patients will be too weak to take care of themselves.  They will need extra help with their activities of daily living either from ...

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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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