I would think that when physicians decide where to set up practice, there are things that they would want to think about other than how much money they’ll make.  Yet if one reads Medscape’s current list of the best and worst places to practice, it would appear that money trumps everything else (although Medscape said it also considered factors like “cultural attractions”). What Medscape apparently did not consider ...

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shutterstock_124482742 The insurance company insisted that they would be saving money in the end.  So they sent the PA (physician assistant) to my patient's house.  They didn't take into consideration that I was just there a week before.  Or that I made home visits on a regular basis.  In fact, they didn't even inform me about the appointment. My patient later told me ...

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shutterstock_253534771 Merriam-Webster defines "value" as follows:

  • The amount of money that something is worth: the price or cost of something
  • Something that can be bought for a low or fair price
  • Usefulness or importance
I find this intuitive, really. The value of something is what it is worth. However, is that something worth the same to me as it is to you? And if I give ...

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shutterstock_145545640 Teleradiology has the same effect on radiologists as Lord Voldemort has on Muggles. It’s the feared end point of the commoditization of imaging, with Rajeev in Bangalore outpricing Rajeev in Chicago for reading follow-up CTs for lung nodules. But despite the fears of U.S. radiologists, their counterparts in India have more pressing things on their mind. “U.S. radiologists think that Indian radiologists are ...

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Idioms are expressions everyone understands as something other than what the literal words say.  For example, when I talk about “putting all of my eggs in one basket,” everyone knows I’m not really talking about eggs. We say things like: It’s raining cats and dogs. It was a piece of cake! I heard it straight from the horse’s mouth. We have a few idioms in medicine, too.  If I talk about “hanging crepe” in a ...

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shutterstock_173798813 My daughter was born, three months premature, during my third year of residency.  Following a harrowing three months in the NICU, we joyfully welcomed her home. After eight blissful but isolating weeks, I was eager to return to the wards. I happily reunited with colleagues and patients, but I also deeply missed being home. During quieter moments, I daydreamed about stroking ...

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shutterstock_228580378 I have written previously about some “aha moments” that I have had as a clinician, when something that I knew was coming seemed to arrive with a thud in my own practice. I had another one of those moments a couple of weeks ago. I was finishing up with a new patient, and had explained to him and his wife my assessment ...

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shutterstock_216140242 Question from a reader: "What are your feelings about when a patient breaks up with you? I love love my doc, but ..." Patients “break up” with me all the time. Well, not all the time, but it’s not uncommon. There are many reasons, some of which are under the patient’s control, and some which are not. Moving across the country is ...

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I hate to be the bearer of bad news.  Sorry to say, breast cancer touches everyone.  If there is no one that you love that hasn't been affected by breast cancer, just wait.  It's coming. I have had personal experience with friends and family with breast cancer.  There's Tina, who was my roommate in medical school.  There's my mother, now a survivor for 20+ years.  I have already flirted with abnormalities ...

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shutterstock_117895975 I often wondered what got me here. I am a reader. Give me a book, an apple and a bus ride home and I was lost in the words. Send me to school and make me create 3x5 word cards for hundreds of new words and I was hooked. Then off to high school where science gave me a new vocabulary. ...

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