The decline of medicine as a profession began when it became legal for doctors and hospitals to advertise. Apparently it all started when an Arizona lawyer sued for his first amendment right to advertise his services. In 1977, the US Supreme Court ruled that states could not prohibit advertising by lawyers. This opened the floodgates for all professionals. Soon advertising by doctors and hospitals became common. I don't know what it's like where ...

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Cardiologists are causing patients to get cancer. It’s true. Cardiologists routinely perform angiograms on patients who have no heart disease whatsoever. As shown in this Harvard newsletter, each angiogram exposes the patients to about 7 mSv of radiation. Add in the myocardial perfusion imaging at another 25 mSv of radiation and you have enough radiation to cause cancer in an otherwise healthy individual. And cardiologists routinely subject patients with normal coronary arteries ...

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When, a couple times each year, dozens of our county teenagers train to become EMTs, they know they are taking on a challenging, heavy responsibility. But probably none of them are ready for the kind of horrible death our community experienced a week ago, when a 15-year-old-girl walking home from school in Rockville was struck and killed in a crash involving two cars that news reports say may have been ...

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I wonder, sometimes, are physicians valued professionals, or merely problems to be solved?  Are we skilled clinicians vital to the well-being of our patients?  Or are we merely assetts to be managed?  It occurs to me as I walk around hospitals these days, and see the overgrowth of people with clip-boards, people with undue authority over our lives and practices, people trained in business and management but untrained in either ...

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The future of robotic surgery can be determined only by probing the possibilities. To ignore the potential for extending the boundaries and safety of surgical care with robotic technology seems unwise. -"The Future of Robotics," Bulletin of the American College of Surgeons (July) 2013; 98:9-15. It is a spring morning in July 2047. Jenny, a nursing assistant, emerges from an exam room and gently closes the door. She is wearing scrubs tastefully covered with ...

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Home visits are hard, there is no doubt about it. I felt like I had been driving for hours.  The thirty minute travel time showing on my GPS was woefully understated due to the arctic temperatures and colossal snowfall.  My jacket and clothes felt caked with dried salt rubbed off from the car or somehow accumulated from the ether.  I pulled the key out of the ignition and braced for the ...

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A few short years ago, my wonderful father-in-law Bill was diagnosed with an inoperable cancer. My husband and I traveled to the Midwest to visit Bill and my mother-in-law Betty. We were happy to be able to spend a little time with him, and he knew we were there. Sadly, he passed away the night before we left. We believe he held on until my husband arrived; all his other children lived nearby. Later, ...

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I feel … Much better than I did after my last chemo cycle. I feel tired, but not bad. I feel really glad that using a smaller needle for the lumbar punctures spared me the headache. I feel thrilled to have a port and have that PICC line out. There’s nothing like having medical tubes dangling out of your arm to make you feel extremely cancery. Plus, with the port buried under my skin, water ...

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Increasingly, the stuff we buy is electronic. In fact, not only that, but increasingly the stuff we buy with is electronic, too. We are using gizmos to shop for gadgets, or possibly gadgets to shop for gizmos. In any event, we are ever more frequently in the company of the energy fields our electronic devices, and in particular our smart phones, generate. This deserves more attention than most of us accord ...

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How should patients determine the quality of their doctor? This is an interesting question that has now reached mainstream media status as evidenced by a Wall Street Journal article by Laura Landro, a very accomplished veteran health care reporter. With the best and brightest going in to medicine, the requirement for more rigorous training than anywhere else in the world by (some might say) "exceptional, world class" medical educators and longstanding ongoing mandated continuing medical ...

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