I am a primary care doctor who makes house calls in and around Tuscaloosa, Alabama. Most of my visits are in neighborhoods, but today my rounds start at a house located down a dirt road a few miles outside of town. Gingerly, I cross the front walk; Mrs. Edgars told me that she killed a rattlesnake in her flowerbed last year. She is at the door, expecting my visit. Mr. Edgars sits ...

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We recently spoke with Jill Marshall, MD (name changed to protect identity), who works as an internist. “I unfortunately became a patient when I was 55-years-old,” she told us, “and I was diagnosed with breast cancer, a disease I had always feared I would get.” Dr. Marshall was found to have multifocal disease and underwent a right mastectomy and lymph node dissection. “Ever since I had seen mastectomies when I was in training, ...

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There’s one question I get asked a lot: “I research my health problems on the Internet. Am I a hypochondriac?” First, we should ban that word when talking about ourselves. No one wants to be called that, and doctors who use that word are committing malpractice. Everyone has some range of complaints and worries in life, often physical and mental together, and this is our job as doctors: to hear them ...

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Before you can even form a thought, emotions are influencing your judgments. -Zimmerman and Lerner It’s 9am on a Monday, and our palliative care team circles a table to prepare for the workday. Before us is a list of names, each representing a patient and his or her needs, support system and care team. Many are referred to us because they are suffering -- be it pain, agitation, emotional distress, existential crisis ...

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shutterstock_94195759 This wasn’t just plain terrible, this was fancy terrible. This was terrible with raisins in it. -Dorothy Parker More and more of my clinic time is devoted to evaluation and treatment of depression and anxiety rather than sore throats, coughs, UTIs and sprains/strains.  An outbreak of overwhelming misery is climbing to epidemic proportions in our society. A majority of the patients who are coming in for ...

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I get it.  It’s not rocket science.  But sometimes everyone in the field of medicine needs a bit of a refresher when it comes to keeping our patients happy. After all, it’s a two-way street with medical providers and patients: we provide and support ways to improve and maintain the personal health of our patients while our patients provide and support the health of our careers and livelihood.  We depend on ...

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Do you have a medical, pharmacy or nursing license in several different states?  Do you have a license in more than one health profession?  Have you been notified that an investigation has been opened against you?  Are you thinking about resigning your professional license or voluntarily relinquishing such a license?  Then you must be aware of the following. First, you should never voluntarily relinquish or resign your license after you know ...

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Just as elite athletes are born with amazing skill, elite surgeons and doctors in other procedure-based specialties are also equipped with innate abilities that others do not possess.  Surgical skill is often difficult to quantify.  Certainly, outcomes data can be obtained and reputations are formed over time.  Years of training allow the truly gifted surgeons to develop their skills and perfect their craft. However, all surgeons are not created equal.  During ...

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I recently participated in a small conference devoted to “physician alignment in the academic medical center.” The meeting was sponsored by a health care consulting firm, and drew about a dozen participants from around the country. The title refers to ways in which academic centers figure out how to work with their traditionally autonomous if not completely independent physicians to advance the institutional mission. An informal format allowed us to ...

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Researchers at the American Academy of Family Physicians' Robert Graham Center have estimated that the U.S. will require 52,000 additional primary care physicians by 2025 due to the effects of population growth, aging, and insurance expansion. Since it takes at least eleven years of post-secondary education to train a family physician, even a renewed surge of student interest in primary care careers is unlikely to meet this anticipated need. Another recent 
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