shutterstock_59443372 The other day, a teen patient of mine told me she is pansexual. We were having the usual talk I have with teen patients, the one where I we talk about sex and sexuality and birth control and sexually transmitted infections. But over the past few years, that conversation often takes interesting turns when I ask about sexuality, like it did the ...

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shutterstock_141622243 Some years ago when my father underwent bypass surgery, he was anxious, depressed and in pain as he lay in the hospital bed tied to IV catheters and tubes. Each day, his surgeon, his hospitalist, and other consultant doctors whisked in and out, asking how he was feeling and then ordering a treatment plan. A few years after his full recovery, ...

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shutterstock_260680658 I wasn't the first simple country surgeon, you know. When I was a resident, our training program broke us into two teams -- one that served general surgery, pediatric surgery, and trauma; the other, general surgery, transplant, and oncology.  Every day was an intricate dance to see all the patients (generally between 20 and 40) for the assigned team, operate all day, ...

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Practicing physicians like me rely on up scientific medical journals to keep us current on medical developments. We learn about new treatments for old diseases. New diagnostic tests are presented as alternatives to existing methods. Established treatments, which are regarded as dogma, may be shown to be less effective or less safe than originally believed. It’s a confusing intellectual morass to sort among complex and conflicting studies some of which ...

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shutterstock_246953212 Let's take a moment to consider what makes a terrific nurse. First, by way of gathering information, let's consider the health care industry's present views on excellence in nursing.  Let's think about how this conception of excellence in nursing aligns with our own perspectives. In a recent Atlantic article, titled "The Problem with Satisfied Patients," Alexandra Robbins writes about the economic ...

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Physicians are struggling to adapt to a sea change in the health care delivery system. Solo physician practices are disappearing, small group practices are merging to become larger, and large group practices are being acquired by hospitals and integrated delivery systems. All of this is occurring in a milieu of decreased fee-for-service reimbursement from government and private insurers, bundled payments and pay for performance, increased levels of student loan debt, ...

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shutterstock_147374198 I have spent 32 years working in hospitals and the last 16 running them.  Hospitals are created for the benefit of the community, a place where people go when they are acutely Ill, injured or have a complex condition that eludes quick diagnosis and treatment.  Hospitals historically provided primarily inpatient care and comprehensive diagnostic and treatment facilities for patients. It took a ...

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A couple of years ago, my clinical practice (Dermatology Associates at Massachusetts General Hospital) began sending patients a bill when they did not show up for an appointment. Dentists do this with some frequency, but it’s unusual for a physician practice to do it. Our reasoning was that we have many folks who insist they need to be seen right away and, despite a large, busy practice (we see more ...

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dr oz Enough already about Dr. Oz. Whichever side you happen to be on, we might collectively acknowledge that much of the noise being made about what is, at worst, a symptom, is itself an indication of a culture-wide disease. The fate of Ozymandias comes to mind. Science is Ozymandias. Soundbites are the ruin of it. In the case of the Oz ...

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shutterstock_118623196 I’ve been a doctor for more than 20 years, and I hate to break it to you, but it’s time I came clean: We lie. Doctors lie. Not always. Not necessarily on purpose. But we do. Sometimes the lies are to our patients. Sometimes, the lies are to our families. And sometimes the lies are to ourselves. But, nonetheless, we lie. A lot. ...

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