The publics lack of trust in science is alarming Cynicism appears to have replaced idealism as America’s defining characteristic.  So many of us just don’t trust the government, scientists, the clergy, journalists, business CEOs, labor unions, lawyers, or just about anyone for that matter, to say or do the right thing. Two years ago, the National Journal reported that as a consequence of the Great Recession, “Americans are losing faith in ...

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I've waited to address this sensitive topic until after the midterm elections, when political slogans such as the phony "war on women" and trumped-up threats to religious liberty were discarded like so many campaign posters. It was curious to see the American Congress of Obstetricians and Gynecologists (ACOG) and Planned Parenthood attacking Republican Senate candidates for supporting over-the-counter birth control pills without a prescription -- a position that, if the pills ...

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I didn't think much of it at the time. Most physicians can trace back and recall their first patient.  For some, it is a clinical encounter the third or fourth year of medical school.  The more creative may point to their cadaver during first year anatomy and nod knowingly.  My first patient was a mouse.   Or shall I say a group of them? My freshman year of college, I volunteered in ...

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What chaos theory has to do with family medicine Open a new browser tab and check your favorite weather forecast website or app. Right now. How many days in the future does it go? Seven? Maybe even 10? Look at the current forecast for the 7th day out from today. Do you trust it to accurately predict the weather for that day? Why? Or why not? Have you ever wondered why they can’t ...

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Primary care fits some medical students. Heres one. One of the top students at one of the nation’s largest medical schools, Ishan Gohil has made an unusual -- and to many of his colleagues -- inexplicable decision.  Instead of seeking to train in one of medicine’s most highly specialized and competitive fields, he says, “I elected to pursue a career in family medicine.”  Many view his choice of primary ...

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The religion of emergency medicine: Its time for a reformation Emergency medicine, like every specialty, is its own religion. And on many levels, it tracks right along with the progression of religions from their ancient origins to their modern incarnations. Our unique profession grew out of a pressing need for physicians who could provide immediate and life-saving care to the sick and injured, at all hours of the day or night. The ...

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Imagine you walk into a restaurant named Luigi’s. From the décor and the smell of pasta sauce coming from the kitchen, you assume that this restaurant serves Italian food. You walk forward, your name is taken and you are then told to sit off to the side and wait until your name is called so that you can get a table. Time goes by, and no one gives you any ...

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Patients are doubly screwed by the malpractice system Part 3 of a series.  Read part 1 and part 2. The aspect of malpractice suits that lawyers seem congenitally unable to understand is how devastating it is. "Ho hum," says a lawyer who read my first two posts in this series. "Get out the violins." It's as if, because I make my living operating on ...

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Need better care coordination? There’s a toolkit for that.A guest column by the American College of Physicians, exclusive to KevinMD.com. Care coordination seems to be the rage these days. It is mentioned in most discussions of new delivery and payment models such as the patient-centered medical home (PCMH) and accountable care organizations. The concept is not a new one; primary care physicians have been coordinating care ...

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Patients: Accept your fate as a hamburger Most of the doctors I know went into medicine because they really truly wanted to help people. But medicine, long honored as a calling as well as a profession, is facing some tough new challenges. Many doctors are disillusioned or simply burnt out. Others have accepted their fates as interchangeable provider units. The name of the game today is efficiency -- i.e., ...

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