My favorite day of the year is December 26th. All work done, house a mess but, who cares – the kids are happy. No dinner to make. There’s enough left-over turkey for the apocalypse. I was sitting by the fire, new book in one hand, glass of Prosecco in the other. I never sit and haven’t read much this year so you’ll forgive me that I did not at first ...

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A few years ago, I was sued. Yes indeed, I can now shout it from the rooftops. I know what it feels like to sit in the fire and burn into ashes of self-doubt, regret and emptiness; staring into the soulless, Cyclopean eye of a deposition camera, recounting my sins, defending my pride. I know what it’s like to live with fear, up close and personal. And I know what ...

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A guest column by the American College of Physicians, exclusive to KevinMD.com. Two years ago, my practice became a patient-centered medical home (PCMH), or more accurately, my practice began the transition towards delivering patient care under this new model. While that process is far from complete at this point, it’s been a positive experience. This month, I’d like to share ...

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The dictates of human kindness are fickle. The eruption of papers fluttered to the linoleum floor of the bustling hospital corridor.  Important persons with grey pressed coats and stethoscopes bouncing against clavicles rushed by without rotating necks downwards to notice.  Loosely fitting scrubs clung to contracting muscles, and pudgy abdomens directed bodies hurriedly around the corner with a misplaced sense of purpose. And the poor woman bent down helplessly, and struggled to collate ...

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I should be encouraged.  I was asked to talk on public radio last week about my new practice, then I was on a panel of “experts” in Washington DC on Monday.  Everywhere I talk about what I am doing I get positive reactions.  I get very positive reactions, actually.  I was approached by someone wanting to work with me “when I get ...

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Seven months ago, in Carbondale, Colorado, staff at the skilled nursing facility where my mother had resided for over a year recommended that she be placed on hospice.  My mother has severe advanced dementia and can no longer walk, speak, feed herself or recognize her family members. As much as I know about hospice care for cancer patients here in San Diego, I knew nothing about hospice care in Carbondale for ...

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“Will this case take very long?” “If  the surgery gods are with me we should be done in an hour.” The above brief exchange took place between me and the anesthesiologist attending to my patient on a recent surgery.  The patient was a middle aged woman who was about to undergo surgery to relieve a small bowel obstruction. She had been visiting her husband in a distant city where he was working ...

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The recent hurricane in New York City and the closures of some hospitals requiring the transfer of a large number of patients reminded me of something that happened on 9/11/2001. I was working at a hospital near New York. You may recall that among the many problems that day was a breakdown in communications. Reliable information on the number of casualties and extent of injuries was hard to determine. Late on the ...

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Medical journals aren't what they used to be. Just ten short years ago, medical journals were places to report scientific study, interesting cases or clinical updates and reviews. They were, for the most part, about science and discovery. Now, there is a dramatic shift of scientific content in our journals to politics and policy. No where is this more evident than the much-heralded and widely read New England Journal of ...

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The role of race in college and graduate school admissions remains controversial in the U.S. In fact, the Supreme Court is currently taking up a challenge to a University of Texas program that considers race in its admission decisions.  Critics of race-based admissions question whether educational institutions would serve the goals of affirmative action better by relying exclusively on non-race based criteria, such as socioeconomic status and family ...

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