Why does treating heart attacks cost so much money? An article from the JAMA has been gnawing at my consciousness for the last couple of weeks. Dr. Prashant Kaul and colleagues out of the University of North Carolina reviewed records from hospitals in the state of California from 2008 through 2011, looking for patients who had been hospitalized with heart attacks. Specifically, they were looking for patients with ST elevation ...

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Standing in front of my patient’s home, I reach out to ring the bell. On the other side of the door live a man and his wife, who have been waiting patiently for my arrival. I hesitate for a moment before pressing the button. As I wait uneasily for the door to open, I think to myself that this is the first time I make a house call on my patient ...

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On September 4th, 2014, iconic comedian and TV personality Joan Rivers passed away due to complications following what seemed to be a routine visit to her gastroenterologist. Up until now, a wave of speculation and mystery has surrounded her case with a trove of unanswered questions. What happened on that tragic day? What kind of procedure did she have? Was it a dangerous surgery? Who was in the room? On October 16th ...

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Ferguson: What should physicians do? There is little to say once you’ve said this before. Although the sadness brings fresh tears, they are also old tears. The grief becomes familiar and so too the inevitable resumption of everyday life. The pain bores to the soul but settles in the subconscious, where it rests, privately born and quietly hidden, lest 
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The recently released report, Shooting at Sandy Hook Elementary School, from Connecticut's Office of the Child Advocate offers a searing in-depth account of the holes in our mental health care system. The report is careful to point out that no causative link exists between their findings and the events at Sandy Hook. However, this in-depth investigation offers an opportunity, if we are able to hear and take action on its ...

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Get help: Most physicians are not good at business We’ve all heard or used the phrase, "Leave it to the professionals." It certainly applies to me as the only tools that I can use with competence are the scopes that I pass through either end of the digestive tunnel. Yeah, I have a toolbox at home, but it is stocked similarly to the first aid kit that your new car ...

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A walk in Central Park: Contemplating physician burnout There are times when who you are and what you do are inseparable. A photographer views a scene from the camera’s point-of-view even when the camera is not in hand. A police officer assesses situations with an “on duty” reaction, even when off-duty. And a health care professional rarely turn off the knee-jerk reaction to assist when someone requires help. That immediate ...

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They didnt do anything! The inverted homeopathy of the ER. How often do we have this interaction: "My wife was here yesterday for belly pain.  That doctor didn’t do nothing! Told me she just needed to get over it. I am not happy and something needs to be done about this!" (Frequently spoken by spouse.) Records are reviewed.  Treatment:  Included numerous doses of morphine and phenergan, as well as fluids and Zofran.  Frequent warm blankets were ...

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Physicians are treating the well, and nurses are treating the sick A rash could be leukemia or idiopathic thrombocytopenic purpura. A sore throat could be glossopharyngeal neuralgia or a retropharyngeal abscess. A blocked ear could be Ramsay-Hunt syndrome, a self-limited serous otitis or sudden sensorineural hearing loss with an abysmal prognosis if not treated immediately with high doses of steroids. A headache or sinus pain could be cancer, and a cough could ...

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As a doc, I need to take care of the whole child. I do this with respect for every kiddo; and with their parent’s consent, presence, and permission. Sometimes the job includes discussing or examining a child’s genitals. In the past, it was not thought of as appropriate to allow children to speak openly about sensitive anatomical areas (“private parts.”) Growing up as kids, we may have had family slang or nicknames for certain areas of ...

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