In July 2016, the U.S. Preventative Services Task Force (USPSTF) published updated skin cancer screening guidelines in JAMA, concluding “current evidence is insufficient” to screen for skin cancer in adults. The guidelines were formulated on a literature review of studies conducted in asymptomatic patients 15 years and older at general risk for skin cancer from 1995-2015; after identifying nearly 13,000 articles spanning two decades of work worldwide, the authors selected ...

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Most people are surprised to hear that the way doctors are recertified every ten years is through a multiple choice test. “Really?” they’ll say. “You take a multiple choice test? As a doctor?” Unfortunately, after all these years that's the most efficient way we can think of to evaluate professionals. But the method is so flawed. And your ability to answer questions on the multiple choice test isn't necessarily linked with ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. In the past several years, there has been a dramatic increase in media attention concerning bills patients receive from health care professionals who are not in the network of providers their insurance company contracted with to provide health services. The out-of-network bills these patients ...

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It is a master of stealth, stretching less than half an inch long and weighing in at 2.5 milligrams with as estimated air speed of 1 to 1.5 miles per hour. It is virtually soundless in flight, registering zero decibels from ten feet. Its tracking systems hone in on targets by detecting infrared radiation from warm bodies, chemicals such as carbon dioxide and lactic acid, body odors from as far ...

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After surgery for my broken tibia, I realized that there were only four points on the pain scale that really mattered to me:

  1. I’m OK. This acetaminophen/ibuprofen/whatever is enough.
  2. I wouldn’t mind a little something more, preferably something that binds mu
  3. Um, could you please hurry that up?
  4. NOW! NOW!  I need it NOW!
On the 0 to 10 pain scale, who really cares if you are at a 2 or ...

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To close out my first week of medical school, the class was treated to a talk by a stuffy but soft-spoken lecturer on the relationship between poverty, education, and poor population health. "Social determinants of health," he labeled them, a clunky and unwieldy term if ever I'd heard one. In those days, audiovisual aids consisted of an overhead projector for black-and-white transparencies. And boy did that talk have transparencies. Chart ...

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Author.  President.  Teacher.  Doctor.  These are all gender-neutral words which happen to relate to a person’s profession.  However, I find it particularly interesting that while “doctor” is a gender-neutral word, the field of medicine is riddled with institutional sexism. Let me begin by explaining that I am a military physician currently training to become a gastroenterologist.  If being the only woman in any room bothered me, my journey would imply that ...

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After rotating in the ICU, I began to wonder about the limitations of modern medicine. In a short time, we have come a long way with the discovery of antibiotics, high-resolution imaging, and the development of advanced surgical procedures. The medical field saves millions of lives. Nowadays, people do not go to a hospital to die; they go to be healed. As physicians, we are very skilled at extending life. Heart ...

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We are standing at a crossroads in health care. Behind us lies a long-lost, nostalgia-tinged world of unfettered provider autonomy, sacred doctor-patient relationships, and a laser-like focus on the art and humanity of medicine. This was the world of my father, an immigrant and primary care physician in rural California. The world of Health 1.0. While many still pine for these “good old days” of medicine, we shouldn’t forget that those days weren’t really ...

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As a long-distance truck driver, he did not have time to visit a doctor. In fact, the last time a doctor ever examined him was decades ago. When his leg started hurting, he ignored the pain for months before it got too severe and started interfering with his ability to drive.  He showed up in my office in severe pain and limping. And while he tried to joke it off, ...

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