What every college freshmen ought to know about sexual assault Dear college freshman, I just saw you in clinic a few weeks ago; your last check up before college. We talked about a lot of stuff, updated shots, filled out forms, hugged good-bye; crammed in what we could in just a few minutes. It was a great to see you. Now that you are out of the office, away from the distractions of a buzzing ...

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MedPage Today recently tackled a very controversial issue in medical practice.  The piece explored the ongoing battle between dermatologists and allied health professionals (AHPs) over the performance of dermatologic procedures.  As independent NPs and PAs begin to bill for more and more procedures (thus potentially talking revenue away from board certified dermatologists) specialists are beginning to argue that the AHPs are practicing beyond their scope of practice. According to the 
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My morning practice session started out with a few patients arriving early, so I was able to get a jump on the day, and it looked like I was going to actually be running on time. As I was walking from one exam room to the other, my administrator came down the hallway, grabbed my arm and said, "Can I have you for a minute?" It seems that a group of systems ...

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Part of a series. Over the past few months KevinMD.com has posted a series of articles by me on what I call the “crisis in primary care.”  Most recently have been a few posts related to direct primary care. They have generated many comments: some pro and some con. I have greatly appreciated everyone’s interest; it makes it worth the time to write. I am also working on a book on ...

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Most of the time I feel as though I am running in quicksand attempting to bring patients to a place of grace and dignity in dying. On occasion, there is someone who jerks me out of my quicksand and plants me squarely on stable shore and then proceeds to show me what grace and dignity in the face of death really look and feel like. Please meet Mr. Jefferson. Mr. Jefferson had long, lacy ...

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Deciphering hospital bills is not for the faint of heartDeciphering hospital bills is not for the faint of heart An excerpt from The Cost of Cutting: A Surgeon Reveals the Truth Behind a Multibillion-Dollar Industry. Deciphering the hieroglyphics of hospital bills, especially when it involves surgery, is not a job for the faint of heart. As Mr. Wilkes discovered when comparing notes with a friend, there’s another puzzle: the huge ...

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You know it’s going to be one of those days when one of the first tweets on vacation inquires about the closest hospital. Victor, one of my 11-year-olds, had something in his eye courtesy of a big gust of wind outside of Westminster Abbey. He was complaining enough to let me flip his eyelid and irrigate his eye on the square in front of Big Ben. (I’m sure several people thought ...

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Cholesterol is bad. Cholesterol is an essential building block for important hormones. Eggs are bad. Eggs are a complete protein food. Salt is bad. Salt is essential for life. High blood pressure kills people. No blood pressure defines death. High blood sugar causes eye and kidney damage. Low blood sugar causes falls, fractures and car wrecks. Low potassium causes heart rhythm problems. High potassium causes heart rhythm problems. Too little vitamin B12 causes nerve damage. Too ...

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How to be a great health care administrator In no other field is unity and collaboration between administrators and frontline staff more important than in health care. Unfortunately my own experience is that the disconnect and mistrust, especially from doctors and nurses, towards hospital administration is growing larger all the time. Let me start off by saying that I have intimate experience of both sides of the divide. Obviously as ...

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"Dr. Sevilla, I have a question for you," a patient asked me this week. "I'm going to tell you something, but I DO NOT want it put in the chart." Hmm, I asked myself, can I really do that? It's the patient's wish, right? The patient went on to tell me that she heard about this week's story about a hospital network being hacked and 4.5 million records being stolen. ...

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