The story of the surrogate offered $10,000 to have an abortion by the couple who were paying her to carry their pregnancy has been making the rounds. If you don’t know the details, let me catch you up

  • Woman hired to be a surrogate for the fee of $22,000
  • Couple who are paying have 3 children, but had a lot of pregnancy complications. Two children spend months in the hospital ...

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When the American College of Emergency Physicians (ACEP) decided not to join the Choosing Wisely campaign, I was among those who expressed disappointment with this decision, in part because I have long been a proponent of efforts to encourage more cost-effective care in the ED.   In fact I had already independently done a significant amount of work in the Read more...

This question was what drove me to graduate school for an MPH degree a few years ago.  I was finishing up my family medicine residency at, arguably, one of the top residency programs in the nation.  I had been well trained in both medical science and doctor-patient relationship skills.  Yet my patients still consistently did not adhere to my advice. I was not disappointed in my MPH studies.  It turns out ...

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Having married parents is good for children. That's why the American Academy of Pediatrics (AAP) thinks that same-sex couples should be able to marry. In a policy statement, that's exactly what they said. It's going to put the AAP in the middle of controversy--but it was the right thing to do for children. There are currently almost 2 million children being raised by gay and lesbian parents in the United ...

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What does the 21st century physician look like? I’ll admit that the question on the face of it struck me as a bit absurd, especially when juxtaposed with the term “tomorrow’s doctor.” Tomorrow’s doctor needs to be doing a much better job of dealing with today’s medical challenges, because they will all be still here tomorrow. (Duh!) And the day after tomorrow. (As for the 21st century in general, given the speed at ...

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Next in a continuing series. Inside the belly, everything is slippery. The peritoneum is a glistening layer of self-moistening plastic wrap, enveloping the surfaces of all the organs, and the inner aspect of the abdominal wall. Undisturbed, the intestines coil and slither, reptilian. Watching waves of peristalsis makes me smile: there's something always entertaining about those moving contractions, following one upon another, gurgling, surprisingly tight bands of tension moving ...

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As a second year medical student in 1971, I still remember an article in the prestigious New England Journal of Medicine, describing a new phenomenon, The Emperor’s New Clothes Syndrome. It was based upon the famous Danish author, Hans Christian Anderson’s fairly tale from the 1800’s. A vain emperor, who cares for nothing except wearing and displaying clothes hires two swindlers who promise him the finest, best suit of clothes from ...

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I was sitting in the resident workroom at Massachusetts General Hospital (MGH) when my co-resident showed me the text from her sister: two explosions had shaken the finish line of the Boston marathon. Though news sites had not yet published the headline, it was immediately corroborated by the cacophonic wails of ambulances heading towards us and our shock was quickly replaced by the urge to learn more and to do ...

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I am old enough to remember when physicians did not advertise. It was considered a professional ethical issue. Hospital advertising consisted of institutional “We’re here” ads.  Anything aggressive by docs or hospitals was considered bad taste… but that was before health care became as competitive as any other type of business. I have been barraged, as have many of you, by a wave of hospital advertisements as our health care marketplaces ...

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Not long ago I noted a certain older patient's name on my schedule. I really dreaded seeing her. It's not that I dislike her--in fact she's one of my favorite patients. It was just that I hated the prospect of seeing her looking as poorly as I knew she would. She'd been through so much: an accident resulting in devastating injuries followed by painful surgeries, and, worst, in the middle ...

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