Why you should protest the deaths of Eric Garner and Michael Brown In the pediatrics playroom, the medical team and I, a medical student, hunkered down in child-sized chairs to review patient progress notes. A television screen nearby diverted my attention. On CNN, video of protesters alternated with Eric Garner’s final moments. The television was mute, but I could hear Garner say, “I can’t breathe ...I can’t breathe …” One moment, he is ...

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Any health care provider can tell you that clinical knowledge isn’t the only thing that determines how well you care for your patients.  We’ve all seen -- many times -- the patient that can’t afford the correct antibiotic, doesn’t get preauthorization for the necessary CT scan, and can’t find a specialist who will take his or her insurance.  Making the correct diagnosis is only the first step in helping a ...

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While millions of Americans are re-enrolling in Obamacare, signing up for health insurance for the first time, or double-checking the plans their employer offers, many will undoubtedly ask what’s affordable for them. Good luck defining affordability. Like beauty, it’s in the eye of the beholder. To better understand what affordability in health care means from the vantage point of the ‘kitchen table,’ the National Quality Forum, with support from the Robert Wood ...

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The food stamp program helps over 40 million Americans pay for groceries. Unlike other forms of economic assistance, this program, called SNAP (the Supplemental Nutrition Assistance Program), only pays for food, thereby constraining how recipients make use of the aid. But are food stamps constrained enough? SNAP recipients experience higher rates of obesity and diabetes than the general  population.  Experts estimate that SNAP recipients consume almost twice as many calories ...

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A few months ago I assessed a patient with dementia.  I dutifully ordered the appropriate blood testing and MRI.  As I delved further into the history, I was concerned that there may be a component of depression. Pseudodementia (memory disturbance and dementia like symptoms caused by depression) can often mimic classic Alzheimer’s disease, but resolves with proper treatment.  The best way to differentiate these two syndromes is neuropsychological testing.  I decided to send my patient to a colleague ...

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My husband and I both like to run.  I run about 3 miles once or twice a week -- if the weather’s not too bad, and if I don’t have something else going on.  Keith, on the other hand, runs half marathons.  He goes for long runs on the weekend for 3 to 4 hours at a time, and shorter runs during the week.  He runs in the heat, rain ...

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In the post-Affordable Care Act health care landscape, sweeping hospital closures have created new barriers to access in a system already criticized for its fragmentation and saturation. Looking back over the past 20 years, urban hospitals, and urban trauma centers in particular, bore the brunt of this impact, closing at the highest rates in the country. Now, evidence suggests the impact of urban hospital closures may disproportionately ...

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One of the most subtle deceptions hidden inside the cracks of our sick care system is the lie told to doctors: that health is our primary goal for our patients. I began to understand this paradox clearly when I listened to my friend’s anguish. She’s been working as a full-time medical assistant in a busy nephrology practice, supporting two sometimes three full-time sub-specialty doctors. The practice is located in a small town ...

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CMS recently announced it would begin next January to pay physicians for care coordination activities. It’s about time. As physicians have been saying for some time, any payment system that hopes to encourage value (better patient outcomes) has to start by paying physicians to coordinate the care of their patients.  When physicians follow up on referrals or communicate with patients outside of the office, healthoutcomes improve, costs shrink and the patient ...

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If a foreign government took the United States surgeon general hostage, I’m confident we’d be pretty upset. I think we would be working on reprisals, and maybe even prepping a SEAL team. I don’t know if it’s better or worse that we need no help from a foreign power to take our surgeon general hostage. Our own political system manages, all on its own. Admittedly, it’s not quite the surgeon general who ...

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