Dr. Daniela Drake writes an provocative and bold piece on the plight of doctors in America and the impact it has on patient care: "Why Your Doctor Feels Like a ‘Beaten Dog’." Though health care is very bureaucratic with administrative paperwork, huddles, and hassles, her linkage of how patients were neglected as a consequence of the system doctors work in is weak. She talks about Victoria, a teenager, who ...

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Is your doctor a hammer and you're a nail? Here's some insider advice coaxing patients to be more wary and skeptical of medical advice. Should you trust your doctor? Absolutely. But you need to serve as a spirited advocate for your own health or bring one with you. Ask your physician for the evidence. Sometimes, his medical advice may result more from judgement and experience as there may not be ...

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Ebola virus is rampant in West Africa. So far, the death toll is around 2,296, which makes it one of the largest outbreaks ever. Ebola is what’s known as a hemorrhagic fever virus, and belongs to a large family of nasty viruses that are widespread around the world. There’s even one in the American Southwest known as hantavirus, that lives in a species of mice. Yellow fever, which killed so ...

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We speak of everyday decisions in terms of cost-benefit analyses. Many of our patients can’t afford a healthy meal, let alone a hefty hospital bill, thus making cost awareness increasingly relevant. But on the day that I met Mr. R., it wasn’t the financial aspects of his care that concerned me. I was thinking about the patient, his family, and two roads diverged in a hospital ward. I was thinking ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old woman is evaluated in the emergency department for loss of consciousness. Her son, who brought her in, says she seemed confused and agitated when he spoke to her on the telephone less than 2 hours ago. The patient has an 8-year history of type 2 diabetes mellitus. She had strict ...

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About seven years ago, the California Healthcare Roundtable and Health Affairs sat down to prepare a white paper on the emerging phenomenon of urgent care centers, and what it might mean for primary care. At the time the group couldn’t agree that urgent care (UC) was a disruptive innovation, but it seemed clear to all participants that it represented a threat to primary care: The rise of UC, the group noted, would lead ...

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This is the story.  Ebola emerged in 1976 and the last major outbreak occurred in 2007 in Uganda and D.R. Congo. Now we are experiencing the largest outbreak of Ebola ever seen with a death toll of 1,848 and number of infected of 3,707, but these are only the “confirmed” cases. Ebola is affecting 4 countries in West Africa: Guinea, Liberia, Nigeria and Serra Lione, and while we have only seen ...

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We’ve gone through four dreadful pre-medical years of learning everything from the composition of atoms to how an apple exerts force when falling off a tree.  We’ve taken a massive exam full of content mostly unrelated to our future field only to be put through four more years of intense medical education (and several additional massive exams).  We’ve managed to receive a medical degree and have gone through at least ...

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Two women, two cancers, two different pathwaysI sometimes wonder what I would do if I was told I had cancer. How much would I subject myself to in order to survive, or to achieve remission? As a parent, I can answer only that I would likely go through hell and back if it meant being there for my kids -- to watch them grow up, graduate ...

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After you've written on a blog for a long time, you begin to ask yourself why.  Oh sure, there are the great opportunities for a single person to make a point, to act as a tiny tugboat trying to push a corporate mothership in a slightly different direction, but you begin to realize that there are very few times that actually happens. You try to provide a voice to issues ...

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As every physician already knows full well, health care services delivered to the home rather than in an institutional setting are increasing, a trend destined to expand even faster in the decades ahead. This shift is inevitable, thanks to our rapidly growing elderly population and the corresponding prevalence of chronic illness, along with the nationwide push for higher quality care at lower cost and dramatic advances in medical technology such as ...

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Top stories in health and medicine, September 19, 2014From MedPage Today:

  1. Ebola Response: Fighting the Last Outbreak? The dramatic U.S. commitment of 3,000 military personnel is arguably the biggest contribution yet to the fight against the West Africa Ebola outbreak.
  2. Microbleeds May Up Afib Mortality. The presence of cerebral microbleeds was associated with an increased risk of death from both ...

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Curbing prescription pain medication abuse by working togetherA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. I recently heard a story on the news about a grandmother of eight who had gotten addicted to heroin after being prescribed an opioid painkiller, Oxycontin, for hip pain. It sounds extreme, but unfortunately to those of us in the pain medicine field, it’s all ...

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This is what population health looks like It is a beautiful day here in my little college town. The sun is shining and at 11 a.m. it is about 78 degrees with a barely perceptible breeze. People are out walking on Main Street and riding their bikes. The mountain nearby calls: I can go for a hike today with my dog and still be within 20 minutes or so ...

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Many healers, teachers and parents have them. At one point, I did, too. I had delusions. I thought I was a hero, a rescuer clad in a shiny white coat and wielding the sword of clinical wisdom. I look back on those days with nostalgia and regret. I wish they'd lasted a little longer -- my belief in my own medical grandeur and invincibility. My most memorable patient changed that for me. I remember how ...

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What is HPV? HPV stands for human papillomavirus, and these viruses are the most common sexually transmitted viruses in the United States. Most of the people who are diagnosed with HPV are young and sexually active. The rates of HPV infection are high because most people who have HPV do not know they are infected because sometimes the virus shows no symptoms. Most HPV infections show no symptoms, and resolve within ...

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“He’d feel okay about not replacing the pacemaker’s battery when it ran down, he said. But turning it off, he said, would be 'too active.' Later he would tell me that it would have been “like putting a pillow over your father’s head.” These are the words of Katy Butler in her book Knocking on Heaven’s Door – The Path to a Better Way of Death in which she writes about her ...

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Recently, Cisco chairman and CEO John Chambers told me that U.S. health care is at a tipping point. A positive one, he hopes, but the truth is no one knows for sure which direction the system will tip. At the close of our interview, I asked Chambers what health care topic he’d like me to cover in the future. He asked me to answer two questions. And they happen to be the ...

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Top stories in health and medicine, September 18, 2014From MedPage Today:

  1. I, Intern: New Questions, New Mistakes. It feels surreal to Emily Lu, MD, when she discharges patients from the emergency department at San Francisco General Hospital and tells them to see her in a month.
  2. U.S. Ebola Response: Troops, Training, Supplies. Calling the Ebola epidemic in West Africa a ...

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Thanks to the popularity of medical television shows, most people have witnessed hundreds of fictional cardiac arrests in their lifetime. In most of these scenes, the patient loses consciousness, and the medical team rushes to the bedside: “He’s in v-fib.” “Get me the paddles.” The team performs urgent chest compressions for a few seconds.  Then they place the metal paddles on the victim’s chest: “Clear!”  Kathump. The patient’s heart is back to normal again, tragedy ...

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