Like much of America, my family is obsessed with everything Hamilton. We jammed to the soundtrack all summer. The season culminated with a late August trip to the show which I described on social media as the best day of my life. Seeing the show, the actors, the set, and choreography, come to life with lyrics we had all memorized was such an amazing experience. I cried. Part of that was pinching ...

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As a severe myopic, it is no wonder I have always had a certain interest in ophthalmology. And just the other day I had reason to ponder the peculiar Dutch dominance in the history of optics and ophthalmology. When I was a nearsighted young school boy in Sweden, my mother brought me on the bus into town every fall to see the eye doctor. He must have been in his eighties, ...

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ZDoggMD's latest.  It's time to start a movement. #unbreakhealthcare

Online reviews for doctors are here to stay. Letting patients review their doctor sounds great right? What could go wrong? That being said, there are several things that reviews do that is, in fact, damaging to the care of patients in medicine.  Here are six things that many physicians now do in the world of online reviews. Focus on showmanship not results. Sometimes I spend extra time on the exam even when I ...

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I began one of my medical oncology rotations alongside my co-resident: an MD/PhD, fast-track (pre-matched into fellowship) future oncologist. Among my three interns that rotation, two were “Harvard kids.” Needless to say, I was intimidated. My colleague and counterpart not only had the entire catalogue of genomic alterations at the tip of his tongue, he knew and understood their implications on disease. I saw my intern having a long conversation ...

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When you are 70 years old, you are bound to have some medical problems, so I am not sure why the media and the public are making a hoopla about the medical histories of Hillary Clinton and Donald Trump. For an elderly patient, my usual medical dictation reads “Mr. A is a 70-year-old former truck driver who has hypertension, diabetes, bypass surgery, and who now comes in with a cough and ...

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Ah, EMTALA! The revered Emergency Medical Treatment and Active Labor Act! It’s one of those things which is like a nursery rhyme to emergency medicine folks like me. We’ve heard about it from the infancy of our training.  "And then the bad doctor sent the poor lady to another hospital because she couldn’t pay!  And the King came and crucified him for doing it!"  The end. EMTALA, for the uninitiated, is ...

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asco-logo Many men experience significant erectile problems after having a radical prostatectomy, and many of the men treated by the urologists I work with eventually land in my office. We talk frankly about the quality of their erections before the surgery, what they are like now, and what they have tried to do to resolve the problems they are having. After this, ...

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Referencing a recent New York Times article “What Kids Wish Their Teachers Knew” got me thinking about both sides of the coin.  Physicians are human beings and sometimes this fact gets lost when a patient is angry or frustrated seeking help from the medical system.  Here is a primer on what I wish my patients knew. (This is a companion piece to "I wish my doctor ...

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Whenever he meets with a new patient, Harvey Chochinov likes to ask one important question: “What should I know about you as a person to help me take the best care of you that I can?” It’s a question every doctor should ask, says Chochinov, author of Dignity Therapy and director of the Manitoba Palliative Care Research Unit; a question he has found helps patient and doctor alike dial ...

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In general, I would predict that the audience reading this blog knows about medicine’s suicide epidemic: Roughly 400 physicians and 150 medical students kill themselves each year in the United States. This means that every year, about a million Americans lose their doctors to suicide. This crisis is a public health issue. The puzzling question is: Why isn’t it publicly known? If one million Americans were affected each year by ...

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Pretend you're a 30-year-old woman who's 34 weeks pregnant. You develop a cough while cleaning a dusty room. You put up with it for several days. After a week you realize the cough has kept you from sleeping and is creating pain in your rib cage. Time, you think, for medical attention. That should be an easy thing to do. After all, you have health insurance, and you're articulate and assertive. ...

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Pain. It permeates every aspect of medicine, crawls into the deepest corners of our practices, sinks its claws in and stays put. Opiates are at the center of a vicious national debate, and our patients are trapped in its clutches. But my thoughts are less on medications, protocols, and procedures and more on how we approach the patient who cries pain. Through everything I have observed, as a caretaker and ...

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an-ingrown-toenail-is-not-a-lung-transplant Illustration by Jorge Muniz, PA-C. Here’s a quick review of health care delivery basics: Primary care. Stuff you can get handled with your primary care doctor in your neighborhood. Example: ingrown toenail. Secondary care. Stuff your primary care doctor refers to a secondary specialist down the road. Example: colonoscopy. Tertiary care. Complex stuff you need to deal with at a big-city hospital. Example: lung transplant. Simple. Right? Here’s the problem: ...

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A manifesto has been making the rounds on Twitter (and other places) over the past year. It has been attributed to Dr. Mike Ginsberg, a California pediatrician. It reportedly was originally a Facebook post that has since been taken down, perhaps because of the controversy it generated. I can understand why; vaccines are a hot button topic, and anyone who writes about them attracts attention, some of it unpleasant. I know ...

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I have already opined on my disapproval of a medical marijuana law recently passed in Ohio.  Once of my points in that piece is that I did not want legislators making medical decisions for us.  They can’t even do their own jobs. I am not against medical marijuana; I am for science.  The currency of determining the safety and efficacy of a medicine should be medical evidence, not faith, ...

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The British National Health Service (NHS) was born in 1948, based on legislation passed that year mandating free high-quality health care for all paid by taxes. In contrast, the U.S. started Medicare in 1966 to provide health care to the elderly and the State Children's Insurance Program (SCHIP) in 1993 to fund health care for children whose parents were unable to afford it. Health care in the UK is still ...

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I recently watched the movie Sully. It was the first time I’d ever watched a movie on its actual release date. Knowing what a legendary actor Tom Hanks is, and what a fascinating and near-tragic story unfolded on January 15, 2009, I felt confident that my choice to venture out to the cinema on a beautiful Boston September evening, would be a good one. The movie sure didn’t disappoint. Brilliantly directed ...

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When it comes to social media, oversharing is the new norm. When #flu season comes around, everyone on Twitter becomes inundated with talk of runny noses, strangers sneezing on their morning commute bus ride, and avoidance of the airport. People update their statuses on their interactions, frustrations, struggles and even locations. When a friend is not feeling well, they may post about it on social media and get an instant ...

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As rheumatologists, we pride ourselves on spending time with our patients, listening to their problems and their family’s problems, and answering all of their questions. Whenever my husband and I run into a patient of mine on the street, they always tell him that I am the best doctor ever. In spite of these accolades, I realized recently I was guilty of doing something with a handful of my patients ...

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