We live in a digital age. Technology has become an integral part of how we see, learn about, and interact with the world. From computers at the office, to televisions at home, to smartphones on the bus or in the grocery line, many of us spend over half of our waking lives in front of a screen. Naturally, some of us have begun to worry about the effects this may have ...

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Today, I saved a life. And I wish I could tell you a story about fancy heroics -- about an exploratory laparatomy, a chest thoracostomy, or a patient that coded and I was the last person to perform the chest compressions that brought them back to life.  But I can’t.  But I can tell you that I saved a life. She was 16-years-old, and moved here four years ago from a different ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 21-year-old man is evaluated during a medical examination for health insurance. The patient is a weight lifter. He has no medical problems and takes no medications or illicit drugs. On physical examination, blood pressure is 128/73 mm Hg, pulse rate is 56/min, and respiration rate is 16/min; BMI is 30. Increased skeletal ...

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The New York Times had a front-page story about the growth of urgent care clinics nationwide. These are the places that are often referred to as “minor emergency rooms,” or “doc-in-a-box” outfits. Their value proposition is simple: You don’t need an appointment. The costs are “reasonable,” and much more transparent than usual medical care at a doctor’s office, emergency room, or hospital. Best of all: They can treat a majority of acute conditions and ...

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Delivering bad news: Dont pass the buckWhen I was a fellow, part of our training involved doing consults for patients, most of whom had just learned they had cancer or recurrence of disease. These consults were never easy, but the importance of sitting with someone who had just learned of their diagnosis was an integral part of learning the medicine and art of oncology. Even after many ...

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I am a regular reader of patient blogs, and I find myself frequently gasping at the mistreatment they experience at the hands of my peers. I recently had the “pleasure” of being a patient myself, and found that my professional ties did not protect me from outrageously poor bedside manners. I suppose I’m writing this partly to vent, but also to remind health care professionals what not to do ...

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Four adages I learned in medical training that I still speak of today: “Common things are common.” (The alternate version of this that might have more appeal to zoologists: “When you hear hoofbeats, think horses, not zebras.”) This cautions physicians to remember that it is more likely that the patient has a common condition than a rare one. Although it is prudent to consider all the possible diagnoses that might match a given ...

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In a previous post, I described how the American health care system is morphing into a system designed to service impoverished populations, and concluded that the transition “will take time, thoughtful planning, lots of innovation and a carefully cultivated disdain for human life.” However, a new blog post from Dr. Peter Ubel makes me think that it may not take that much time after all. It seems that Dr. Ubel ...

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The unrelenting opposition by American conservatives to Obamacare may have the unintended consequence of leading the United States to a single-payer system like Canada’s. How’s that, you say? Isn’t the whole point of conservative opposition to Obamacare to drive home the point that the government is incapable of managing people’s health care?  Yes.  And aren’t conservatives effective in driving home that point? Yes, polls show that confidence in government is at ...

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From time immemorial until about 75 years ago or so most babies were born at home. Now it’s around 1% in the USA, although it’s much higher than that in many Western European countries. The shift to hospital births paralleled the growth of hospitals, pediatrics, and obstetrics. With that shift there has been a perceived decrease in women’s autonomy over their healthcare decisions. There has also been an unsurprising jump in ...

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Most busy doctors completely forget (or ignore) the importance of integrating personal downtime and self-care into their schedules. It’s no surprise so many doctors wrestle with overwhelm. Downtime is crucial for stress management. What about you? Are you guilty of skipping your “you time?” No, I don’t mean attending a seminar, reading an article, or talking about stress reduction at a staff meeting. I mean, when is the last time you scheduled some real ...

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Last week a patient said to me, "You live your whole life thinking you're going to have time to enjoy life later on, and then this happens." Then he started to cry because we had just reviewed his recent CT scans and some of his lab results and he had a new diagnosis of a type and stage of cancer that meant he likely had about eight months to live. ...

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When it comes to preserving health and prolonging life, study after study shows that prevention is essential. From type 2 diabetes to early-stage prostate cancer, clinical trials have demonstrated that countless diseases can be avoided or even reversed through (often simple) lifestyle changes. We know the solution. Yet the challenge is reaching it. For example, tens of millions of overweight Americans are dieting at any given moment, but only a ...

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A baby’s smile reflects the purity in their heart.   An infant’s world is a marvelous place of possibility and love.   Children see themselves as special, capable, even omnipotent.   Time teaches failure, loss, and mortality.  How much we lose of that original perfection, that first excitement, that natural confidence, determines how we face the challenges and tragedies of life; whether we will be happy.  It may even determine how we cope ...

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Top 10 ways to know its time to quit your job as a doctor Attention all doctors: The first three are mine. The rest are from miserable colleagues. All true. And common. If you’re a doctor and you recognize anything on this list, please quit your job. 10. You feel nauseated when you see your clinic logo; you alter your commute to avoid streets with your clinic’s billboard. 9. Discouraged by the general despair among staff, you ...

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Top stories in health and medicine, August 21, 2014From MedPage Today:

  1. Nutrition Experts Like 'Outdated' Foods Initiative. Public health specialists offered high praise for an initiative by a former Trader Joe's executive that will funnel unwanted produce into stores in low-income areas.
  2. Doctors' Spouses: What's Not to Like? When it comes to domestic life for physicians, things have changed since ...

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Over the last year I’ve become rather addicted to golf. Having always been more into cardiovascular sports I’m actually quite surprised with how much I’ve taken to it. Fresh air, outdoors, lots of walking in beautiful nature and spending time with friends -- what is there not to like? Anyway, I’ve frequented several different courses in the Boston area in just the last few months. Last week, we were due to ...

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I was shocked and deeply saddened when my daughter announced at the dinner table that Robin Williams had died of an apparent suicide. My wife and I and the three of our children home at the time all pretty much gasped audibly in unison, and then for a moment after, you could have heard a pin drop. For a bit after that, we talked about our shock and sorrow. And then after that, ...

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William was doing great.  His C. Diff  was finally gone after a month taper of vancomycin.  He was stronger.  The nursing home staff reveled in how much progress was being made over such little time.  It seemed every one was ecstatic, except for, of course his family.  Every step this octogenarian took forward was accompanied by a litany of concerns and complaints from his daughter. If he was not gaining weight, ...

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I see it again and again in my practice: parents who seem to have forgotten that they are in charge. "You can say no," I find myself saying to family after family. Which is kind of an amazing thing to have to say, if you think about it. You'd think that parents would know that they can say no when their child asks for yet another toy, to watch more television, ...

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