As Congress returns from its summer recess, the health care debate is sure to heat up … again. And over the past few months, the debate has had a significant impact on public opinion. A recent report describes how Americans currently view the ACA. According to national polls, over 90 percent of Americans would change the current law. Most Democrats would expand ACA coverage while most Republicans ...

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I have been working on this essay for some time now. It has been difficult for me to convey in words this complex issue of physician-patient relationships that, to me, is the crux of the art of medicine. The first time I met Rachel was when she showed up at my office with Mary, her closest friend for her first prenatal exam. When a year later, I walked into my office ...

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Sexuality can be hard to talk about. I think this is true for adults far more than for children. Children are naturally curious and nonjudgmental. They just want to know: What is that, what’s it for, why are yours different from mine, and why does he have one of those and I don’t? It’s we adults who squirm and dodge, deflect and bolt. From a very early age, children learn ...

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I have a very interesting job: I travel around the country providing neuromonitoring to surgeons in the operating room. I’m also an anesthesiologist assistant, certified and licensed to provide anesthesia. Throughout my ten-year career in the OR, I’ve been the guest of nearly a hundred hospitals in the U.S. and the UK. No two hospitals are the same. My career has allowed me to meet hundreds of incredibly caring doctors, ...

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What should you do if an insurance company denies a test?  Record the name of the denying physician in the chart and take the burden of the denial off of your shoulders and onto the shoulders of a faceless, algorithm-following insurance clinician.

She came to me with complaints of weight gain. I gave her a pill, and she shed 200 lbs. in 2 weeks. No, of course not. There is no such pill. Mrs. Lopez did not lose weight. At her follow up four months later, she had gained 11 pounds. I went back to my note, and it clearly said that I “counseled her ...

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Is the practice of medicine a different experience for male and female physicians? Two recent studies from athenahealth suggest that it is -- in ways that should make us rethink what we value in health care. The first study found that male physicians are more productive than their female counterparts. In an analysis of 47 million visits on the athenahealth network in 2016, male physicians generated 30 to 40 percent more ...

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I recently asked, “Who’s to blame?” for patients not taking their medications and cited a couple of papers describing the poor state of medication adherence. I concluded nonadherence was a huge problem, and doctors failing to educate their patients was not a major cause. To support my contention that physicians are not the reason why patients do not take their medications as ordered I submit the following new information. A 
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Dr. Tara Zandvliet was inundated with calls and emails from parents last year, after California passed a law nixing personal beliefs as an exemption from school vaccinations. Suddenly, many parents sought exemptions for medical reasons. Someone even faked two medical exemption forms purportedly written by the San Diego pediatrician, copying a legitimate document she’d provided for a patient and writing in the names of students she’d never treated, she said. She ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old man is evaluated for elevated blood pressure noted recently at a local health fair. He has no other medical history and takes no medications. On this visit and on two subsequent nurse visits, the patient's blood pressure measurements are less than 140/90 mm Hg. BMI is ...

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I used to practice locums medicine; which for the lay person means traveling to different jobs, sometimes several states at a time.   During that time I stayed in a lot of hotels.  But, occasionally, I had more unique accomodations.  Obviously, if you travel enough, you’ll sleep in an airport here and there. No big deal.  I actually like sleeping in airports occasionally.  When you’re stuck, you’re stuck.  Weather or ...

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STAT_Logo I’m a physician, a husband and dad, a guy who tries to live by the golden rule. But sometimes I’m an escort into sadness and despair, plunging families into the darkest emotional depths with the news I must give.

One particular case from years prior stands out. Mary (whose name and identifying details have ...

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A curious post popped up on my Facebook feed recently: "Another doctor running for office!" A picture of an attractive family was nestled below that exclamation, asking to show your support (in the form of dollars) for this doctor running as a Democrat for the House of Representatives. It had that sense of enthusiasm that implied I was obligated to be excited, but instead came off more like Jeb Bush's ...

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For the last several weeks, I have been working as a medical volunteer on a remote island off the coast of Fiji called Batiki. Home to 234 natives, Batiki has no running water, and no electricity (other than solar generated power). The inhabitants are subsistence fishermen and farmers. They are filled with joy and a real sense of community. While on the island, I found extremely high rates of high ...

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I’m pleasantly surprised to see how a growing number of physicians are finally starting to percolate openly with their extreme dissatisfaction about a just how broken our medical system is. I admire and am proud of these brave vanguards who are a minority but have seemed to pick up steam. I still don’t hear their fearless voices carried in major media outlets (shame on these outlets!), but they are more ...

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Determination and resilience connect two medical students -- hear their story of strength and friendship. #BornToHeal Courtesy of the American Medical Association (AMA).

One of the biggest points of contention in the ongoing discussion of burnout is that the system of health care is flawed.  The endless bureaucracy, decreasing physician pay, and increasing meaningful use requirements that spawn endless clicking on an already inefficient electronic medical record platform have become unbearable by most practicing physicians today. Furthermore, all the talk about mindfulness only riles up more anger in physicians as they feel they are ...

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Let me start by saying that I am a huge Dave Ramsey fan.  When I completed residency and began my current position, The Total Money Makeover was the first personal finance book I read, and pardon the cliché, but it changed my life.  It instilled in me a strong foundation in money management and offered me a road map to handle the situation I was in: hundreds of thousands of dollar in ...

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Two months into my pediatric residency, while working on an overnight call, I encountered my first medical mistake. We, fortunately, had had a very good night, and all patients had remained stable. It was an hour before sign-out to the morning team, that I received a page. I quickly held my pager and dialed the 4-digit number, only to find a busy dial tone. I was a little surprised and ...

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As an attending and educator, I give a lecture to the residents each year about stroke syndromes.  In the lecture, I use mnemonics, pictures, and associations, so that the trainees can retain the information in non-traditional ways and have fun learning what could be otherwise dull material.  When I talk about the internal carotid artery stroke syndromes, I bring up the possibility of “the good, the bad and the ugly” ...

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