As a parent, my words to and about my child will probably be one of the single most influential aspects of their development. Children learn to see themselves through their parents’ eyes, and what we tell them they are, they are likely to become. The labels we place on them often tend to be a self-fulfilling prophecy. I’ve seen this play out in my own life and in the lives of ...

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ZDoggMD with another classic parody: "Let it flow."  As he puts it, "an emotional, epic anthem ... about urinary retention." Men with BPH rejoice!

Youre doing it wrong: The Paleo diet Go ahead, eat more meat, butter and cheese. Let me know how it turns out for you. I certainly won't be joining you, despite the current popularity of the proposition. For one thing, there is no case -- none -- that eating more meat, butter and cheese would be good for us. Rather, the case is advanced these days -- 
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I got a letter the other day from a local urologist requesting clearance for a patient of mine to have surgery.  The doctor wanted to know whether there were any contraindications, from the standpoint of the patient’s cancer, such as bleeding, infection or poor wound healing, which would preclude local anesthesia, bilateral incisions, sharp separation, ligation, and electrocauterization of the vasa deferentia.  In other words, could my patient, a 42-year-old ...

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We all want the advantage.  We put our kids in special preschools so they have the advantage.  We work 100 hours a week so our kids can do 8 activities and get the advantage. Tall people have an advantage, we’re told.  Poor people are “disadvantaged.” Well folks, there are a whole bunch of senior citizens in Massachusetts who are about to get disadvantaged starting September 1. UnitedHealthcare (UHC) will be
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It was a sunny spring day as the bus turned the corner. It was a yellow school bus filled with young children jumping up and down in their seats. It was an average day in an average school year. Nothing about it stood out. Let’s take a closer look. The boy sitting in the front of the bus holding tightly to his lunch box is named William. His clothes are tattered ...

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Tom Insel, director of the National Institute of Mental Health (NIMH) in his recent blog post, "Are Children Overmedicated?" seems to suggest that perhaps more medication is in order. Comparing mental illness in children to food allergies, he dismisses the "usual" explanations given for the increase prescribing of medication.  In his view these explanations are; blaming psychiatrists who are too busy to provide therapy, parents who are too busy ...

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Top stories in health and medicine, June 26, 2014From MedPage Today:

  1. Drug Discounts Have Pharma Crying Foul. In 1992, the federal government told drug manufacturers they had to give steep discounts to hospitals that treat a large percentage of poor patients.
  2. Quitting Snus After MI May Lower Death Risk. Stopping the use of smokeless tobacco after a myocardial infarction (MI) ...

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In an article entitled, ”Why the ER admits too many patients,” Dr. Michael Kirsch tries to explain that emergency department admissions are inflated due to emergency physicians acting in their own self-interest.  Many emergency physicians have read this and taken offense, feeling that his assertions point unfair blame on them for a significant portion of excesses in medical care and costs.  I share this visceral reaction in part, but ...

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British comedy duo David Mitchell and Robert Webb imagines what a homeopathic ER would look like.  I love the "homeopathic lager" at the 2:20 mark of the sketch. Classic.

From the moment some patients arrive in your office, nothing seems to suit them:

  • Your parking lot charges too much.
  • Your front desk staff has too many forms for them to complete.
  • Your waiting room magazines are too old.
  • The temperature in your exam room is too cold.
So why are some patients so grumpy? I believe many patients come to us with a wall of fear around themselves. They are worried about the outcome of their ...

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My second miscarriage started in a Starbucks bathroom, and I couldn’t have felt more alone. Where to go from there? I drove home, took as much ibuprofen as I could stomach, and resolved to quit my stressful teaching job. I found a new position at a nonprofit, training writers to teach in public schools. My husband, who’d always been an entrepreneur, continued to lead a startup that encouraged girls to dream ...

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It's one thing to ask a doctor to stay current on his knowledge, it's quite another to insist he survey his patients for a private enterprise, especially if that survey represents unvetted independent research. Recently, a colleague of mine was attempting to maintain his board certification credential with the American Board of Internal Medicine (ABIM) and signed up for the ABIM's requirement for a practice improvement module worth a required 20 ...

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Every time I see a GlideScope, I can’t help but lament, “why didn’t I think of that?”  To me, the GlideScope exemplifies how physicians can apply their practical knowledge of medicine to create technology that improves patient outcomes. I had a front-row seat to physician-designed technology prior to my residency, when I worked at an early-stage venture capital fund advising on health care investments.  We invested in a number of physician-founded ...

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This story has become all too familiar. The patient enters the ER with crushing chest pain and their EKG shows an acute MI, (known today in the colloquial as STEMI, for ST-elevation myocardial infarction). The interventional cardiologist is summoned quickly and in less than 90 minutes from the patient's arrival across the ER door threshold, he or she is on a cardiac cath lab table, where a coronary stent is ...

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Top stories in health and medicine, June 25, 2014From MedPage Today:

  1. Obesity, T2D May Alter Gut Bacteria. The portfolio of gut bacteria in patients with obesity and type 2 diabetes may look different from that of healthy people.
  2. Ohio Amish Rethink Vaccines in Measles Outbreak. The Amish countryside in central Ohio looks like it has for a hundred years. There ...

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The New York Times recently published two articles in a series about inflammatory bowel disease, or IBD, in hopes to destigmatize the disease, and to broadcast medical and surgical advancements that have worked to change how we conceptualize IBD. I applauded the Times for highlighting what can be a debilitating disease for the 1.4 million Americans who are afflicted with it, and thought: Finally! IBD is getting the attention it deserves. Albeit ...

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Taking a page from firefighting to fix health care In firefighting, pump physics is one of the most critical things an engine company officer must understand.  How do we "get the wet stuff on the red stuff" in sufficient quantity without sacrificing penetrating power? The inverse ratio between volume and pressure (as the water pressure increases, volume decreases) has befuddled many a rookie lieutenant. The same, I think, is now true ...

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A few months ago, I walked into work on a late-night shift. One of the nurse practitioners came up to me and said, "There's someone you need to see right away." The patient was a woman of about 60, and it was clear that she was critically ill. According to her husband, she'd been diagnosed with cancer six months ago. It had metastasized throughout her body. Her oncology team made several ...

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In the forty years since I started medical school, I have worked in socialized medicine, student health, a cash-only practice and a traditional fee for service small group practice. The bulk of my experience has been in a government-sponsored rural health clinic, working for an underserved, underinsured rural population. Today, I will make a couple of concrete suggestions, borrowing from all the places I have worked and from the latest trends ...

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