In college, I once marched for the plight of Tibetans. Forty of us marched in Hyde Park, London; after an hour, half retreated to the nearest pub to discuss global injustices. Recently, over a million, including five penguins, marched for science. There were no penguins at our march for Tibetans but our goal, though naïve and unrealistic, was clear -- we wanted Tibetan independence from Chinese rule. The goals of ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old woman presents to the office to discuss management of her type 2 diabetes mellitus. She is unhappy with her recent HbA1c value. She adheres to the maximum dose metformin monotherapy, which she has been taking for 1 year. Additionally, she has been working toward weight ...

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With the Department of Justice announcement of the $155 million dollar eClinicalWorks settlement (including personal liability for the CEO, CMO and COO), many stakeholders are wondering what’s next for EHRs. Clearly, the industry is in a state of transition. eCW will be distracted by its 5-year corporate integrity agreement.    AthenaHealth will have to focus on the activist investors at Elliott ...

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I receive a significant amount of email in response to my blog posts about locum tenens work. Curious colleagues (from surgeons to internists and emergency medicine physicians) ask for insider insight into this “mysterious business” of being a part-time or traveling physician. I am always happy to respond individually, but suddenly realized that I should probably post these conversations on my blog so that all can ...

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On a recent vacation in St. Lucia, I came across this mama nursing her babies. “Public breastfeeding. How great!” I thought. But, after posting this picture on Facebook, these were some of the responses: “Yikes! They need to be weaned!” and “they are pretty big to be still nursing.” This, of course, got my head whirling about people’s attitudes toward breastfeeding. On the surface, ...

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I recently attended a conference in Savannah, Georgia sponsored by the Association for Prevention Teaching and Research. Since I haven't spent much time in Georgia outside of Savannah and Atlanta, the welcoming plenary on improving health outcomes for the state's rural and underserved populations was eye-opening. According to Dr. Keisha Callins, Chair of the Department of Community Medicine at Mercer University, Georgia ranked 39th out of 50 states in primary care physician ...

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Why can’t doctors be depressed? They encounter challenging and emotional situations every day, and they are robbed of the emotional intelligence training necessary to handle them properly. The 32-year-old single mother of two who was recently diagnosed with metastatic breast cancer and given a prognosis of four months to live. The 13-year-old daughter who suffered her first seizure while swimming alone in her home pool and now lies paralyzed in the ...

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Without question, the interconnectivity created by social media is a plus when it comes to talking about physician burnout, suicide and policies affecting our practice of medicine. We are no longer in independent silos with the surgeons suffering in one corner and pediatricians elsewhere. Physicians are no longer isolated contemplating if what they are experiencing is just unique to them. We are developing collective voices. It is incredible to believe ...

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Dear John Oliver, First of all, thank you for your recent segment on dialysis. Kidney disease deserves much more attention and discussion than it currently receives. Thank you also for your full-throated support of transplantation and the need for more kidney donors. As a practicing nephrologist, there is nothing better than hearing that one of my patients has been given a transplant. Finally, thank you for pointing out that end-stage renal ...

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For the most part, the sexism in medicine is not subliminal at all — it’s quite overt. Unless you’re a female physician, you probably are unaware that it’s still an ever-present reality for us. I want to note that there are very good men out there who are trying their best to be advocates for equality in our field even though they cannot fully appreciate the female physician plight. My ...

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3 a.m. The alarm blares. Get up, make food, study. Maximize caffeine intake, maximize studying efficiency. 4:12 am. Take the last sip of water, pray. Maximize studying with residual caffeine power. 7 a.m. Get dressed, go to work. Stay awake, stay alert, see patients, present well, regurgitate answers, retain information. Produce saliva, clear dry throat. Study during lunch break. Stay awake, stay alert, see patients, present well, regurgitate answers, retain information. 6 p.m. ...

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Medicaid is the largest single health insurance program in the nation, spending more than $500 billion to serve the most vulnerable people with some of the highest need, including children, pregnant mothers, people with disabilities, the poor and the elderly living in nursing homes. Recent proposals to repeal and replace Obamacare – such as the American Health Care Act (AHCA) – would fundamentally change the Medicaid program. ...

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Delivered at the Harvard Medical School Class Day Ceremony, May 25, 2017. Distinguished faculty, dedicated staff, and most importantly, loving parents and family members: Thank you for all you’ve done to support us and transform us into doctors. Harvard Medical School Class of 2017, congratulations. It is an enormous honor to address you all today. When I was a third-year medical student, I scrubbed in on the surgery of a woman ...

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An excerpt from Distracted: How Regulations Are Destroying the Practice of Medicine and Preventing True Health-Care Reform. If you want to learn what is wrong with the American health care system, just follow ...

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He entered the hospital on Monday morning with a list of patients running through his mind. From the time he received a sign out of 22 patients from his colleague on Sunday evening, he was planning his workday. It was a ritual of his to pray and sleep early on Sunday night to prepare him for what lie ahead. What lied ahead was a busy week of inpatient medicine — ...

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I am not an employee. Maybe I should have said this four years ago when I was an employee. When I opened my private practice in 2014, I was running away from something as much as I was running to something new. I’ve been out of training for over a decade. Early in my career, I envisioned myself as an employee of either a non-profit organization working with underserved communities ...

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Dear future medical student: It’s graduation week. I’m running into people I haven’t seen in a long time. There are a few things on my mind currently, and in four years, you’ll have the same conversations. “Did you have so much fun in med school? Did you love it?” “No.” “Wow! Those four just FLEW by, didn’t they?” “No. They absolutely did not.” “Well just WAIT ‘til you get to residency. THAT was hard. What you ...

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Doctors have been bemoaning changes in the practice of medicine for years and with good reason. It’s harder and harder to make a go of it in private practice. In recent years our area has lost several small practices — Hal Grotke’s Redwood Family Practice closed, Dr. Garcia retired, Teresa Marshall’s solo office shut its doors, Eureka Internal Medicine transitioned to Humboldt Medical Specialists (which then became St. Joseph Hospital ...

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My husband is a doctor. Similar to any other career, this is what he spends most of his time doing. It’s also our family’s livelihood — how we pay our mortgage, our bills and send our daughter to preschool. He went to through seven years of training after college, often working all night or even 24-plus hour calls. He’s had to miss family dinners, birthday parties, nights of putting our daughter ...

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Over the last few decades, public perception of physicians has been on the decline. Many issues are to blame, but a largely overlooked contributing factor is the media. Physicians are often portrayed negatively, with stories of narcotic abuse, greed and medical mistakes dominating the news. Rather than fight back, physician organizations have stood silently and allowed their reputations to be tarnished. On the other hand, nursing organizations have been busy ...

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