Zubin Damania, also known as ZDoggMD, has a message to parents who are skeptical about vaccines.  Even if you don't agree, it's a video you should watch.

One year ago (read: before intern year), pretty much the most exciting part of my fourth-year emergency medicine rotation was having my pager go off. BZZZZ! I leapt into action, excitingly reading the text page: “Leg lac in E9.” I was on it. Suture kit in hand, I burst through E9’s thin emergency department curtains with abandon; I was going to fix this. The “leg lac” turned out to be a ...

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No, customer service in the U.S. is terrible when it comes to health care.  No, the customer service in the U.S. health care system is horrendous.  No, health care has the worst customer service of any industry in the U.S. There.  That seems about right. What makes me utter such a bold statement?  Experience.  I regularly hear the following from people when they come to my practice:

When I first seriously began discussing the possibility of applying to medical school with my family and close friends, I received mixed reactions. Although medicine seemed like a great fit for me in many ways, I also heard sad stories about relationships and even entire families that had struggled to survive the strenuous period of medical training (particularly residency). As somebody who values family and close relationships highly, I was ...

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Advice to doctors: Beware of what you say during a procedure! Before, we had a patient secretly record an anesthesiologist during a colonoscopy. Now, a patient hid a microphone in her hair, and secretly recorded the medical staff during hernia surgery. It's now national news.

Back in my first year of blogging, I wrote a post, titled "A Day Without a Diagnosis," about the way we now spend most of our time “managing” chronic diseases, some of which weren’t even considered diseases when I went to medical school. That’s not how all my days go nowadays: A week ago I had a day of some very real doctoring. My first patient of the day was ...

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An excerpt from What It's Like to Become a Doctor: The Year-by-Year Journey From Medical Student to Practicing Physician, Greenbranch Publishing, 2016. I passed the board exam in November 2011 to become a gastroenterologist. This is the last exam I have to take until I recertify in internal ...

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"I hereby authorize xxx, my patient, to donate plasma up to two times per week." I moved to Cleveland over the summer to start work as a full-time primary care internist. Within a few weeks, I started receiving a form in my mailbox that I had never seen during my training in San Francisco: an authorization request for my patients to donate their plasma. By the time the fourth form came, I realized ...

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Dear doctor, I need you to be healthy. When I come to you for help, I need your "A" game. I need you sleep enough. Eat healthy food. Not too much. Mostly vegetables. I need you to exercise regularly and take time to take care of your own physical, emotional and spiritual needs. I need to you use the bathroom when you need to. I need you to stop and take ...

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There has been a significant amount of outrage over the past few months of the maintenance of certification process. The anger has not only been targeted towards the ABIM, but also towards the other specialty boards. Pediatrics, for example, now requires ABP approved quality improvement (QI) projects that have been widely criticized. While these MOC requirements are a major nuisance for most, the implications may actually run much deeper. A number ...

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The media is full of stories about the current opioid crisis. But unlike many national crises, such as the Flint lead-contaminated water crisis, the focus is on solutions and not blame. A few weeks ago, the Centers for Disease Control and Prevention issued guidelines for prescribing opioids in chronic pain, Congress approved funding for prevention and treatment, and the US HHS released a "National Pain Strategy." So ...

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My heart tells me I lost them.  My brain tells me I never had them to lose. One of my mentors has said that all trauma surgeons have their own personal graveyard, filled with patients we couldn’t save, and families’ hearts left broken.  A truer statement has never been said, and this weekend, this trauma surgeon’s graveyard has increased yet again. The feelings that accompany this increase are always varying and deep. There ...

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asco-logo She had been admitted overnight: a previously healthy 62-year-old woman who had been blindsided by acute onset of abdominal bloating and pain 6 months prior. A flurry of tests showed she had pancreatic cancer, and that it was advanced. She had started chemotherapy, but the regimen was so toxic; she suffered from unrelenting nausea and fatigue to ...

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I was at a locums assignment yesterday using FEEMRS. (You know, "Fancy Expensive Electronic Medical Records System.") It was all kinds of busy, with wait times of many hours. And as I slogged along, relearning FEEMRS after a few weeks away, I realized that it takes about one hour of looking at that screen for me to become exhausted. It’s just too busy. Every bit of the screen seems filled with ...

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It’s Tuesday around 9 a.m., and I, a pediatric ear, nose, and throat surgeon on my third or fourth patient at a satellite clinic an hour away from home when the abdominal pain started. It feels as if someone is repeatedly stabbing a knife, and twisting it around, right below my breastbone. I barely got through that encounter, then moved to the next patient. It will stop, it has to. There were 14 ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. With the recent expansion of ambulatory surgical centers, the number of outpatient surgical procedures has increased at an exponential rate. Coupled with the rise in volume has been the increasing complexity of procedures and underlying diseases of patients. The convergence of these factors ...

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An excerpt from Seductive Delusions: How Everyday People Catch STIs. Dear Ashley, Your blood count and mono test did not show any signs of mononucleosis infection. Unfortunately, however, your throat swab was positive for gonorrhea. Please schedule an appointment today in urgent care so you can be treated with the appropriate shot ...

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There’s been a lot of talk for quite some time in health care quality improvement circles about why health care can’t be as safe as airline travel. Some of the reasons behind asking this question are very valid, as there are many things health care can learn from the aviation industry. Others, however, are complete fallacy; because on so many levels, it’s like comparing apples to oranges. Over recent weeks, I’ve ...

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This year marks 33 years of administrative positions in academic medicine.  When I first started, I suspect I made many major mistakes.  I learned through the time-tested school of hard knocks.  As I reflect on my own career, and those whom I have observed, I have come to believe the famous saying, "Culture eats strategy for breakfast." Look at ward attending physicians.  The same attendings have “good teams” every ...

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Policy makers who are responsible for shaping how the federal government (the country’s biggest payer of health care services) pays physicians are pushing CMS on a rapid path away from traditional fee-for-service (FFS). As I discussed last year, CMS intends to have 50 percent of its payments flow through “alternative payment models” such as ACOs and bundled payments by 2018, with nearly all of the rest of the ...

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