I consider myself a pretty savvy and resourceful consumer. I know how to solve problems that come up in the day to day situations we all face. I have navigated my way through more than a few complicated and sensitive financial situations. Add to that my ability to be persistent, and you would think that I could figure out a simple denial of an insurance claim with ease, right? In ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man is evaluated for a persistent rash for 6 years' duration. The rash waxes and wanes in severity, and it becomes pruritic only after he becomes hot and sweating, such as when he mows the lawn or exercises. It has always been limited to his back and lower chest. He ...

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Andy McAfee is the associate director of the Center for Digital Business at MIT’s Sloan School of Management. He is also coauthor (with his MIT colleague Erik Brynjolfsson) of the 2014 book, The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies, one of my favorite books on technology. While he sits squarely in the camp of “technology optimists,” he is thoughtful, appreciates the downsides of IT, and ...

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The concept of “personalized medicine” gets thrown around a lot these days. And as an oncologist and a palliative care doctor, who advocates for using data to get information that can provide more personalized cancer care, I believe strongly in it. But what would truly personalized oncology look like? More than 14 million people are living with cancer in the United States, according to the National ...

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Dear doctor no longer seeing vaccine-hesitant families, I know that creating your “no tolerance” office-wide vaccine policy was not easy or came without soul-searching. I can only imagine the heated boardroom meetings and passionate arguments throughout the weeks the policy was being drafted. I trust it is because of your support and love for the families you currently care for that you felt the need to create the policy, and it ...

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shutterstock_176790740 I bolted through the conference room door on the first day of residency orientation.  The room full of interns shifted in their seats.  All one dozen of the faces looking up at me were male.  I got some crooked, goofy grins.  So began my introduction to the world of surgery. So, what would I tell my daughter about how to survive and ...

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shutterstock_112215167 Regular readers here are well-versed on the controversy surrounding maintenance of certification (MOC) and the American Board of Internal Medicine (ABIM). The story recently made mainstream news, with a comprehensive recap by Newsweek senior writer Kurt Eichenwald: The Ugly Civil War in American Medicine.  Go read it. The ABIM subsequently released a strongly-worded statement.  They are clearly not happy with the ...

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Myth #1: Vaccines work by preventing disease in individuals who are vaccinated. Nope, that’s not actually true -- it’s quite wrong, but in a subtle way. And a misunderstanding of this concept, I think, has led to a lot of mischief. If people understood how vaccines really work, how they can best protect us from disease, it might help overcome some skepticism. Vaccines do indeed prevent diseases in individuals, but that’s ...

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shutterstock_126097835 When my older children were in elementary school, I sent in cupcakes for their birthdays or for class parties. My youngest is in elementary school now, and for his birthday, I sent in pencils and temporary tattoos for classmates -- because the school doesn't allow us to send in sweets anymore. When the change was first made, my reaction was: For real? Banning ...

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medpagetodayFrom MedPage Today:

  1. Opioid Abuse Drops, Then Levels Off. Making an abuse-deterrent formulation of OxyContin (oxycodone ) diminished abuse in the short term, but the reductions eventually hit a plateau.
  2. After Ebola, Measles Death Toll Could Be High. The death toll from post-Ebola measles outbreaks in three West African countries could rival ...

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In a recent article posted in JAMA, authors presented a viewpoint about the phenomenon of the flipped patient when describing the increasing reliance that millennial trainees place on getting to know the electronic health record (EHR) of patients rather than the patients themselves. As I read through the text, I found myself agreeing with the points made by the contributing writers that EHRs are increasingly used as the first line of ...

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One of the obligations of a medical or surgical specialist is to communicate with the referring primary care provider.  This can take many forms: a phone call, texting via smartphone, email, messages sent via EMR, and dictated letters.  The format is pretty standard no matter what medium is chosen.  You thank the referring doc for the consult request, you give some brief background info about the patient in question, and ...

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"I've been getting winded lately." He's a middle-aged man with diabetes.  This kind of thing is a "red flag" on certain patients.  He's one of those patients. "When does it happen?" I ask. "Just when I do things.  If I rest for a few minutes, I feel better." Now the red flag is waving vigorously.  It sounds like it could be exertional angina.  In a diabetic, the symptoms of ischemia (the heart not getting ...

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shutterstock_233214331 In the busy world of hospital medicine, where doctors and nurses find themselves rushed off their feet for most of the day, time to sit down and actually listen to patients is at a premium. Every doctor knows that our primary focus has to be on the most important aspects of the history and clinical examination in order to get to ...

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I admittedly don’t understand much about the intricacies of economics. But I don’t have to in order to recognize the significance of Walmart’s decision to raise the minimum pay for its lowest paid hourly employees. In the week following the company’s announcement, plenty has been written about the impact that such a move will have on the company’s success and on local economies. It goes beyond that, however. What I see ...

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shutterstock_134837474 I’m an old school general surgeon. I graduated from med school in 1974 and after a five-year surgical residency in San Antonio, Texas, I started out on my own, ready to cure the world. Boy, was I raw. Like many of my peers, I got married during medical school, and like every surgeon back in those days I told my wife, ...

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medpagetodayFrom MedPage Today:

  1. MedPage Today at 10: Where We Have Been. Sometimes things go so right, that you get nervous. Really nervous. That's pretty much what happened when MedPage Today launched 10 years ago.
  2. Sepsis Readmissions May Be Correctable. It might be possible to prevent many of the hospital readmissions that occur ...

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Recently, I had the honor and pleasure of introducing my book, Women and Cardiovascular Disease, in London. During the event, I was able to meet with many of my European colleagues from both the media as well as the health care space. I spoke with countless bright and motivated attendees who are excited to be part of a wave of change in cardiac care for women. We identified many ways ...

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For 25 years, I have taught medical students how to give bad news.  Step one: Be prepared.  Step two: Find a safe, personal, quiet environment.  Step three, and this is most important: Before you speak, ask.  What do the patient and family understand? Fail to follow this vital rule and reap the whirlwind.   So, therefore, you might ask, if I have such wisdom and experience in this critical area ...

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I came to hospital medicine from the land of pulmonary-critical care. I had spent ten years dealing with septic shock, respiratory failure, and acute renal failure. I had intubated, withdrawn life support, placed central lines, performed thoracenteses, and even placed a couple of chest tubes. I had changed tracheostomy tubes; I ran codes. In short I was a critical care bad ass. I thought I was hot stuff. But I ...

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