Dear Dr. Wible, I lost my beautiful son Evan to suicide four weeks ago. He was a second year internal medicine resident -- a very smart, loving and funny man! He left a lengthy letter and in it he stated, “I do not want any attention drawn to this.” I have been crying all day reading your book and blog and I’ve seen ...

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Dr. Leon Pedell discusses how to transition from memorizing physical exam techniques to applying them with real patients to find real abnormalities. Many students have a misconception that they can forget much of what they learned in first and second year as, "low yield." This is not the case. More than anyone else on a care team, medical students have time to perform thorough physical exams and you ...

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A recent Medical Economics article asked “Is the DPC model at risk of failing?” The piece focuses on two large DPC-like organizations, Qliance Medical Management of Seattle, Washington and Turntable Health of Las Vegas, NV, working in partnership with Iora Health, which recently closed their doors. Qliance and Turntable were not actually DPC practices by strict definition; they were innovative large business operations providing health care services ...

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Here's a question that has been debated for several years: Should radiologists talk to patients about their imaging results? Citing several issues, I came down solidly on the "no" side in a 2014 blog post. Two major radiology organizations have committees looking into the concept, and New York Times article said, "they hope to make their case [for it] by demonstrating how some radiologists ...

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President Trump campaigned on repealing and replacing Obamacare. Congress, when campaigning for reelection every two years, promised the same. Yet Congress can’t seem to get the job done. First, they needed the House, then the Senate, finally the White House. All delivered to GOP control by the voters. With the reasonable expectation of repeal and replace. Yet nothing from Congress but a dial tone. The House passed an Obamacare-lite bill, tweaking ...

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Kalisha A. Hill, MD, FCAP is a mother, a runner and a pathologist. She believes that a healthy lifestyle can prevent many of the diseases she diagnoses every day. You’ll meet her, learn about her expertise and see why her clinical partners rely on her diagnoses to guide their treatment decisions. Healing begins with her and that’s what patients count on for their care. Created by the
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High-stakes standardized testing is an enduring facet of medical education, and the standardized test that is on every medical student’s mind is the USMLE Step 1. The paramount importance of this test for getting into residency creates a demand for high-quality test preparation materials. Established test prep names like Pathoma, Sketchy Medical, First Aid and UWorld fill that demand in a market consisting of more than 40,000 test takers worldwide ...

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I want to sincerely thank you from the depths of my heart. I don’t show it, and I certainly don’t say it, but you have always been my role model. You positively shape who I am as a man, and your staunch encouragement is invaluable to me. In a world of words, texts and tweets, you have let your actions speak. You have remained apolitical and areligious, choosing to focus your ...

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“We’ve had a number of calls about ‘inaccuracies’ in your letter to the editor,” a member of my hospital’s media relations team told me. “Because of that, we’ll have to review it.” I had written a letter to the editor of our city’s major newspaper regarding immunizations and the National Vaccine Injury Compensation Program’s vaccine court. I was responding to another letter alleging that the court’s mere existence meant vaccine ...

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Many people have skills they develop for work that they end up using outside of their job. Some of these skills may be mundane, some may be difficult to master and some may be only tangentially related to their job. Mechanics are probably asked by family and friends to help all the time with cars making strange noises. Lawyers are asked by to help fix speeding tickets. Accountants are asked if ...

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I take my 10-year-old son to school as many school days as possible. We recap events from the prior day, and I give him early morning pep talks. It is a rarity, however, that I pick him up from school. During one of those rare occasions, he got into the car, smiling as he handed me a project he completed in class. It was an assignment in which he was ...

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Whether you believe in science, God, neither or some combination of the two -- we can all agree that death is inevitable. Due to the finality of our lives, each of us should understand and prepare for that moment not only for ourselves but also for our loved ones. As medicine continues to advance and people live longer, we have a generation of baby boomers who are now entering their ...

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On the surface, the news from America about health care seems rather grim: cost and dissatisfaction keep rising, reforms are stalling, and, for some, even life expectancy may be declining.  If that wasn’t bad enough, President Trump issued a tweet on March 25 predicting that “Obamacare will explode.” For a small but growing number of doctors and patients, however, the future is surprisingly hopeful. The nascent direct care movement is made up ...

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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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