“They need you in room 13,″ she said when I answered the phone and I ran back to the ICU.  The patient was coding and for each minute that felt like an hour, we tried, and failed, to save her.  She wasn’t breathing, her heart wasn’t working, and despite the 30 people gathered in the room, in the end, she died. Running a code, as we call it, means that someone is ...

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Josh Green’s novel -- and recent film -- The Fault In Our Stars (TFIOS) is a new classic of young adult fiction, deservedly famous, and it’s easy to see why. The story is simultaneously deeply sad and really funny, mostly due to the narrator, Hazel. She is an intensely likable 16-year-old, who charms you even while she explains, stoically, that she is dying of thyroid cancer that has spread to ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated for episodic migraine without aura that first presented in high school and has persisted into the third trimester of her current pregnancy. The headache attacks occur two to four times monthly and last 12 to 24 hours. She experiences moderately severe pain, significant nausea, no vomiting, and ...

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Patients are being stuck with huge and unexpected medical care bills in circumstances where they have no say in selecting the physician who is billing them, and no way for them to know in advance which services the physicians would render or what it would cost them, says the New York Times. Mr. Peter Drier received a “surprise $117,000 medical bill from a doctor he didn’t know” for services relating to ...

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The mind body association with back painThe mind body association with back pain An excerpt from The End of Back Pain: Access Your Hidden Core to Heal Your Body. The evolution of our species has been powered and guided by a survival advantage. Our unique adaptation for survival lies in the development of a brain that can plan, worry, and abstract. Perhaps the most ...

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You can find reviews on almost anything; we “Yelp” restaurants before we try them, we scrutinize customer feedback when we purchase products on Amazon and we check out how many stars a dry cleaner or car mechanic has. Medicine is, for better or for worse, becoming the same way. You can Google a hospital or physician and find comments or reviews, and this worries many doctors. Most physicians don’t like the ...

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The unknown unknowns of Ebola: A message to physicians I did not think I would ever quote Donald Rumsfeld in one of my blog posts, but some of the missed opportunities as well as the media and public panic surrounding the Ebola epidemic in West Africa have brought this quote to the forefront of my mind this past week. First, let me share my personal view of the Ebola crisis in ...

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How many health coordinators does it take to screw in a lightbulb? Four. But none actually do any screwing. One is your point of contact for screwing lightbulbs. One helps the bulb get screwed. One goes between those two. And one manages the other three, raises funds and writes reports. My office strives to cut all barriers between the patient and provider. The patient calls me to schedule and comes in, or ...

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How did a Dallas hospital miss Ebola? Maybe we shouldnt be surprised. The first “wild” Ebola case in the United States has occurred in Dallas, Texas. The patient, who is from Liberia and had contact with a pregnant Ebola victim in his native country, was initially sent away from the emergency department (ED) of a Dallas hospital after reporting there with viral symptoms. He told the triage nurse that he had just arrived ...

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I'm honored to keynote CHEST 2014 on Monday, October 27, 2014. Here is my speaking trailer for the event, and I'm looking forward to meeting everyone there.

This weekend the kids and I had our influenza immunizations. There is always a difficult lead up as Oliver has severe anxiety around every medical procedure. An EKG (painless heart rhythm test) and a throat swab cause extreme fear and often tears and anything with a needle, well, let’s just say that’s on a whole different level of terror and emotional pain. I remind myself that his anxiety is a normal response ...

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Around the country, for every health system that is successfully navigating the early years of value-based health care, there are several others that are failing -- even though many don’t yet realize it.   These failing organizationscan’t or won’t restructure themselves to deliver effective, efficient and affordable care. I’ve come to the conclusion, after observing struggling systems, that two basic characteristics are necessary for systems to transform themselves in response to external pressures: execution and motivation. Successful systems have ...

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As practicing pediatric gastroenterologists, my colleagues and I remove a fair number of esophageal and intestinal foreign bodies (i.e., things kids accidentally swallow). A couple of years ago, several physicians across the country began noticing serious injuries in children who swallowed high-powered magnets. The issue was raised in an email forum for pediatric gastroenterologists and the response was overwhelming. There were hundreds of cases -- throughout the world, as we later ...

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Top stories in health and medicine, October 17, 2014From MedPage Today:

  1. Confusion Clouds U.S. Ebola Response. As officials from Washington to Atlanta to Dallas sift through the rapidly changing flow of information regarding treatment of Ebola in the U.S., the first Dallas nurse infected with Ebola will be transferred to a high-level treatment center in Bethesda, Md.
  2. Ebola: Emory to ...

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The e-patient movement represents everything that is positive in medicine today.  This grass roots force has introduced shared decision making and empowered both physician and patient.  The quality of health care dialogue has risen meteorically both in the exam room and out.  Today's health care "consumer" is more engaged, more intelligent, and more agile at wending their way through the confusing maze of sickness and health. It's awfully sad that it ...

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As Ebola spreads, what can we do to help? Last week, after dinner, as I was rinsing the dishes, I casually mentioned to my wife, "I spoke with the volunteers at Doctors Without Borders today, and they need help." This was before the first case of Ebola was diagnosed on U.S. soil. A pregnant silence fell in the kitchen except for the clattering of dishes and the boiling of water as ...

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It’s funny to think that the internet and the online world, so entrenched in our modern day lives, is still a relatively new phenomenon. When I first started medical school (not really that long ago) we hardly used the internet and the concept of a web search barely existed. It only became widely available on home computers shortly after that. The invention of social media is newer still. If any of ...

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Recently, I have been reflecting more about my musical journey as an organist over the past 15 years. It has been great to learn how to continue my medical training to the best of my ability while still trying to keep my musical interests alive. Despite the busyness of medical training, I have thankfully had opportunities to perform publicly, as well as meet other musicians. I began ...

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To be or not to be: An artist in medicine “Why would an artist want to go to medical school?” It was a good question, and one of my favorite questions asked of me during my medical school interviews. I am what one might define as an artist, and yes, I really wanted to go to medical school. I was a photographer, musician, composer, and actor. I loved the arts and they ...

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The EHR report card 2014: Has it gotten better?A guest column by the American College of Physicians, exclusive to KevinMD.com. A little over two years ago in this blog, my “EHR report card” evaluated the effect of the electronic health record (EHR) on my practice. I thought it would be interesting to see how things have changed.  As in 2012, I will not identify my ...

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