Right now, there are two patients in every room. One is made with flesh, bones, and blood. One is made with a monitor, a mouse, and a keyboard. Both demand my time. Both demand my concentration. A little over two weeks ago I wrote the short story "Please Choose One." I posted it online. The response it generated exceeded anything I could have ever imagined. It struck a nerve. People contacted ...

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In mid-January, a patient called me from her pharmacy, frantic. Her asthma inhalers came to $168 -- a sum that she hadn’t been prepared for. But she can’t live without those inhalers, so she withdrew cash from her meager savings account and skipped her blood pressure pills for that month. This is such a familiar story by now that it hardly makes news. Yet it is tragic, every single time, when ...

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I explain why an online reputation is so important for doctors in under 1 minute. This is the first of a series of short physician online reputation videos produced by The Doctors Company as part of their social media resources for physicians.  Enjoy.

I am a clinician and a clinical trialist. Medical research in some form or another (performing it, consuming it, reviewing it, editing it, etc.) occupies much of my time. Therefore, you can imagine my excitement while watching Apple’s product announcement when they introduced a new open source software platform called ResearchKit. Apple states ResearchKit could “revolutionize medical studies, potentially transforming medicine forever.” ResearchKit allows clinical researchers to have data about various diseases ...

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medpagetodayFrom MedPage Today:

  1. Folate Supplements Cut Strokes in Hypertension. Folic acid supplements significantly decreased risk of first stroke in those with hypertension.
  2. Patients Will Record Encounters, and Docs Must Adjust. Physicians must accept the possibility that every conversation with a patient may be secretly recorded by the patient.
  3. Legalities of ...

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(with a hat tip to “Who’s On First?”) acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. (Scene is the back office of a small primary care clinic. Lou is sitting at his workstation, looking at a computer screen. Bud walks by and Lou stops him …) LOU: Hey, Abbott! I just saw a lady ...

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So you want to match into surgery?  This video shows you what it takes.  From the University of Chicago Pritzker School of Medicine, who also created the ever-popular Frozen parody.

Thanks to the measles outbreak, the news is full of stories on vaccines and anti-vaxxers. The blogosphere and Twitterverse and all the other social media dimensions are buzzing with invective against ignorant unvaccinated savages and their backward science denial. For the record, I’m a pro-vaccine physician. My children have been and are vaccinated, despite being unsocialized homeschoolers. I’ve had my own share of needles; Physicians are mandated to have hepatitis B, ...

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They say that the path to hell is paved with good intentions. Few things in medicine illustrate that as well as how we've approached chronic pain management in the past 10 to 20 years. The advances that we have made in medicine in the past few decades have been truly remarkable. But, unfortunately, pain is one of the ailments we still do not treat well. One of the difficult aspects of ...

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It happens every once in a while in my practice: Parents ask if we can delay or skip certain vaccines, or spread them out. According to a study just published in the journal Pediatrics, I'm not alone -- in fact, 93 percent of pediatricians get asked the same thing. Now, it's important to point out that most families don't ask for this. Most families are fine with the current vaccine schedule -- ...

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The world of health care will likely look very different in a decade, owing to a variety of diverse factors including; medical breakthroughs, political reform and not least of all the tremendous advances in technology that are occurring at breathtaking pace. The traditional model of the doctor-patient interaction will also continue to change dramatically (as it already has over the last several years). The days of an unchecked paternalistic relationship ...

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Termites are endemic in southern California, and we’ve had spot treatments several times over the years at various sites in our house where little piles of sawdust have appeared as evidence of termite activity. Finally, it became clear that the termites were winning, and more aggressive treatment was in order: tenting. This is the process of hoisting a big, brightly-colored tent over the whole house and putting an end to ...

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medpagetodayFrom MedPage Today:

  1. Turbulent Future for Oncology. The nation's cancer care system risks slipping into a socioeconomic vortex that threatens the ability to meet a growing demand for care, according to a report from a leading organization of cancer professionals.
  2. Newer Stents Fall Flat in Multivessel Disease. Surgery still beats stents in ...

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The “age of the giants” has passed. The idea of larger-than-life doctors devoting themselves completely to patient care and sacrificing their personal lives in the process is giving way to an era of recognizing the limits to a physician’s work life. This change in attitude has been advanced, in part, by resident work-hour restrictions. These Read more...

You’ve likely seen the Jimmy Kimmel “public service announcement” on vaccines. Over 3 1/2 million people have viewed it on Youtube so if you’re not yet one of them you’ll likely add to the tally now. The first 3 minutes of the monologue are spot-on, and they’re also very funny. Jimmy takes a stand against the “anti-vaxxers.” He mentions that some parents are more scared of “gluten than small pox” ...

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“What would Spock think about the ‘husky’ designation?” That’s what I was pondering. I was wondering how the master of logic would justify and make sense of the clearly derogatory way I was feeling about myself. “Fascinating,” I imagined him saying, and he would raise that patented eyebrow. Then I looked in the mirror, furrowed my brow, took note of the barely present peach fuzz growing under my nose, and with all ...

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Many readers know that I favor empiric antibiotic treatment for adolescent/young adult pharyngitis when the clinical signs and symptoms strongly suggest a bacterial infection. I favor narrow target antibiotics and only in the patients with Centor scores of 3 or 4 (and perhaps some 2s when the patient looks very ill). This would exclude over 50 percent of patients from antibiotics. Most organisms already have developed resistance to penicillin, amoxicillin, and ...

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Physician burnout -- and burnout in general -- is at an all-time high. From this Wall Street Journal article by Dr. Sandeep Jauhar to a recent TEDx talk by Dr. Romila Mushtaq, the angst is palpable. Sadly, as noted in this piece in the New York Times, the suicide rates of physicians and doctors-in-training increase every year. The insurance companies’ complications, government involvement, and economic downturn have all added fuel to this fire of discontent. ...

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To the staff overseeing my medically-complex child, My child has been in this world much longer than you expected; thus I’ve been in this relationship with you much longer than I expected. If I could break up with you and find someone new, believe me I would (I’m sure so would you some days). But that isn’t possible; we’re in a dysfunctional relationship. If we recognize this together and just come to an ...

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medpagetodayFrom MedPage Today:

  1. Helmet Bests Mask for Infant CPAP. Infants with bronchiolitis who were treated with a continuous positive airway pressure (CPAP) helmet did not need to be intubated as often compared with those who used a CPAP facial mask.
  2. Negotiations Heat Up on Permanent SGR Fix. As a deadline looms, Congressional ...

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