It was a Wednesday in late spring, 1972. I was a nursing student in my final months of training, eagerly awaiting graduation. When I arrived on the maternity ward that morning, my nursing instructor told me that I'd be caring for a baby, only hours old, with special needs. I thought she'd send me to the neonatal ICU. Instead, to my surprise, she motioned toward the linen closet, its doors closed tight. "The ...

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shutterstock_100776622 Everyone likes to be recognized for a special achievement or accomplishment. Every career has special awards and commendations for everything. While there’s no reward that matches cold hard cash, many of these honorable mentions have no tangible value whatsoever. Pull into a fast food parking lot and you may see a parking space designated with a sign proclaiming, employee of the ...

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We spend a lot of time in medicine in education. Pursuing medicine as a career requires embracing learning for a lifetime, because there is always something new, always something different, new approaches, new medications, new discoveries -- we want what's best for our patients, and you can't deliver on that promise unless you know what's out there. As a consequence, we spend time trying to organize information, categorize it, study it, ...

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Compared to most others in society, physicians endorse, and are held to, higher ethical standards. (To illustrate, here are ethical codes from the AMA and the World Medical Association.) High standards apply to professionals in other fields as well, especially fiduciaries such as attorneys, accountants, school teachers, and judges. But standards of medical ethics may be among the most stringent. We put patient welfare first, and anything that interferes ...

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If I could invite four people for dinner, alive or dead, they would be Mark Twain, William Shackleton, Christopher Hitchens and Homer Simpson (Bart’s dad). If Mehmet Oz turned up with a bag of Garcinia cambogia, I would excuse myself. Few things drive me to the abyss more reliably than the banality of status updates on Facebook and the monotony of health freaks. I would rather face the aftermath of vindaloo ...

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In October, 2013, at the launch of the Affordable Care Act, I predicted that the health insurance exchanges about to go into effect would grow in popularity and improve the health insurance marketplace, then so imperfect. Twenty months later, the exchanges are proving effective in reducing the number of uninsured and are beginning to provide the information people need to make an informed selection about which plan is best ...

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One of the words we don’t use anymore is cretin; it’s long been a derogatory slur rather than a precise description of something. But a century ago cretinism actually meant a specific thing: a person, generally a child, who was severely damaged by a lack of thyroid hormone during early development, particularly fetal development. Now we call the condition congenital hypothyroidism. A few cases still exist, which is why we ...

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We both agreed that it was unfortunate. I sat on Paul's living room couch with a computer perched on my lap as he recounted the events of the last few weeks. His business flight was interrupted by severe spasms of cough and high fever. He called me upon landing, and based on my advice, went to a local urgent care center. After waiting for a few minutes, he was seen by ...

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I suffered from extreme nausea during my pregnancy; I had triplets, and I’m pretty sure I had a triple dose. I never threw up, but you know how your mouth salivates the moment right before you vomit, that sensation that sends you running to the bathroom? I had that. All. Day. Long. For four weeks. By day four or five I was beside myself. I was drooling on my knees into ...

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Now that we no longer have to worry about the SGR, we have a new worry. The law consolidates several measurement tools into one big tool. CMS has declared that it wants to pay for value. The law provides a blueprint for paying for value. The underlying assumption of this approach is that we can define and measure value through measuring quality components. Can we define health care value through measurement? ...

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The harder the conflict, the more glorious the triumph. What we obtain too cheap, we esteem too lightly; it is dearness only that gives everything its value. I love the man that can smile in trouble, that can gather strength from distress and grow. ― Thomas Paine Dear my oncologist, This year was my 11th anniversary as a breast cancer survivor. For the past 6 or 7 years, I have visited your office every ...

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asco-logo The patient was a young looking 74-year-old woman, accompanied by her husband. She was not exactly sure why she was seeing me and nodded as I explained that I see all women with anal or rectal cancer who are being treated with radiation therapy. I explained that we recommend that these patients use vaginal dilators to improve elasticity after ...

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Dan Roman gives a powerful account on what it's like to live with depression, performing at the 2015 College Unions Poetry Slam Invitational.  Sometimes, words can't explain it.  In this case, poetry can.

The progression of science in medicine has been as remarkable as it is relentless. From alchemy, chants, purges, and leeches, medicine has progressed to a deep understanding of human form and function through biology, anatomy, and physiology. Microbiology and pathology revealed details and causes of diseases while chemistry and pharmacology opened the doors for advanced diagnostic testing and a variety of therapies. Physics added more diagnostic capabilities and additional options for ...

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In my work as a bioethicist, I have very rarely taken an “absolutist” position regarding the use of a biomedical technology. But when I read an article titled “Chinese Scientists Edit Genes of Human Embryos, Raising Concerns,” my reaction was that this should not be done. I am not alone. The technique mentioned enables genes to be altered in every cell ...

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A continuing series on physician online reputation.   For more KevinMD minutes, please visit my YouTube channel. How do you deal with trolls on the web? Whenever you're online you're going to have people who disagree with you, and they can do so in ugly and inflammatory ways. These people are known as trolls. I'm going to borrow from marketing legend Guy Kawasaki. He suggests going ...

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medpagetodayFrom MedPage Today:

  1. Breast Ca Patients Need Better Cardiac Monitoring. Breast cancer patients received suboptimal cardiac monitoring during treatment with trastuzumab (Herceptin).
  2. FDA: Smokeless Tobacco Warning Stays. The FDA denied a petition by two tobacco companies to ease up on the warnings around smokeless tobacco.
  3. King v. Burwell: What Color ...

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A company has produced prototype robots that can draw blood from human arms. The video above is a 48-second video showing one of them in action. Using an infrared camera, the robot identifies a suitable vein and accesses the vein with ultrasound guidance. A second video, not embedded in this post, explains that the robot is about 83 percent successful at drawing blood that compares favorably to the success ...

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Recently, the new surgeon general of the United States, Vivek Murthy, was officially sworn in by Vice President Joe Biden. Congratulations to him, it’s quite an achievement at the relatively young age of 37. Nobody can doubt the hard work, intelligence and passion that must have gone into reaching such a height. His nomination was first put forward at the end of 2013, and he faced something of an uphill political ...

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Although the time of year when everyone has their list of tax questions has just passed, tax questions are appropriate all year. It’s best to be prepared at tax preparation time, so much less stress is created. Tax time can be especially stressful for younger taxpayers who are going through life changes, or earning substantially higher income for the first time. Young physician families are an excellent example of this type ...

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