In the academic world, there is an unspoken rule under which faculty, residents, and fellows collectively live and work. Educational programs are to be separate from industry and its financial stronghold. I understand the rule and its application in certain scenarios and clinical departments. But I would like to challenge it within my specialty of orthopedic surgery. As I finish up residency and look ahead to fellowship, I am constantly thinking about ...

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No pain no gain. Pain is weakness leaving your body. What’s your excuse? Have you seen these? The ubiquitous fitness themed motivational memes foisted upon us by corporations and Internet bloggers alike. You know what these all have in common? Aside from the fact that they typically aren’t associated with the funny cat videos that comprise roughly 94 percent of Internet traffic, they all do one thing: They make you feel more inadequate ...

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medpagetodayFrom MedPage Today:

  1. A Case of C. Diff: Did a N.J. School Overreact? Administrators at a New Jersey middle school said they faced a major health scare that required them to shut down for nearly a week and hire biohazard specialists to disinfect the school. The culprit? A case of Clostridium difficile.

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It’s no secret that medicine has become a highly specialized business. While generalists used to be in charge of most patient care 50 years ago, we have now splintered into extraordinarily granular specialties. Each organ system has its own specialty (e.g., gastroenterology, cardiology), and now parts of systems have their own experts (hepatologists, cardiac electrophysiologists)  Even ophthalmologists have subspecialized into groups based on the part of the eye that they ...

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There’s a lot of talk these days about patient satisfaction. Physicians are being measured in so many different ways. What concerns me is there’s not much talk about physician happiness. With levels of physician burnout and discontent growing, why not pull back the curtain on how to improve physician happiness? Let’s think back to what life was like in grade school. For those of you who have children, what is the ...

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It's that time of year again. Bright-eyed fourth years have begun wandering our hospital in uncomfortable shoes and fancy suits. They look equal parts nervous and excited, ready to embark on the insane adventure that is being an intern. But first, they have to survive interview season and Match Day:  a stressful, expensive, hoop-jumping endeavor that culminates with an envelope containing the result of eight years of hard work. Wouldn't ...

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Part of the fun of ringing in the New Year is looking back on the achievements of the previous one. And in 2014, there were plenty of health care success stories to celebrate: major medical advances, new technologies and the Affordable Care Act’s unexpectedly good first year. At the same time, many of the health care changes in 2014 yield potential risks for patients, employers and the nation as a whole. ...

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January marked the start of what promises to be a four-month public reckoning: the trial of alleged Boston Marathon bomber Dzhokhar Tsarnaev. If the press reports about the evidence against him are accurate, most of the trial will not be about guilt or innocence; it will be about sentencing. Not a who-done-it, but a why-done-it. If Tsarnaev is found guilty, the death penalty will be on the table, and the proceedings will ...

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Most women report some painful or discomfort with their period. However, some women have killer cramps (the medical term is severe dysmenorrhea) and for many of them life goes on a 3 to 5-day hold once a month. Period pain is due to release of a substance called prostaglandins from the lining of the uterus during menstruation. Prostaglandins help the uterus contract (cramp), which is one of the mechanisms used to ...

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medpagetodayFrom MedPage Today:

  1. Salt May Not Be a Demon After All. Increased sodium intake was not associated with higher risk of mortality over the course of 10 years in Medicare patients.
  2. How Pizza Impacts Kids' Health. Pizza serves up the building blocks of obesity, and kids are always ready for another slice.

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NPR recently reported, “Measles makes an unwelcome visit to Disneyland.” Nine people who visited Disneyland theme parks in California over winter break had caught measles, almost all of them unvaccinated children. The next day, ABC reported that the number of cases has grown to 19. Of these, only two had been fully vaccinated. Some of the cases were too young to receive vaccines, others apparently chose not to get ...

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In respectful memories of Benson, Rose, and Sandy. I want to thank each one of them for helping me become a better physician. I stepped into the intensive care unit with a feeling of apprehension. I knew deep down, the patients I was going to care for were sick patients. Their status could change at any time. This was my first week on the ICU as a resident physician. Benson needed emergent ...

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Influenza has arrived refusing to be ignored or be the ugly step-virus to Ebola any longer. This influenza season is officially an epidemic. The Washington Post's Wonkblog reported earlier this month that December 2014 was “one of the worst flu months in years.”  In fact, they found that it was “the worst December since the polling organization started tracking flu season in 2008.” As of January 3rd, the CDC reported widespread ...

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Like most doctors, I was a young resident, fresh out of medical school, when I had my first experience with the American way of mistreating the dying. Taras Skripchenko was a frail, bed-bound 78-year-old man with inoperable lung cancer who was admitted to my service during my first year of residency training. Skripchenko was too confused to have a lucid conversation and lacked family members to guide his decision-making. His oncologists hadn’t ...

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In defiance of dire predictions, children haven’t been sent to workhouses and women haven’t been chained to utensils after the GOP gained strength in the House and the Senate. And Vivek Murthy, the unabashed Obamaphile, was finally confirmed surgeon general. To be honest, I always thought the controversy surrounding Murthy’s nomination because of his stance on gun control was rather daft. Stopping doctors from pontificating over guns, such as the docs ...

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Between 1991 and 2010, opioid drug prescriptions increased from 75.5 million to 209.5 million.  How can we stop prescription drug abuse? Let's start in the ER.

medpagetodayFrom MedPage Today:

  1. New Guidelines: Treat Obesity First. Treat weight problems first, then deal with comorbidities like dyslipidemia, hypertension, and impaired glucose tolerance.
  2. Lower Maintenance Abatacept Dose Maintains RA Remissions. Patients with early rheumatoid arthritis (RA) and poor prognosis who achieve remission on standard-dose abatacept at 2 years may be able to ...

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The insurance companies have discovered a new way to give me a headache. About a month ago, a number of providers in our practice received an email with instructions about a new task to which we had been assigned. Apparently, we were supposed to log on to some website, create an account, and fill out a SOAP note on about a dozen of our patients. Wait, a SOAP note? Didn't I write one ...

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Health care in the United States is often compromised by fragmentation in its delivery, limited patient access due to a shortage of primary care doctors, long wait times (even for patients who have appointments), and spiraling costs. As a result, innovative approaches to delivering health care are becoming increasingly important in America’s continued pursuit of improved outcomes and reduced cost of care. Health care delivery models such as telemedicine aim to ...

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shutterstock_136890005 gomerblogCiting slow load times, confusing menu structure, and overall frustration with the user interface, St. Barnaby’s Hospital has announced that the old electronic health record (EHR) will be replaced with a new state of the art binder-based system, in which a so-called “paper chart” is kept for each patient. The new ...

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