STAT_Logo The publication of Andrew Wakefield’s notorious and now discredited research on autism and vaccines in 1998 triggered a surge of worry about vaccine safety. Since then, questions about a purported connection between autism and vaccines have been asked and definitively answered: There is no link. But there are other factors linked to the development of autism that have ...

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The current American climate seems to champion those outside the establishment and eschew the experience of career professionals. Medicine, like politics, has not been immune to the rise of populism. There exists a growing distrust of traditional medical institutions and a movement to concede medical expertise to the public, particularly evidenced by the development of platforms that crowdsource diagnosis. While online medical crowdsourcing is trendy and has received nearly universal ...

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When Donna Helen Crisp, a 59-year-old nursing professor, entered a North Carolina teaching hospital for a routine hysterectomy in 2007, she expected to come home the next day. Instead, Crisp spent weeks in a coma and underwent five surgeries to correct a near-fatal cascade of medical errors that left her with permanent injuries. Desperate for an explanation, Crisp, who is also a lawyer, said she repeatedly encountered a white wall of ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated in follow-up for elevated liver chemistry test results, which were performed to assess a 3-month history of fatigue. He has no history of liver disease and has not had abdominal pain or fever. His medical history is significant for a 3-year history of diarrhea. Following a ...

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One night in 1997, as Americans watched Touched by an Angel they were touched by something else unexpected: an ad for a prescription allergy pill called Claritin, sold directly to patients. Prescription drugs had never been sold directly to the public before -- a marketing tactic called direct-to-consumer or DTC advertising. How could average people, who certainly had not been to medical school, know if the medication was appropriate or safe ...

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I met a man recently who had wandered about life dragging the rotting corpse of his arm barely attached to the rest of his body for over a year. His limb carried such a pungent malodor he stopped eating months ago because the noxious stench of his own dripping pus made him perpetually nauseous. A former handyman, he had jimmied up a poor-man’s sling with a tattered Hanes undershirt. It too ...

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There was a lot about that place I didn't want to see or hear. The buzzing and whirring of ventilators; the loud call bells; near-dead patients; nurses running around with IV pumps and tubes dangling along behind them; the heart-stopping "Code Blue" warning; or the electrical sizzle of a patient getting shocked as someone screams, "All clear!" I didn't want to do it. Just a few days before, I had buried my mom. First ...

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The scene at the resident teaching session was all too familiar: Awkward silence with either blank stares or brows furrowed in deep valleys of confusion. As I scanned the room, I recognized the moment many lecturers experience: I had completely lost my audience. And, whatever I had planned for the next 10 minutes, would now be spent “taking a step back.” We weren’t talking about a crazy exam finding or ...

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Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following the publication of that post, I heard from several hospital executives and was pleasantly surprised that they all responded positively to my ...

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The frenetic pace and chaos of working in an urban trauma center are addicting -- at least for a while. Interesting, unusual, and tragic patients test the mettle of even seasoned physicians. For some, the lure is too strong to step away. For others, the attraction of a quieter life and promise of a more sane existence is too powerful to resist. My story After training in one of the busiest level 1 ...

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I swear by Epic, by eClinicalWorks, by Allscripts, by AthenaHealth, and by all the coders and accountants, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. To hold my mouse in this art equal to my own hand; to make it right-click as well as left-click; when my ACO is in need of money to share an “at-risk” portion of ...

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To be clear, this is about one person.  It warms my heart to know that people want to come and start new lives as Americans.  Some of the best doctors got their education and training overseas.  Not only have I worked with many of them, I’m related to three by marriage.  Most people have heard of Mr. Andrew Wakefield.   He used to be a British doctor before being stripped of ...

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“I attribute my success to this-I never gave or took any excuse.” -Florence Nightingale I was publically thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit. Over the past Christmas holiday a couple of patients, being human as we all are, forgot to get their medications squared away before the clinic was going to close for a total of ...

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Wellness. It’s all the rage these days as we try to manage our crazy work schedules while still maintaining balance in life. We have wellness committees, wellness workshops, wellness coaches, and wellness apps for our smartphones. So, then, what does it mean to be well? To the average person, and to the dictionary, to be well is to be “in good health” or “in a good or satisfactory way.” However, to those suffering ...

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Just after I started at Stanford’s Graduate School of Business, I wrote an article on why I’m doing an MD/MBA. I argued that business school can help clinicians develop a new perspective, acquire important skills and build bridges between doctors, policymakers, and administrators. I heard from dozens of students, faculty, and physicians who supported the idea of an MD/MBA. However, a question repeatedly came up about as to ...

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So, how do you do it all? It’s a Monday morning.  After a flurry of activities, I am walking into the office at 8:00 a.m.  I think back to the past 2  to 3 hours.  I was up at 5:30 a.m., and in my workout clothes soon after.  I managed to squeeze in a 20-minute workout, thanks to a video on YouTube.  I then reviewed my schedule and patient charts for ...

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As the immediate past-president of the Society of General Internal Medicine (SGIM), the major professional association of academic general internists, I participated in SGIM’s Hill Day on March 8, 2017.  Hill Day is when an organization mobilizes its members to visit the offices of Senators and Congresspersons on Capitol Hill in Washington, DC to discuss key issues.  Coincidentally, March 8 was also the day two House Committees began deliberations on ...

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As a medical student, I had nightmares about my first day in the OR: scrubbing incorrectly, contaminating a sterile field, forgetting the anatomy I had so carefully studied the night before. It seemed like the only thing I could do in that artificially lit room was mess up. After a few cases I came to love the routine and ceremony of each surgery: the timeout; the rhythmic pattern of suture, ...

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I am a member of the American Medical Association and chair the Delegation from the Florida Medical Association. As an advocate for the medical profession, I am very proud of the work that we do, but I also realize that much more is needed. In particular, we desperately need to address the growing disconnect between the AMA and the broader physician community. This disconnect is one of the key reasons ...

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I knew the moment when my career in pediatrics was over.  I was in the fourth year of my med-peds residency, taking overnight call in the pediatric ICU.  Nights were busy, stressful and I was alone.  A young boy came in as an unrestrained MVA after his father hit another car. Dad was OK (although severely distraught), but the five-year-old towhead boy in front of me was not, with his head immobilized in ...

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