Early retirement is a hot topic these days, particularly in the field of medicine. It is associated with the concept of financial independence, and together they are known by the acronym FIRE (financial independence and retiring early). In essence, FIRE means having enough saved that you can live off your investments, and no longer need to work for a salary. While FIRE is not for everyone, it is something my ...

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Dear intern, It will be the best of times, and it will be the worst of times. But what a special time this will be. It will be a time of learning the details and nuances of clinical medicine — the diagnostic features of sarcoidosis and the second, third and fourth line treatments for community-acquired pneumonia. You will learn how to learn, and you will forget what you learned, only to learn ...

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Physicians need tools that are powerful in the eyes of Google and allow them to create content online. And today they're all in luck because we have those tools. A KevinMD keynote video excerpt.  Please visit my physician keynote speaking page to find out more.

Part of a series. Beginning at about age 40, our bodies begin a process of organ and functional decay of about 1 percent per year. Bone mineral density decline leads eventually to osteoporosis and fracture risk, cognition decline leads to memory and thinking impairments, and muscle decline leads to loss of strength while increasing the fracture risk of a fall. According to the Centers for Disease Control, almost ...

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In a recently published JAMA meta-analysis, medical students were found to have a higher prevalence of suicidal ideation and depressive symptoms than the general population.   From the mental exhaustion that begins in medical school to the physical fatigue that peaks with residency, it is not shocking that medical trainees are suffering.  Current discussions have ignored one of the biggest hindrances for the ...

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When I started my intern year, I was told that I was going to be sleep deprived and it was going to be the worst years of my life. Yes, there were times I racked up a sleep debt, but it was for patient care.  And because of the camaraderie and relationships I formed (both inside and outside the hospital), I will forever remember residency with a smile. Rather than the words ...

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An open letter to doctors still prescribing opioid medication when necessary: Thank you so much for standing up for us pain patients. My chronic pain comes from a genetic connective tissue disorder (Ehlers-Danlos Syndrome), so there is no treatment or cure for my slow, but relentless, physical deterioration as the collagen holding my body together falls apart. I, like so many other pain patients, spent years (1982-1995) trying other therapies (yoga, acupuncture, ...

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"Medicine is a science of uncertainty and an art of probability." - Sir William Osler Two people presented to my clinic on the same day with classic symptoms of head and neck cancer. Each reported several weeks of unilateral throat discomfort, ear pain, and a neck mass. Each was having some trouble swallowing and had changed his diet to accommodate the soreness. When they opened their mouths, each had a mass with a ...

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As a physician who left clinical medicine because of burnout and as a writer, I’m drawn to stories of physicians whose professional and personal lives have improved after reasoned interventions. So my ears jumped to attention earlier this month when a colleague at a summit on physician burnout described the positive results his practice had achieved in reducing burnout. Read Pierce, MD, is interim director of the Hospital Medicine Group ...

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The New York Times says nonadherence to prescribed medications is “an out-of-control epidemic” in the U.S. and quotes a review in Annals of Internal Medicine, which found “20-30% of medication prescriptions are never filled, and approximately 50% of medications for chronic illness are not taken as prescribed.” For example, “a third of kidney transplant patients don’t take their anti-rejection medications, 41% of heart attack patients don’t take ...

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Lots of people write about how “doctors work so hard.” But let's look at it from an economics and value-creation perspective. I’m a neurosurgeon, so you know I do pretty well financially, but how much value am I adding to society? Here are a few examples: 1. A mail carrier couldn’t work because of a herniated lumbar disc. We'll figure he makes $50,000/year. I operated on him; he goes back to work. ...

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In honor of everyone graduating and moving on to the next step, let's talk about money. And by money — I mean debt because new doctors don't have any money! All we have are bills to pay! I am the one who does the finances in our household. It really happened by accident. My husband was deployed shortly after we got married, so all daily responsibilities were de facto handed off ...

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As doctors, we are good at lots of things — we are smart, efficient, hard-working, proficient, role models and leaders. Then why do so many of us place our own health and well-being after our jobs? As a physician, my most prevalent discussions with patients always boil down to very simple recommendations: eat right, exercise, sleep and manage your stress. Lifestyle changes are really the key to solving many of the ...

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At the graveside, they still talk about judgment, intelligence, and the wisdom that is the practice of medicine. Deans and health care leaders wax poetic as they tell stories of great cures to lift in memoriam remarkable healers. Yet, though we bow to Hippocrates, Osler, and Salk, the time has come to mark a revolution in human history: The art of medicine is dead. It is not that doctors have fallen from ...

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You've been swindled. At least that's the conclusion I've come to. It wasn't the hucksters or the snake oil salesman. It wasn't big business, big medicine, or some greedy hospital administrator. It was most likely pharma with a large dose of helping from your doctor. Plain and simple. I've learned quite a bit being a hospice medical director. Covering dozens of new admissions a week has given me much insight into doctor ...

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Recently I found myself sitting in my car in the parking lot of my clinic, unable to will myself to open the door. I didn’t want to head into the clinic that morning. Instead, I was filled with despair; overwhelmed with the events of the world. How can I do it? I thought. How can I walk in there and summon the energy to see my patients? An even worse thought: Why should ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old woman is evaluated for a 3-week history of substernal chest pain. The pain is dull, nonradiating, and unrelated to activities. Sometimes the pain is worse after eating spicy foods and can be occasionally triggered by emotional stress. She has not had shortness of breath or ...

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I wish I knew who coined the term “DRexit” so I could send flowers or a bottle of whiskey as a thank you gift. There couldn’t be a more perfect term to describe the growing exodus of physicians from our beloved profession, which is turning into a morass of computer data entry and meaningless regulations thought up by people who never touch a patient. The one bright note on the horizon ...

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It is surprisingly easy to sell snake oil. I know, because I’ve done it. In 2014, I helped create and sell The Right Detox. This was a bogus detoxification program that purported to improve anyone’s well-being and perhaps, cure disease. I was the face of the scam. I launched The Right Detox at a spring-time women’s health expo in Tucson, Arizona. I kicked off my sales-pitch in front of a small ...

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Earlier this week, as I write this, our office lost a skirmish against technology. It was my procedure day, where lucky patients file in awaiting the pleasures of scope examinations of their alimentary canals. A few will swallow the scope (under anesthesia), but most will have back-end work done. We are a small private practice equipped with an outstanding staff. We do our best every day to provide them with the ...

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