In news to absolutely no one with an iota of common sense, the purported physician shortage isn’t actually one of numbers, but rather a problem of distribution. Per this article by in the Washington Post:

Critics of doctor shortage projections have argued for years that the problem is actually poor distribution of physicians, with too many clustered in urban and affluent areas and too few in poor and rural areas.
Doctors prefer to ...

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Dwight Frost had all the risk factors, plus he had already had a stroke several years ago. His blood sugars were too high, his lipid profile was near the top of the class, he still smoked a cigar now and then, and his blood pressure hovered around 200. He also seemed a little vague about which medications he actually took and which ones he didn’t. He spoke rapidly with a slight ...

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shutterstock_141318316 I understand that there is a difference between perception and reality.  I also get that the kind of people one meets on a tropical vacation in the middle of March are of a certain economic and sociopolitical status. Nonetheless, I am amazed at how history seems to repeat itself.  Year after year, while sitting in the shade and relaxing by the pool, ...

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I walked into room 30 to find two eager sets of eyes awaiting me. One set belonged to a young man, late-twenties, muscular and imposing, sitting in a chair in the corner of the room. His eyes were hazel brown, big and inviting, relieved at seeing my entry into their sheltered world. The other set of eyes, darker brown and magnified by her gold-stemmed glasses, belonged to my patient, a ...

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American physicians have had it.  We are retiring early, cutting back, changing careers, and moping in to work in astounding numbers.  The typical pep talks, whether given aloud by medical directors and administrators or consisting of internal dialog occurring in the physician’s mind, are not working anymore.  “You have it better than most people.”  “You are still making good money.”  “Your patients still need you.”  “It will get better.” “You ...

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Thomas Hobbes described life as pitifully “nasty, brutish, and short.” Thanks to the free market and the state, life is no longer a Hobbesian nightmare. But death has become nasty, brutish, and long. Surgeon and writer, Atul Gawande, explores the medicalization of aging and death in Being Mortal. Gawande points to a glaring deficiency in medical education. Taught to save lives and fight death, doctors don’t bow out gracefully and say enough ...

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Health care in the U.S. continues its radical transformation with the rollout and rapid adoption of high-deductible insurance plans. More than even value-based purchasing, this has the potential to reshape the health care landscape because it has awakened the health care consumer. In its 2014 Employer Health Benefits Survey, The Kaiser Family Foundation reported that 41 percent of all firms (32 percent of large employers, 61 percent of small ...

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Members of Congress and the news media have a bad habit of referring to efforts to stop Medicare from arbitrarily cutting payments to physicians for taking care of their patients as the “doc fix.”  Typical is this story from CNN -- “Bipartisan Love: Boehner, Pelosi strike deal to kick doc fix” -- that reported on the release yesterday of an agreement between the two leaders on a bill to repeal ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old woman comes to the office for advice regarding maintaining bone health. She has no history of fracture. The patient recently had a lumpectomy and radiation therapy to treat breast cancer, is currently taking tamoxifen, and will begin taking an aromatase inhibitor in 2 months. She underwent menopause at age 52 ...

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CryingDoctor-640x480 Outside of a Southern California hospital, an ER doctor is crouched down against a concrete wall grieving the loss of his 19-year-old patient. A paramedic snaps a photo of the tender scene. His coworker, a close friend of the doctor, posts the photo (with permission) online. Minutes after the photograph, the doctor returns to work “holding his head high.” Thousands of people have ...

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As we begin the journey to value-based health care, the relationships between a hospital and its medical staff are changing. For decades, these relationships were straightforward: doctors admitted patients to the hospital, performed procedures and delivered therapies, and at some point, sent the patients home. This simple formula was the business model for hospitals, and it worked well. Same with the doctors. The hospital would pretty much let us do what ...

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The mortality from colorectal cancer has decreased substantially in the U.S. during the past decade. While some of the improvement is due to better cancer treatment and reduced risk factors, the largest proportion is thought due to screening. The concept that early detection saves lives has now become well recognized. The harms of screening -- particularly among individuals with limited life expectancy -- are less well appreciated. Royce et al. recently published a ...

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shutterstock_186139613 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 ...

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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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