An increasing amount of parents are choosing to delay or spread out vaccines for their infants and toddlers. Dr. Allison Kempe and her colleagues at the University of Colorado School of Medicine found that in a typical month, 93 percent of pediatricians and family physicians reported that some parents of children less than 2 years of age requested to spread out their vaccines. The findings, published in the April 2015 edition ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Clearly, physicians are the leaders of the health care team.  We were educated and trained for that role. But on the business and political sides of health care, maybe not so much. One reason is that the word “leadership” has a lot of different meanings.   A leader in one ...

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I recently sat down with a well-known physician within the orthopedic community as well as among the medical socialites of social media.  When I walked into his office, the first words out of his mouth were about my attire.  As I was concerned about first impressions, I broke out the fancy suit, custom tailored, of course, a matching shoe and belt combination, as well as my go-to “interview tie.”  I ...

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People like tests. You get numbers, and maybe a printout, and there’s science and blood and things just feels more ... serious, when testing is done. You can picture Marcus Welby (or perhaps a more modern physician), looking solemn, declaring “We’d better run some tests.” Are medical tests magical and mysterious, and can they unlock the secrets of life? Usually, no. And among the worst and most misunderstood tests we do are ...

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On March 20, 2015 the stars aligned to produce four simultaneous events that will never again coincide during the life of human civilization. The first three, the vernal equinox, a total solar eclipse and a new supermoon, were brought to us by the stars themselves, and the fourth one was thrown out there by the government. The regulations for meaningful use stage 3 were finally published. Meaningful use of electronic health ...

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medpagetodayFrom MedPage Today:

  1. Health IT: 'We Were Bound To Be Disappointed'. Robert Wachter, MD, works an hour north of Silicon Valley. Being surrounded by an "incredibly dynamic, vibrant IT ecosystem" contributed to a sense of disconnect for the associate chairman of medicine at the University of California San Francisco.
  2. Americans Miss WHO ...

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As the Obamacare machine continues to grind forward, many patients have re-enrolled in a second year of coverage. While most have not had to use their insurance (the young and healthy crowd), others have found their newly minted coverage to be far less than promised. High deductibles, and up front out of pocket expenses, forced many covered by the exchanges to avoid seeking regular preventative care. Prevention was one of ...

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I was asked by one of my readers recently to write a post on how I maintain work-life balance during the all-consuming intern year of medical training. I love this idea because keeping myself sane while spending 80 percent of my time in the hospital has proven to be a constantly challenging task, and I’ve come up with a few ways to cope. Instead of giving tips that sound good ...

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"Safety first" is a mantra of today's hovering parents.  It's the default explanation that a parent invokes when an edict has been issued that cannot be challenged or reversed. "Mommy, can I please have a water pistol?" "I'm sorry, honey.  You know how Daddy and I feel about guns.  This is a safety issue.  Now go and practice your violin and afterwards help yourself to some kale chips." The safety concept has crept ...

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I remember being more confident that most of my peers.  The look of dread on my fellow interns face pre-call, and the fatigue post-call always seemed unnatural to me.  Maybe it was on account of my lifelong pursuit of medicine.  I felt nothing but elation at the newly branded "M" and "D" that came after my name on the hospital badge.  I was no longer a volunteer, no longer a ...

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shutterstock_76711840 A couple of weeks ago I was on-call and had to go down to the emergency room to see a patient. Before I entered the room, I was told that the patient was accompanied by her long-time physician who was a bit “crazy and old school." “Hmm … that’s strange … why would her physician be in the room with her?” I ...

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shutterstock_133319240 As a third-year medical student, I realized one particular morning on rounds that I had let the demands of the job overtake the joys of why I went into medicine at all. I found myself running behind my team, barely even able to say goodbye to the last patient we had seen. The human interaction had become an afterthought in the ...

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medpagetodayFrom MedPage Today:

  1. Methotrexate Helps Save Large Joints in RA. Patients with rheumatoid arthritis (RA) who received concomitant methotrexate with their tumor necrosis factor (TNF) inhibitor were less likely to need a large joint replacement than if they were on anti-TNF treatment alone.
  2. More U.S. Teens Opt for Birth Control With IUDs, ...

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As the rugged beauty of the Pacific Coast unfolded in all of its splendor, I was in awe of the entirely different experience: the one created by our Uber driver, Calvin (name changed to protect anonymity). My friend and I, attending our annual cardiology meeting in sunny San Diego, carved out a few hours of rest and relaxation. We were heading to La Jolla, a scenic seaside community about 20 minutes ...

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“Doctor, I have trouble breathing when I walk up stairs, and I cannot lie flat in bed, so I have to sleep sitting in a chair. I feel much worse than before I got pregnant.” I recognized the diagnosis at that point, but I continued the appointment to confirm my suspicions and to revel in the art of medicine. I listened to the young woman’s lungs, full of crackles from fluid backup, ...

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I’m walking very slowly with my dad down the produce aisle at the local supermarket, past the colorful waxed apples, Mexican mangoes and Rainier cherries, and imagining my life's blood trickling onto the floor from an invisible wound. As I pass by the misting system spraying the bins of green, red, yellow and orange peppers, past the lady reaching for carrots, past the stock guy balancing the heirloom tomatoes into a ...

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Spring is here. The days are getting longer. The temperature is slowly getting warmer. Green stuff will start poking through the ground and popping out on trees. We’ll see more of our neighbors, since they won’t be trying to get from their cars into their houses (and vice versa) as quickly as possible before they freeze. Pollen allergies will start up again. And grass allergies. So many people suffer from the watery, itchy eyes, itchy, ...

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Waaaah-Hoo!! – Slim Pickins as Maj. ‘King’ Kong, riding the bomb in “Dr. Strangelove” I am converted. Like many doctors, I was very leary of social media, wary about using it, skeptical of its professional value. Especially Twitter, but really all of the platforms. No longer: I have embraced social media, and it has embraced me. I feel a little bit like Dr. Strangelove, only the subtitle is now “How I Learned To  Stop Worrying ...

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I’ve just finished sitting through a wonderfully aptly named lecture: Probability and Statistics, in which, among other things, we learned (again) that the utility of various clinical tests depends at least as much and generally more on the patient and condition involved than on the specific test itself. From stress tests to mammograms to PSAs, the relationships of true and false positive and negatives, positive and negative predictive values all ...

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There were a lot of happy faces on March 20th as depicted in this brief video of the excitement on the campus of the University of Rochester School of Medicine. Similar scenes took place at every U.S. medical school because 93.9 percent of the 18,025 graduates of U.S. allopathic medical schools matched in a specialty. But for the 1,093 (6.1 percent) U.S. graduates who didn't match things were not ...

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