Why you should love your doctor Doctors spend their 20s and 30s studying while most of their friends are at parties and enjoying their youth. Doctors may amass up to $500,000 in debt for the honor of one day caring for you and your family. Doctors delay childbearing and starting their own families so they can care for your family. Doctors miss their own kids’ ballet recitals and baseball games ...

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The administration issued a report recently that says individuals who selected plans in the federal health insurance exchanges have a post-credit premium that is on average 76% less than the full premium for the plans they selected. And, 69% are paying less than $100 after the subsidies -- 46% are paying $50 or less. The administration also pointed out that 65% of individuals selecting the silver plan in the federal exchange chose ...

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You’d think, being land-based mammals, we’d all be able to agree on the basic fact that humans breathe air, and that newborn human babies ought to be born into the air.  You know, so they can breathe. That’s how human babies have always been born, and that’s how all other primates are born, and that’s how all other land mammals are born. (Hats off to our cetacean cousins for their ...

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I'm impressed by how much we struggle with seemingly simple health decisions when faced with sorting through too much information. Buying sunscreen: It's a simple task, right? Most of us do it every year about this time. And among actions we can take to reduce our risk of cancer in general and skin cancer specifically, this choice is fairly important. So my colleague was surprised to hear this snippet of conversation as she contemplated ...

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Dear Jane: Thank you for asking me about my perspectives on medical school. Here are some general principles that you might find useful in your own training: 1. View everyone as your teacher. Everyone you encounter will teach you something. Be open to what they have to offer. Yes, your professors and attendings, the “official” teachers, will educate you. Patients, however, will often be your best teachers. Listen to what they say, watch how ...

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A recent meta-analysis by an accomplished international team of researchers, published in a prestigious medical journal, shows that high intake of saturated fat is exactly as bad for health as a high intake of sugar and refined starch. The study also suggests there is something far worse. The study, which pooled data from prior research and in the process aggregated findings for over 500,000 people, compared the rates of coronary ...

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“Everyone I know agrees that President Obama’s problem is that he isn’t liberal enough.  Everyone I know believes that the problem with Obamacare is that it gives insurance companies too much power, when what we really need is a single payer system where the government runs everything, like Canada.  Everyone I know believes that  the answer to gun violence is to ban guns,  and if the Supreme Court won’t allow that, to at least license, ...

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I have made several observations as to why developmentally challenged people are losing out in our health care systems. Given that there are 11 million children in the United States with an emotional, developmental or behavioral condition, we really can’t afford to neglect this important issue. My first observation is that primary care remains a chronically undervalued component of health care delivery in the U.S. Despite the 60 million Americans who ...

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A simple trick to remember your doctors recommendations An excerpt from The Thrifty Patient – Vital Insider Tips for Saving Money and Staying Healthy.

You’ve told your story. Your doctor gets it. He has completed the physical exam. He formulates a plan to get you better. The next skill you should master may be as important as being a great storyteller. Your doctor has told you the ...

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Most physicians recall the medical school ritual of unboxing our first stethoscope. From the first physical diagnosis course, we were all solemnly instructed as to the importance of the physical examination in the diagnosis and of management of illness. Given that perhaps the most notable use of the stethoscope is cardiac auscultation, it would seem that this should hold particularly true for cardiology. And yet, on moving from classroom to bedside, ...

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I am not strongly against the death penalty on principle or on moral grounds -- assuming, of course, that it could somehow be narrowly and efficiently restricted to a very few egregiously deserving and certainly guilty criminals. I don't even find it particularly appalling (or cruel and unusual) punishment that a killer may have some few minutes of physical discomfort before expiring during a clumsily administered execution. My experience as a ...

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Whenever I talk with groups of medical professionals about job frustration and burnout, there’s a theme that shows up that’s hard to ignore. I call it “the pain of perfection.” Most of us pursued careers in medicine to help others. And if we’re honest, we must admit that we have type A tendencies infused in our bloodstream. Can I see a show of hands, please? That part of us, the one that strives ...

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Replacing transcriptionists with physicians is a fools bargain My general internal medicine practice is equidistant from the three academic institutions and a Veterans Administration facility, and thus I have patients who receive primary, secondary and tertiary care at each of these institutions. The notes I receive back from one of these organizations are hands down the best of the four institutions. These notes are personal, concise, precise and clear. If ...

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A new study poses one of the most vexing ethical questions concerning research with human beings: When is it acceptable to conduct research without the consent of the research subject? In emergency situations, patients often arrive at the hospital unconscious or with severely impaired decision-making capacity. Progress in medical practice depends on results from carefully designed research; yet in these emergency cases such patients are unable to fulfill one of the ...

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It is a trade secret among patients of many practices: If you’d like to be seen by your personal physician with no waiting and without an appointment, just ask for a free blood pressure check and then mention to the medical assistant that you are not feeling well at all. They can’t send you home without being seen and they don’t have enough to go on to call an ambulance; ...

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How do you really know if your doctor, surgeon or hospital is good, bad or somewhere in between? I frequently speak with large audiences, ranging from CEOs to Stanford business school students. I often start by asking participants to raise their hands if they receive excellent health care. Each time I ask, about 90% of the hands in the room shoot up. But all the hands come down when I ask, “How do ...

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The world is asunder.  Iraq is sinking into a sectarian abyss.  ISIS, a terrorist group, now controls a larger territory than many actual countries.  Russia has swallowed Crimea and has her paw prints all over eastern Ukraine.  China is claiming airspace and territories in Southeast Asia increasing tensions with Japan, Vietnam and the Philippines.  The Israeli-Palestinian peace process is in another deep freeze.  Terrorists in Sudan and Nigeria are kidnapping ...

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FiveThirtyEight had a provocative article: "Patients Can Face Grave Risks When Doctors Stick to the Rules Too Much." The subsequent comments have debates over the value of guidelines. Guidelines are like a box of chocolate, you never know what you are going to get. Many clinical questions yield competing guidelines. We all know the controversies over breast cancer screening and prostate cancer screening. Recently blood pressure targets and lipid management have ...

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I flunk as a parent. I have no plans for my youngest kids this summer. The older ones are working. But the 13-year-old and 8-year-old, the ones at the formative stages of their academic and skill development (if you believe what everyone says), are doing squat. No camp. No enriching activities. No special trips. Well, we do rent a house at the beach for two weeks every summer, that's something, but ...

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Kasey sits alone in the examining room, staring at the drug company calendar of a perfect Caribbean beach hanging above the doctor’s desk, but not seeing it at all. She is very frightened.  After three years of treatment for cancer, she is in trouble.   Kasey feels fine: no shortness of breath, no cough, no pain.  Still, she is there to get the report on her CT scan, and she knows ...

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