Dr. Leon Pedell why it's so important for physicians to have relationships with patients' families. Courtesy of Before the Floors.

I told you so.  I also told the POTUS in my open letter, but he did not read it. Who could honestly believe the nation would support dumping coverage for 22 million people?  As David Leonhard wrote recently op-ed in the New York Times: “They [Republicans and President Trump] had only one big weakness, in fact: They weren’t dealing in reality.”  When faced with reality, it is interesting what a few good ...

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Antibiotics save lives, but antibiotics can have negative effects.  When patients have bacterial infections, we want to treat them to prevent complications of the bacterial infection, but not treat them for an excessive duration.  So we have a Goldilocks problem -- we want antibiotic duration to be just right -- neither too short or too long. Some clinical conditions have adequate research to define the Goldilocks duration.  Community acquired pneumonia only ...

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Two seemingly unrelated national policy debates are afoot, and we can’t adequately address one unless we address the other. Health care reform has been the hottest topic. What to do about America’s aging infrastructure has been less animated but may be more pressing. Yet even as cracks in America’s health system and infrastructure expand, political divides between parties and within parties have stalled efforts to develop policies and implement solutions. Problematically, debates ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old woman is evaluated during a routine examination. She has a history of hip and knee pain related to degenerative joint disease. The joint pain is now well controlled with diclofenac, which was started 3 months ago. A previous trial of high-dose acetaminophen was not effective. ...

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I get on the phone with a physician. She is stressed. Her tone is exasperated. Her frustration has been building and building. I hear the stress in her words. She feels like she has been juggling ball after ball after ball. Living her circus of a life. Taking care of her patients. Pulling extra shifts and doing locums. Somehow, fitting in a little bit of time when she can for her caring ...

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"OK, one more patient to go," I said to myself with my eyes quickly scanning the patient list in my hands. I was in the elevator, going up the spanking new glass tower in the giant tertiary care hospital I call my workplace. Today was turning out to be a better Monday than usual. I had worked over the weekend, so I knew the patients. And there were no major ...

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When I began my career as a physician in the late 1990s, I was relatively apolitical. Since then, as our health care system has crumbled, and as its demise (and our repeated failure to fix things) has increasingly affected my patients and my practice, I have become very political. In 2008, I began giving lectures in the community in support of a single-payer health reform model. My political leanings tend ...

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I sit in my living room at the end of a long day. I open my laptop to complete the day’s clinic notes. I look up to see my daughter busy painting (she’s two years old, so less than half the paint is going on the coloring book and most is being smeared over her hands and feet). I hear the distant clatter of dishes as my husband loads the ...

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Fireworks, champagne toasts, sparkly hats, and the ball drop are all items that we conger up in our minds as we think of the New Year. For the majority of the world, January 1st represents the transition from one year to another on the calendar. New resolutions are made, and there is a global fresh start. However, for those of us in the medical field, there is another new year ...

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My sister calls my name three times before I hear her. I am so distracted by the palm trees and the ocean view that I don’t feel her put the car in park. I look up at the “Physician Parking Only” sign straight ahead. “Hurry up and get out. We’re running late, and I don’t want to have to stay after my shift ends,” she says. “Don’t you always stay like two ...

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I feel privileged to be practicing medicine. Many people consider doctor careers and imagine how great it may be. Is it the right thing for you? Yes there are days of frustration, exhaustion, and utter defeat, but at the end of the day I home and know that I helped at least one person if not two from the 16 I meet. The fact that I alleviated one individual’s anxiety or ...

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Watch Bailey Alexander Loving's compelling medical student journey. Courtesy of Black Men in White Coats.

Even after all this time, the phone calls aren't always easy to make. “Hi, Mrs. Smith, this is Dr. Kass at camp, don’t worry, everything is OK.” I usually get that out in one breath, then immediately transition to concrete details. "It's a finger. It might be broken." It doesn't matter if I'm calling about a cough, a fever or a bite from the camp pet pig -- I know that ...

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Cancer treatment delays are sometimes inevitable. Here is a story, though, that haunts me. Years ago, long before the Affordable Care Act, I was asked to evaluate a very pleasant man with hoarseness in a local free clinic. He struggled to make himself heard. "Things have been getting worse and worse," he said. "When did you start losing your voice?" I asked. "About six weeks ago," he responded. "When it started getting more ...

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Recently, I had an opportunity to drop in on two of the foremost researchers in physician burnout, Sara Poplau and Mark Linzer of Hennepin County Medical Center in Minneapolis. We chatted about various aspects of the current burnout crisis and exciting new initiatives on the horizon. Then we spent some time contemplating a frustrating truth: leaders in health care often fail to acknowledge a reality that leaders in other industries ...

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An article in Newsweek magazine says, “Artificial intelligence will cure America’s sick health care system” using data and automation to “drive down the costs of health care while increasing effectiveness.” According to Newsweek, it will work like this for diabetes. A company called Virta Health has come up with a smartphone app that is like “a live-in doctor and diabetes coach.” Type 2 diabetics who enroll will enter data such ...

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Recently, getting dressed after working out in the gym, the guy in the next locker decided to complain to me about his recent surgery. Having lockers next to each other had led over time to "What do you do for a living?" After discovering that I was a physician he has occasionally asked some medical questions, and done what a lot of people do when they know you're a health care ...

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In the spirit of World Breastfeeding Week, I want to highlight all we can about breastfeeding; why it’s great for you and your baby, some ways to make it easier, and how to manage common challenges. But one challenge that often gets ignored in the offices of doctors and lactation consultants is the issue revolving around the ethics of breastfeeding. That is, addressing uncomfortable questions like these:

STAT_LogoDear Sen. McCain, I was saddened to hear that you received a diagnosis of glioblastoma. I also live with this particularly aggressive type of brain cancer. On the surface, you and I are very different. I am a 35-year-old dad with three sons aged 5 and under. I have a beard and listen to indie rock. I hold ...

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