Physicians, whether practicing medicine or not, should not be involved in clinical research. They should never be consulted on development of new drugs and medical devices. Doctors should not invent new treatments, and should never supervise clinical trials. They should not travel to or speak at conferences either, and they should banish all entrepreneurial notions out of their heads. If they insist on engaging in these activities, they should do ...

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Thousands of people have travelled from West Africa to the U.S. in the last 6 months.  While the CDC and others throughout the Obama administration continue to reassure everyone that the U.S. is 100 percent prepared for an outbreak,  potential cases and exposures continue to surface all across the country. In Dallas, the first confirmed case of Ebola has passed away.  Even more concerning is the fact that the patient initially ...

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Top stories in health and medicine, October 14, 2014From MedPage Today:

  1. ID System Reduces NICU Errors. Mistakes made when entering clinical orders in one hospital's electronic medical records system were reduced after implementation of a unique naming system to reduce confusion and miscommunication in the neonatal intensive care unit (NICU).
  2. Clinicians Explore EV-D68, Paralysis Link. The mysterious cases of acute ...

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Having a healthy life is more than getting an annual physical examination. It is about having healthy habits. Some of these healthy habits make common sense. Others seen unnatural, but yet are vitally important. A healthy life is more than feeling well. It is about living life to the fullest and ensuring you are doing your part to improve both your quality of life and longevity. Which ones are you missing? How do ...

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What the Dallas Cowboys cheerleaders can teach us about hiring doctors I’ll admit it. I like reality TV. In fact, one of my favorite reality TV shows is Dallas Cowboys Cheerleaders: Making the Team. It shows what it takes to become a Dallas Cowboys cheerleader (DCC). Why am I talking about cheerleading in a health care blog? Because the Dallas Cowboys cheerleaders put more effort into hiring cheerleaders than most health care ...

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Ebola in the ER: What you should and shouldnt worry about As an ER doctor, right now I'm thinking a lot about Ebola -- it's in the news, in my inbox, and in questions from my patients.  Whether it's an outbreak, a flu epidemic, or a bombing -- we in the ER see them first, and so I'm always thinking about how we'll be ready. So, what concerns me, and what doesn’t? Ebola patients in the ...

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All health care professionals must be skilled at effectively communicating with patients who have dementia.  Some professionals may erroneously assume that only those employed in long-term care, assisted living facility and other similar places need these skills.  However, patients with dementia visit medical practices, acute care hospitals and other health care centers.  This article will provide a framework to effectively interact with patients who have dementia. Go along to get along This ...

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Giving prescription refills is not quite as fun as it used to be. Years ago, we doctors would whip out our prescription pads -- often sooner than we should have -- and we’d scribble some coded language that pharmacists were trained to decipher. I’m surprised there were not more errors owing to doctors’ horrendous penmanship. On occasion, the Food and Drug Administration (FDA) would require a pharmaceutical company to change ...

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The Internet was recently atwitter (see what I did there) about the major health care story of Ebola in the United States. However, there was also a interesting rumor announced at the end of last week, to which people should really be paying attention. As reported by Reuters, Facebook is taking aim at health care, your health care: "The company is exploring creating online 'support communities' that would connect Facebook users ...

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Top stories in health and medicine, October 13, 2014From MedPage Today:

  1. Cashing in on Ebola. What was your reaction when you first realized that Ebola was killing thousands of people in Africa and would probably come ashore in America at some point? Sympathy? Worry? Scientific curiosity? An urge to hop the first plane to Monrovia?
  2. Ebola: Body Fluids Carry the ...

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Why do doctors still use pagers? I was on call last night. Don't get me wrong, this is not as bad as it sounds. With over 20 partners sharing evening call, and residents getting the calls first, we do not have it bad at all. And certainly nothing like my obstetrician friends, who seem to go in every time they are on call for labor and delivery and then ...

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Please don’t call call me a “prescriber.” Yes, I know it’s easier to say “prescriber” than “psychiatric nurse practitioner or psychiatrist.” The word “prescriber,” however, puts severe limits on what I can do and how I can help. You may believe that, because I have a license to prescribe medications, that’s all I choose to do. In fact, you may believe that’s all I know how to do. Psychiatrists can do a lot more than that. As ...

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As the birth of our first child loomed on the horizon, I couldn’t help but worry.  As a first time mother and a pediatrician, I found the uncertainly coupled with too much knowledge of all manner of possible problems particularly unsettling. In addition to worrying about my baby’s health, I grew increasingly concerned about how I would handle the balancing act that all working mothers must perform.  Having put motherhood off in order to complete ...

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Insurance is without a doubt the best business on earth. Every month, insurance companies from many industries collect premiums from thousands of clients, relying on the statistical likelihood the companies themselves will collect more than they pay out. If the company has a poor year, they raise the premiums for the next year. It is a beautiful business model and a way to guarantee consistent profits year after year. Even ...

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Outpatient anesthesia in elderly patients: What to watch forA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. More than 75 percent of operations in the U.S. occur in an outpatient setting. Outpatient, or ambulatory care, can take place in a number of different settings, including physician offices, outpatient surgery centers, or hospital or non-hospital-based outpatient clinics. With more and more elderly patients undergoing outpatient ...

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In their current form, most (if not all) EHRs kind of stink. I don’t speak from direct experience, as I’ve held off buying and implementing a system to date. But I’ve never heard any of my colleagues say they love -- or even really like -- their EHRs, and I’ve asked many. The most ardent supporters state that they've gotten used to their systems (usually after years of tribulations) and ...

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What happens when the federal government and the states have split responsibilities for caring for Medicaid beneficiaries? Not much, other than casting blame on one another or on doctors for not providing the care. Buried on page 26 of the front section of a recent New York Times is a story about Medicaid patients not finding doctors or having to traveling long distances to find one. It says a federal inquiry finds ...

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Do you want a culturally competent practice? Here are 15 tips. Over the last few years I started a family practice serving refugees, and have seen 10,000 refugee patient visits. With regards to culturally competent medicine, medical schools teach about traditional remedies such as coining, and maybe role play with interpreters, but stop short of practice design ideas. The AAFP provides a checklist of qualities, which I feel could ...

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The ER demonstrates the inverted priorities of American society We fling open the doors of America’s emergency departments to help those who can’t afford health care.  We have legislated this protection: No person can be turned away for financial reasons.  This is very compassionate, and represents the higher angels of our culture.  Alas, it also is emblematic of the stupider demons of government.  You see, the ER demonstrates the inverted priorities ...

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The Journal Psychological Science just published a complicated, long, and fascinating study about happiness. The full text is tucked behind a paywall, but it’s great reading if you can get your hands on it. The authors arranged four separate experiments, looking at the effects of getting things versus experiencing things, and how the anticipation of waiting might affect happiness. Some of the studies involved just imagining a future purchase or vacation; ...

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