Managing diabetes is all about control: controlling what you eat, when you eat, and the amount of insulin you give yourself. As someone with type 1 diabetes, I understand how control over one’s blood glucose levels is vital to maintaining a healthy lifestyle. When I was hospitalized due to a car accident, however, I saw how the hospital’s desire to control my care ended up costing my insurance company more ...

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The growing wearable sensor market is yielding ever-increasing amounts of consumer-derived digital data. These data can consistent of many different physiologic measures such as heart rate and rhythm, sleep quality, brain activity, and physical activity levels. As many consumers and commercial organizations look toward using wearables to monitor medical conditions, clinicians may begin to find themselves in the role of a digital data decoder. This will be no easy task, as ...

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As a traveling physician, I’m often asked if I have a favorite place to work. Since I have licenses in 14 states, I have an unusual vantage point from which to compare hospitals. I know that people who ask this question presume that my answer will be heavily influenced by the town where the job is located, and all the associated extra-curriculars, environmental peculiarities (ocean, mountains, desert), and potential amenities. ...

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As with the beginning of each new year, the word “improved” gets bandied about: improved patient care, improved patient satisfaction, improved efficiency. Physicians are constantly being told to push past their burnout and embrace multitasking for the sake of improved health care delivery. Patients are told to “hurry up and wait” as they line up for health care like lemmings on the top of a cliff. In a world in which ...

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Physicians need to complete about 50 hours of some kind of continuing medical education (CME) every year. The ideal kind of class is one that we actually attend in person, with teachers who are expert in the field being taught and are somewhere near the cutting edge. CME classes are especially nice when they include something hands-on rather than just a lecture format because much of medicine is hands on ...

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It has become perhaps the silliest four letters in health care: PQRS. It stands for Physician Quality Reporting System. It’s another this and another that created by the Centers for Medicare & Medicaid Services (CMS). After you read this, you’ll be like me, scratching your head trying to understand why anyone thinks our health care system is better under CMS’s leadership. CMS has setup a thing called PQRS, so physicians across the country ...

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It’s hard to miss the headlines and breaking news feeds on the latest medical studies showing the health benefits of plant-based eating patterns: Vegetarian diets lower the risk or colorectal cancer. Dementia can be delayed through a healthful diet, cognitive training, and physical exercise. Folic acid -- a plant-based product of foliage, or leafy greens -- boosts heart health. And that’s just in the past few days. As a primary care specialist ...

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As I reflect back on the last four years of medical school, I am reminded of the ghosts of patients past. Those of you already entrenched in the dredges of patient care know what I mean. The images of their faces burned on your brain: the ones you couldn’t help, the promises you never meant to break, and the hope you weren’t able to give. Those ghosts take on several shapes ...

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I recently took another survey confirming the obvious: As a resident, I am horribly burnt out. I sat, along with a half-dozen health care providers and bemoaned our current states. What, if anything, can we do about this? The typical answers came up: sleep more, increase our commitment to enjoyable activities outside of work. Oddly enough, there was little talk about the daily work itself, and how the medical culture ...

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Peanut allergy is a worldwide concern, but especially in Western countries, in which prevalence has doubled in the last ten years, to a rate of 1.4 to 3.0 percent of children.  To prevent the development of peanut allergy, national guidelines have attempted to keep pace with this crisis, with recommendations, at first, of delayed exposure to peanut and, more recently, of earlier exposure.  But a universally accepted and research-supported approach ...

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There are a lot of frustrated and unhappy people out there when it comes to their perception of health care today. The contemporary practice of medicine is changing, rapidly, and those changes have been a challenge for patients and  physicians alike. The list of reasons for this is lengthy. Certainly physicians and hospitals are finding it difficult at times to meet all the changes and demands put on them, by ...

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Referring physicians are critically important not just for the care and attention we provide patients but also for the referrals we make to specialists. Patients don’t have access to the same data or knowledge that we as healthcare professionals possess, so as referring physicians we can have a significant impact on our patients’ health after they’ve left our immediate care. Big data has given us more information than ever in making ...

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medpagetodayFrom MedPage Today:

  1. Can Burning the Midnight Oil Lead to Diabetes? If you tend to be a night owl, add that to the list of risk factors for developing diabetes.
  2. Experts Weigh In on IgG4 Disease. The diagnosis of IgG4-related disease (IgG4-RD) requires biopsy confirmation and should not be based on the ...

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One winter afternoon during my first year as a hospice volunteer, I drove slowly through the kind of neighborhood where the only people you see during the day are landscapers, contractors and housecleaning services and where one house is grander than the next. I was looking for the ranch house where Bobby had been living since his diagnosis. Most people I visit, as a hospice volunteer, are my senior by 20 ...

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Tournament time! The time of year that brings friends, family, and colleagues together to cheer and commiserate over brackets and games. When it comes to the final two weekends, it is often the same teams year after year. What can the coaches of great teams teach us about doctoring? Preparation and fundamentals (John Wooden, UCLA) The first thing coach John Wooden taught his players was how to put on their shoes and socks. ...

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I am relieved and proud to report that I passed my boards: I am officially a diplomate of the American Board of Obstetrics and Gynecology. While the oddly formal “diplomate” is a term in common use with physicians, I didn’t understand what “diplomate” and its sister phrase "board-certified physician" meant until I undertook my own board preparation. The Medical College Admission Test (MCAT) is a memorably stressful element of applying to ...

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“Samantha is your next patient,” my medical assistant informs me in my primary care clinic.  Samantha is a Caucasian woman in her late 40s, and I typically find her in the room with well-groomed blond hair and a cheerful outfit, such as a pink blouse, a flowery skirt, and golden sandals. She has been my patient for over a year, and I know that her life is anything but cheerful. ...

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It is amazing to me how far emergency medicine has come as a specialty. Until the 1970s, emergency rooms were staffed by low-level resident interns who moonlighted for extra money or physicians who couldn’t find work elsewhere. After finally getting recognized as a specialty, the specialty still spent a few decades finding its way: developing training programs, improving quality, and generally trying to raise the bar on emergency care in ...

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A drug company recently received FDA approval to peddle its speed-like pill for "binge eating disorder" (the very same pill that is already widely overused for ADHD). And it is sparing no expense pushing the drug -- a former world tennis champ is the shill and commercials are everywhere. Five years ago, I predicted binge eating disorder (BED) would become a new fad diagnosis and a wonderful target for pharma disease ...

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shutterstock_117726904 I suppose it is obvious that I am a fan of stories. I like to hear them, read them, watch them, collect them and tell them. I believe I am participating in stories every day of my life. The story of my family is a beautiful epic. The stories I hear at work can break my heart. One of my favorite ...

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