Around the U.S., millions of college age kids head back to start their fall semester in college. Their courses carefully selected months ago and their packing completed in a frenzy of activity. But, little thought is given to the most violent crime that happens on college campuses: rape and sexual abuse.  Estimates show that approximately 25 percent of college women have been victims of rape. In fact, ...

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Pamela Wible MD’s book, Physician Suicide Letters Answered, is a devastating view of raw pain, the pain of young, energetic, highly committed young people motivated to help and heal. These healers themselves have been plunged into the spiritual, physical, emotional, and intellectual hell of suicidal thought and action. Iatrogenic illness in action (iatrogenic illness being that which is caused by medical practitioners). Unfortunately, and tragically, the iatrogenic illness that ...

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“If physicians aren't happy, they can't heal others” - Vivek Murthy Last year, nearly 400 physicians committed suicide, a rate higher than other professions. Our nation is facing an epidemic of overwhelmed physicians subjected to increasing external stressors. Modern medical practice has evolved into a system driven by incentives to meet care quality measure benchmarks, implement incomplete electronic systems, provide care that is satisfying to patients and more. To keep up, physicians ...

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Dr. Kaveh Shojania, a prominent patient safety expert who scoffs at the numbers and laughs at the tragedy inflicted on countless victims of medical error, should step down as editor of a leading hospital safety journal. About three years ago, a scientist named John James published a study proclaiming that -- at minimum -- 210,000 people die every year from hospital errors, making it the third leading cause of death in ...

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The recent horrible events involving racial profiling, excessive force, and gun violence are deeply troubling but not new. Who can forget the Bronx shooting of Amadou Diallo in 1999 when 41 bullets rained down on his unarmed body. I can uniquely identify with the black experience because of my own numerous experiences of being pulled over for no other apparent reason except for being in the wrong neighborhood, wrong state ...

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When I talk to my patients, one of the greatest concerns I hear is regarding the fear that they might get a cancer at some point in their life. It is a very reasonable fear, as cancers of the female reproductive tract and breasts are not as rare as we might like. Perhaps educated by Angelina Jolie’s announcement of her BRCA mutation in 2013, many women now ask me about ...

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We are witnessing a strange migration of restless tribes, moving between doctors and clinics, traveling great distances in search of what no one wants to give them any more. This eerie movement is steadily gaining momentum in our community, in our state, and across the country. We can hear it in telephone calls, we can read it in records of patients looking to switch their care, and we can see it ...

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Smoking and drinking caused the cancer, which Ed ignored for a long time. By the time a doctor looked at the hole in his neck, the mass had congealed the base of the tongue to the right side of the jaw and burst through the skin. A steady drip of pink tinged, foul saliva ran down the side of Ed’s neck. Ed, not being able to chew for months, was ...

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Prior to the release of DSM-5 in 2013, I referred at times to the pocket copy of DSM-IV parked in my office bookcase.  The main reason was to enter the right diagnostic codes on insurance forms.  I also sometimes quoted DSM criteria to show a patient that ADHD can’t arise in adulthood, that daily mood swings are not characteristic of bipolar disorder, or that six months of sobriety is still “early” ...

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Recently, CMS sent out press releases touting over $1 billion in savings from Accountable Care Organizations.  Here’s the tweet from Andy Slavitt, the acting Administrator of CMS: https://twitter.com/ASlavitt/status/768908822081667072 The link in the tweet is to a press release.  The link in the press release citing more details is to another press release.  There’s little in the way of analysis or data about how ACOs did in ...

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EpiPens have gotten crazy expensive, yes: $600 for a two-pack. Here are some alternatives that might help you save a few bucks. 1. Wait a few weeks, and see what Mylan does. Mylan, the company that makes the “EpiPen” brand of epinephrine auto-injector, has been under a lot of pressure lately to back off their unseemly price gouging. They’ve introduced a savings card that claims to lower your ...

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“So, will you go get me a bedpan?” The bar was fancy, so I let it slide. This was not the first time my response to an occupational query was followed with a statement about bedside toileting; people just don’t know what to do when an educated, confident woman says she’s a nurse. I smiled tersely, as I have trained myself to. In past years, I’d offer varying responses: anger, heated debate. ...

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I was treating John W., a psychiatric patient who was an insurance executive. He was angry about his work situation. He complained bitterly about his supervisor whom he felt singled him out for unfair criticism. Over the course of months, John’s complaints escalated to the point where he said, “I swear … if there was a chance I’d get away with it, I’d love to get rid of the guy.” I ...

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Medical training in the United States is a long and tedious process. It begins in college, when one must complete the mandatory prerequisite curriculum and take a medical entrance exam; your score on which is directly compared to other applicants, immediately labeling you as a competitive candidate or not. The process of applying requires the completion of multiple comprehensive applications, the compilation of countless hours of research, clinical experience, letters ...

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You are currently on inpatient wards and notice your chief medical resident has been demonstrating erratic behavior, frequently muttering about MEN syndromes and antibodies associated with rheumatologic diseases and has been reciting gene translocations. What is the most likely cause of her symptoms? A. Hospital-associated delirium B. Conversion disorder C. Symptoms related to completing an excess number of multiple choice questions in preparation for taking internal medicine boards If you guessed C, you understand what I have been going ...

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Until my physical ailments began worsening rapidly in my late 40s, I was a high achiever, proud of my "kick ass" attitude, thinking I was so competent I could surmount any challenge life threw at me. Life appeared to be straightforward, and I didn't understand why this didn't seem to be the case for so many other less fortunate folks. Though I worked hard for my accomplishments and sometimes struggled, there ...

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Ever since I started medical school, my friends and family will often ask my opinion on a new medical recommendation they recently read online or heard on the radio. The trouble is, many times their query falls upon my clueless ears, as it is the first I am hearing about that medical study. In this last year, as I diligently pour through my medical textbooks, or almost exclusively answer my ...

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Think keeping your life organized is hard? Try keeping your doctors organized. In this era of fragmented health care, patients find themselves in the impossible position of having to coordinate their care themselves -- a task that many can’t meet. Having multiple chronic medical conditions often means being subjected to a dizzying assortment of specialists, medical terminology, and tests that can quickly overwhelm patients. How many times have you found yourself in ...

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I recently was speaking to two doctors about newspapers. Neither of them subscribed anymore. “Who has time to read the paper?” they agreed. “And any news you need is free online anyway.” No big news there, right? Plenty of people -- in medicine and otherwise -- have made similar decisions since the rise of the Internet in the mid-1990s. But what was striking to me is that these were not millennial ...

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Last week I had an appointment with one of my well-controlled diabetics.  She has been in my care for the last six years.   Our usual cheery interaction turned sour when she stated in an accusing tone, “My husband is diabetic, and I talked to his doctor about the medication you have me on.  He says it is junk, and he only writes it for poor people, and he doesn’t understand ...

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