Dr. Oz is going to love this one. At least, I think that he will. I've never actually met him. To be honest, I wouldn't have a clue as to whether he's really a good guy or not. In fact, I suspect that he's never read my book, but I did devote almost an entire chapter to him, because he intrigues me by being a physician businessman. All I can tell you ...

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Our health care system needs more physician leaders. Physician-led accountable care organizations have been shown to improve the quality of patient care while reducing overall costs. Physicians, by their nature, tend to be goal-oriented, have the ability to gather and assimilate evidence, and make difficult decisions, but these traits do not always translate naturally into leadership skills. We are trained to make a diagnosis and map out a treatment plan ...

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shutterstock_124837006 We recently had a session hosted by the medical education staff at our school where we were encouraged to share any difficult situations encountered in clerkship (submitted anonymously beforehand if that was preferred) and discussed them as a class. Issues regarding ageism, sexism and racism were brought up and addressed with the group. While I have not encountered any of the ...

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Everyone deserves a chance to be healthy. Physicians, of course, focus on helping patients. Unfortunately, I often see patients’ frustrations with the health care system itself directed toward doctors. Meanwhile, doctors are under increasing pressures on multiple fronts. Yes, we’re imperfect, but making physicians the primary focus of patient anger will not solve problems we all face as humans who will, at some point, need health care. (Note: I’m using doctors ...

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shutterstock_2262685 We have met the enemy, and he is us. -Pogo (a comic strip character of Walt Kelly) I doubt that physicians would have supported the creation of the American Board of Medical Specialties (ABMS) in the early 1900s if they had known that eventual maintenance of certification (MOC) might be used as requirements for re-licensure. In my state of Connecticut, we already have continuing ...

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As a faculty member, I’ve encountered many medical students excelling inside and outside of the classroom. Students can be recognized for their contributions through scholarships, awards, and grants. Whenever I can, I try to direct students to these opportunities. It’s been a great joy for me to help students win scholarships, and here’s what I’ve learned from award recipients. 1. Your ability to develop strong relationships with faculty mentors is crucial ...

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BottnerWeightLoss I am a recovering addict. My compulsion started when I was 10-years-old. I remember thinking about when I would get my next fix. These feelings got in the way of my ability to perform scholastically and socially. I yearned not for marijuana, cocaine or heroin, but for something with much easier access and profound availability. My drug was food. By the time I was ...

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To critics who admonish emergency physicians like myself for our excessive use of CT scans, I’ll ask them to consider the leaf blower. I’m sipping my morning coffee on our front porch, a bright, idyllic autumn day in New England, the tranquility ripped apart by the landscapers across the street. For many jobs, a powerful leaf blower might prove superior to a rake or broom. But in my neighborhood known ...

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Ear infections (or, what we like to call “acute otitis media”) are one of the staple diagnoses of pediatrics. Most kids have at least one before their third birthday.  And most pediatricians see at least one every day by 11. You would think we would always get it right. But I have a confession -- we don’t. In fact, children are misdiagnosed and over-treated at an alarming rate. There are several reasons for ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old man is evaluated in the emergency department for a 3-day history of fever and chills as well as confusion. He has a 5-week history of a nonhealing ulcer on the plantar surface of his left foot. He has diabetes mellitus, hypertension, and peripheral vascular disease for which he takes metformin, ...

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It’s really quite easy to kill a doctor. Here’s a step-by-step process guaranteed to succeed at least 400 times a year: Start early. Be sure to denigrate medical students whenever possible. Even if they’ve come to the profession later in life and have accomplished all kinds of amazing things personally and professionally (which don’t count, of course, since those are other professions) they don’t know squat about medicine and you do. Make sure to emphasize ...

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During the MOC debate that JAMA sponsored, I was asked what I would do if “I were king” of MOC. As an internist, I believe in first making a diagnosis, then prescribing a treatment. So I have spent time diagnosing my needs as an internist. When I passed my boards I showed knowledge competency. But medicine changes over time. We have major advances and changes since I took my boards. Some examples follow:

Sexism is a major problem in education around sciences, technology and engineering. The first step in addressing this problem is awareness. A new study suggests many men deny that sexism is a problem in STEM fields. A study in Psychology of Women Quarterly says that that among 423 respondents in an online forum, men were more likely to suggest sexism isn't a problem even when confronted with evidence it is. Wow, men are ...

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I arrived at my designated gate at Chicago’s O’Hare Airport.  After handing over my crumpled boarding pass for scanning, I made my way down the jetway and onto what appeared to be a small but fairly packed little jet. Passengers on each side of the aisle eyed me as I walked past, a few noticed that my jeans were soaked from the knees down. Some caught the odor that trailed ...

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As part of a plan to improve our practice's quality of care for patients with high blood pressure, my office's nurse announces at every morning huddle which patients on that day's schedule had a blood pressure measurement of greater than 140/90 at their last visit. Most of these patients have measurements consistent with mild hypertension (systolic blood pressure less than 160 mm Hg and/or diastolic blood pressure less than 100 ...

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The case of Cassandra C., a 17-year-old in Connecticut who refused to continue receiving chemotherapy to treat her Hodgkin’s lymphoma, poses a genuine ethical dilemma. The dilemma stems from a conflict between two leading ethical principles. One principle, respect for autonomy, calls for respecting individuals’ right to self-determination. In the medical context, that means allowing people to refuse medical treatment, even lifesaving therapy. The other ethical principle, beneficence, directs physicians and hospitals to ...

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medpagetodayFrom MedPage Today:

  1. Current Flu Vaccine Half as Effective as Previous Years. People receiving this year's seasonal influenza vaccine are 23% less likely to seek medical treatment for flu-type symptoms relative to unvaccinated individuals, according to an interim CDC estimate based on reports submitted so far for the current season.
  2. New Board ...

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A front page entry in a recent issue of Anesthesiology News: "Physicians Versus CRNAs: Redefining Roles in the Changing Landscape of Health Care."  Sounds like a prize fight or a gang war: Crips vs. Bloods.  I immediately got my boxing gloves on, readying myself for another bout of vitriol and dislike thinly disguised as concerns for patient safety.  But the author, Michael DeCicca, a second-year anesthesia resident, surprised me. He writes: “Logically the ...

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Doctors have a difficult time adjusting to other cultures and because of this flaw, patients, and the medical profession suffer.  By culture, I do not mean religious or philosophical background, socio-economic difference, country of origin, nor even the silence created by language and education barriers.  I am referring to the communication and comprehension chasms that exist between different occupations and physicians. What are the core values and guiding principals of medical ...

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Last year, I underwent a colectomy, a surgery that removed my entire colon. Afterwards, I had to wear a temporary waste-collecting pouch attached to my abdomen known as an ostomy. Until my next surgery, I was now an “ostomate.” One of the early side-effects of the surgery was that I was prone to bouts of severe dehydration that left me hospitalized for a few days. During one of my dehydration-related ...

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