A friend of mine recently had a very sore throat. She knew how to manage her symptoms — lozenges, warm tea and the like. But she was worried she might have strep and would, therefore, need antibiotics. That should be a simple question to answer with a quick trip to the primary care clinic. Except that her primary care physician was booked, and if she wanted an unscheduled appointment with ...

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Even though I am over 40 — by a long shot — I am familiar with the abbreviation TMI. Today, we are inundated with so much noise, chatter and static. I feel that we are bombarded with information that we must sift through and ultimately delete. The news cycle is 24 hours and hits us from so many electronic sources simultaneously. I am deluged each day with so many unwanted ...

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The morning after the recent presidential election, I entered our clinic building feeling as though I was in a daze. Like many people, I had stayed up late following the election results and trying to understand what they meant for our collective future. I could see our country’s divisions fresh in my mind. I could picture the electoral map, with each state colored firmly either “red” or “blue;” I could ...

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We are like a restaurant that charges handsomely for sit-down dinners but gives away food for free at the takeout window. And we only pay our providers for serving the dining room guests. If traffic gets backed up at the drive-through, we hold our providers responsible, even though we never planned for our ever increasing demand for takeout. In simpler times, patients went to the doctor when they felt unwell, and ...

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Imagine training for ten years in an environment that is abusive, isolating, and stressful. Imagine going $250,000 into debt for that training. And imagine that at the end of all this, you have a 50 percent chance of being unsatisfied with your job. This is the path for physicians in this country. But why should it matter to everybody else? First, the short term: Quality of care will decrease. When the person in ...

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President Barack Obama, whether wittingly or not, invested his entire political capital in reforming health care in America. He gambled and lost. Not because he had nefarious intentions, but because he left the gory details to a corrupt Congress and a shady cadre of lying and conniving technocrats, ending up with something vastly different from what he campaigned on. From everything I’m reading now, President-elect Donald Trump is about to ...

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As health care increasingly propels itself into the world of corporations and big business, it may seem like the practice of medicine has entered an irreversible new era. Gone are the days of good old Dr. Wilson in his solo private practice around the corner, loved and respected by all his patients and the community. Nowadays, it’s all about mega multi-specialty groups, health care mergers and hostile corporate takeovers. Being someone ...

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During sports physical appointments, I routinely address preventive health topics that range from asking about alcohol, drugs, and sexuality, to addressing accident prevention and updating immunizations.  At one such appointment recently, a young male teen was due for two routine vaccines.  The mother accompanying him had no concerns about one of the vaccines, but expressed concern about the other. A friend had recently shared information on Facebook about how the ...

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The Affordable Care Act is perhaps the biggest overhaul of the U.S. health care system in many decades. Enacted by President Barack Obama in 2010, it made health care attainable and affordable to millions of Americans. Individuals with pre-existing medical conditions cannot be denied health care coverage; insurance companies have to cover essential health care needs including mental health and preventive services, children can be covered under their parents’ plans ...

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I remember that morning in January 2016 very well.  I opened up my Twitter feed to find many people linking to an article that made me stop dead in my tracks.  The New York Post was reporting that Dr. David Newman had been accused of sexually assaulting a patient in his emergency department.  He was accused of giving the patient a dose of propofol and then sexually assaulting ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man with type 1 diabetes mellitus presents to the office. He seeks advice on his diabetes management as he intensifies his exercise routine in preparation for participation in a 10-K race. He reports prolonged hypoglycemia during intense exercise, despite eating a meal prior to the activity. His insulin regimen ...

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Dear patient, I may never get to meet you, which is a real shame. I think I would have enjoyed getting to know you and working together with you to overcome whatever particular medical issue with which you had come to meet me. We might have learned about each other. We might have learned about our community. We might even have made some kind of change together. I myself am a patient, ...

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"I did a weekend of 72 hours in which I only got four hours of sleep. I would also secretly hope to get in a car accident and maybe break a leg so that I would be force to take off from work ... just so I could get some rest. Thank God, I never got in an accident, but I have had colleagues fall asleep at the wheel." - Dr. ...

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Dr. Pronovost is a leading figure in the patient safety movement, and is someone I greatly admire.  His work with surgical checklists is touted by Dr. Atul Gawande as having saved more lives than any researcher in the past decade.  However, I disagree with his latest initiative: to get hospitals who perform certain procedures at very low rates to stop performing them altogether. On the surface, it seems like a ...

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Why am I here? It’s already a half hour past the end of my 12-hour hospitalist shift, and I’m hustling to finish admitting a new patient from the ER. Once I finish, I still need to see patients at another facility before I finally wrap-up for the night and head home. Staying late is a professional courtesy for tonight’s nocturnist nurse practitioner. Nocturnist mid-level practitioners are a unique breed of ...

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We live in a world that is rapidly evolving and changing. The future is uncertain as policies change, as well as politicians. No one can predict what 2017 or future years will herald. We watch as dozens of news stories pour into our mobile apps every time we check in. And for those of us that practice medicine, health care research, and news coverage can change the way we approach ...

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Anti-immigration policies are hazardous to the health of immigrant patients. In the last ten years, there have been over 1,500 anti-immigration laws adopted by states across the country. These laws have come with discriminatory, racist, and xenophobic undertones, which has created a hostile environment for immigrants and citizens perceived as immigrants. Patients don’t need to be deported or detained to be harmed by these policies, laws, and language. Research shows an ...

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A huge thank you for your continuing readership in 2016.  I sincerely appreciate the vibrant KevinMD community, driven by your readership, contributions, and conversations. KevinMD is about to enter its 13th year as the leading platform for the voice of the health care professional.  I look forward to another great year. Here are the most popular posts of 2016: 1. An open letter to Justin Timberlake 2. The opioid epidemic: It’s time to place ...

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In January, the National Academy of Medicine is launching a new committee to address the high rates of depression and suicide among physicians and other health care workers in the United States.  They plan to bring together medical professionals, educators and hospital administrators, and I hope they will also bring to the table professionals who have experienced burnout, and who may have attempted suicide due to burnout.  I say this ...

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Recently, Dr. Michelle Herren, a professor of pediatric anesthesiology at the University of Colorado and Denver Health Hospital, resigned after posting racist comments on her Facebook page. In particular, she wrote that Michelle Obama speaks “ebonics” and stated that our first lady has a “monkey face.” Dr. Herren ended her post by affirming that she is not racist but was “just calling it like it is.” This post remained on ...

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