As a consumer and admirer of movies, I always look forward to the Academy Awards.  A celebration of the best movies and performances of the past year.  A night filled with spectacular performances, glamor, and amazing speeches. The speeches are truly special for me since we get a glimpse into the true character and soul of the award winners as they thank those who helped them along their journey. I feel like ...

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"I can do that?" During a recent morning practice session, a resident was presenting a patient who had had several episodes of syncope which culminated in a trip to the emergency room. She had a brief stay there, and on the discharge plan was written "follow-up with PCP and with cardiology."

We went through her history and physical examination, we talked about how to further ...

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If you were to sit in on any routine doctors visit, you are bound to hear a few things repeatedly. “Do you smoke? How much alcohol do you drink, if any? What is your diet like? How much exercise do you get weekly?” These are questions we are trained to ask as early as the first week of medical school. We are taught to treat not just the conditions a patient presents ...

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I am not God. Nor do I want to be, but I feel sometimes that my patients and their families do. When I entered the ICU early that overcast morning I knew judging from the throng of anxious people waiting outside that things were not right. He came to me straight away, his eyes haunting and sunken as if he hadn’t slept for the whole night. His body barely able to support ...

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I stared at the ceiling, my hands twisting the drawstring of my scrubs. It was midnight, and I was occupying one of the on-call rooms of the delivery ward. I was going to be observing my first infant delivery, a milestone in my education that had terrified me since beginning medical school. I had been advised to get some sleep, but I was too anxious. I closed my eyes reviewing ...

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Health care guidelines are produced in ever-increasing numbers. The National Guideline Clearinghouse, a U.S.-based public website compiling summaries of “clinical practice” (health care) guidelines, has over 1,000 entries and is updated weekly. The National Institute for Health and Care Excellence in the U.K. has over 180 clinical guidelines. The Conversation Health care guidelines cover all aspects of medicine, from using ...

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In no other field is change received with so much resistance and skepticism than in medicine.  The oath taken by physicians to “do no harm” is profoundly ingrained in the medical culture that any deviation from tradition is regarded as near blasphemy. As a physician, I frequently catch myself relying on superstition and past experiences more than on evidence and proof of progress.  As the world is witnessing an unprecedented technological ...

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STAT_LogoOn March 17 at noon, about 18,000 medical students will open envelopes telling them where they will spend the next several years of their lives. It’s residency Match Day, and for many, that letter is one of the most important they will ever receive. The process is supposed to be straightforward. Medical students, like me, submit applications to hospitals and health systems ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril. On physical examination, temperature is 35.8 °C (96.4 °F), blood pressure is 120/68 mm Hg, ...

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A recent publication in JAMA Internal Medicine clearly demonstrated that female physicians were able to provide better care when compared with their male counterparts. Researchers from Harvard University studied the relationship between physician sex and 30-day mortality and readmission rates of over 1.5 million Medicare patients between the year of 2011 and 2014. What they discovered was that female physicians had lower mortality and readmission rates ...

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In August of 1991, I became a family practitioner in the United States Air Force and was sent to Clark Air Force Base in the Philippines. During my time there, I was asked to go on a medical mission. This experience struck me with the missionary bug to provide my talents and to care for others in another country. With medications that were near expiration date in USAF stock and ...

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The SOAP note isn’t what it used to be. And what it has become needs to be scrapped, because it has made the office practice of medicine cumbersome and unsafe. In simpler times, when medical records were written by and for doctors, the SOAP note represented a significant leap forward in expanding and organizing office notes and also notes from emergency rooms and walk-in clinics. Before that notes sometimes only documented ...

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Debt is destroying the lives of doctors everywhere. The cost of getting an education has moved into the ridiculous range. Many doctors are now starting their practice so far in the hole, that they do not see the way out. I would not have been able to start on my debt-free journey (I peaked at more than $600,000) if I had not developed a new attitude toward debt. Putting debt into ...

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The year was 1976. I was graduating from a small branch of my state university with a bachelor's in chemistry when I first applied to medical school. I was living at home and paying my own tuition. There were no physicians in my family, but I became interested in medicine after I was impressed with a surgeon who had operated on my shoulder. I had a better-than-the-medical-school-acceptance-rate average on my ...

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An excerpt from Five Moments: Short Works of Fiction. “Dad ... you can let go now.” Thomas heard his daughter’s voice from a distance. It awakened him from his reverie. He relived those five moments of life and took their lessons seriously.

  1. Rejoice in the ordinary as if you were a child seeing everything ...

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(This letter was jointly written by members of the American Association of Women Emergency Physicians.) We are writing to condemn James Green’s letter “Equal Pay for Women has Consequences” in which he suggested women be paid less than men as a matter of “simple economics.” This letter is heavily laden with bias against both women and men. The assumption that men need to ...

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To my beloved patients and your families, Over the years, it has been an incredible experience and honor to be allowed to enter into your world. It is a world that I know few people are privy to, and it is an intimate world where the deepest questions about life tend to arise. I know that when you are confronted with sickness that leads you into this world, it can be ...

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After writing about the coming demise of the Affordable Care Act, I began to think, again, about why it costs so much to deliver health care in this country. If it were cheaper, legislation to make health care a right, rather than the randomly distributed privilege it is now, would be so much easier. Medical costs doubled every decade from 1960 through 2000. This happened in tandem ...

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A month into Donald Trump’s presidency, it is clear we are in for a wild and dizzying ride.  As is typical in matters of opinion, post-mortem analyses on how we got here are frequent and varied. However, I believe the Affordable Care Act was the iceberg which sunk Hillary Clinton’s ship.  Sure, there were both real and fabricated scandals which dampened enthusiasm among potential Clinton voters.  There were the emails.  There ...

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A report in the Journal of the American Medical Association (JAMA) shows that too few women with recently diagnosed breast cancer and at high risk of a BRCA genetic mutation received appropriate genetic counseling. And that testing for the mutation is a missed opportunity not only to improve treatment for these patients but also to prevent some breast,
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