Atul Gawande is the preeminent physician-writer of this generation. His new book, Being Mortal, is a runaway bestseller, as have been his three prior books, Complications, Better, and The Checklist Manifesto. One of the joys of my recent sabbatical in Boston was the opportunity to spend some time with Atul, getting to see what an inspirational leader and superb mentor he is, along with being a warm and menschy human being. In my continued series of ...

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ESPN sportscaster Stuart Scott's recent death has given the American public a chance to reflect on what it means to live with a cancer diagnosis. His speech at the ESPY awards in the summer of 2014 was widely hailed as an inspiration to people with cancer. Obviously, the Jimmy Valvano Award for Perseverance with the ties to cancer research (Jimmy V Foundation) and Scott's public image as someone being ...

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It was a rather unlikely place to begin my clinical career. Shortly after starting medical school, I signed up to volunteer in the hospice unit of my academic medical center.   The first few visits I relegated myself to fairly banal activities.  I shredded old medical records, or I might do a load of laundry for a family member who had been waiting tentatively by their loved one's side and was ...

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medpagetodayFrom MedPage Today:

  1. CDC: Most Nosocomial Infections Fall. Rates of most major types of healthcare-associated infections have declined markedly in recent years.
  2. RA Patients More Likely to Abandon Remicade. Rheumatoid arthritis (RA) patients were more likely to discontinue infliximab (Remicade) than adalimumab (Humira) and etanercept (Enbrel) in the first year of biologic ...

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shutterstock_74650402 Dangerous ingredients, like toxins, antifreeze, and mercury, are touted by many as reasons to decline vaccination against influenza. However, toxin is an inaccurate term regarding vaccines (a toxin is a poisonous substance made by cells or organisms and is definitely not in any vaccine), mercury is a non-issue (see below), and there is no antifreeze in vaccines (although some contain propylene glycol, ...

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Our children will never be the sole judge of our job as parents of course. We are likely our own closest and most fastidious critic. And really it’s just us (and our partners) that can truthfully reflect and evaluate how it goes as we raise our children -- what our hopes were when we started on the journey of raising another and where we find ourselves. And so, however radiant the ...

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As more doctors work for hospitals and large conglomerates, patient satisfaction rules.  And these physicians are saying, "My boss is CEO!"

For years, my husband and I have argued about how to dress the kids for cold weather (given that we have five kids ranging in age from 23 to 9, this argument truly has been going on for a while). He says I don't dress them warmly enough. I say he overdoes it. After all these years, I still think I'm right. But that doesn't mean I don't appreciate the way ...

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shutterstock_215289142 When my husband started medical school, we immediately got hooked on getting student loans. After spending years of being broke all through undergrad, we felt like we were getting “magic” checks in the mail. Life was good. We could go out to dinner, buy our son the toys we wanted him to have, go shopping. We were enjoying all the luxuries ...

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It was 11:47 p.m. That meant that I had 13 minutes to reach my pre-set goal of  “activity” that the fitness tracker on my wrist had been registering throughout the day. If I met the goal, I would get a “trophy” on the accompanying app. I probably looked pretty funny bouncing around my living room doing a squat here and a sit-up there, punching a pretend opponent, and running in ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. How many of you have heard a flight attendant or pilot announce, “We know you have a choice of airlines when you fly, and we want to thank you for flying with us”? Over the years, many other industries have adopted similar statements.  Continuing medical education (CME) ...

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medpagetodayFrom MedPage Today:

  1. Carotid Stenting Linked to High Real-World Mortality. Carotid stenting was associated with much higher than expected 2-year mortality in the Medicare population.
  2. 'Generic' Colchicine to Hit Market. A so-called authorized generic version of the colchicine formulation sold as Colcrys for acute gout flares and for treating familial Mediterranean fever ...

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Do physicians in training take better care of patients or perform better on their exams when their work hours are restricted?  Two recent studies in the Journal of the American Medical Association suggest that the answer is no.  In one, patients of surgery residents showed no difference in morality or postoperative outcomes after duty hour restrictions were implemented.  Their test scores did not improve either.  In the other, hospitalized Medicare ...

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A patient story tonight, from Jackie: It was one of those days.  I had been to the gynecologist the week prior because I somehow knew the sporadic bleeding, which I had experienced, was not a simple urinary tract infection for which I had been treated three times.  My doctor did the scrapings and biopsies and had me run down the hall for an ultrasound.  I’d had lots of ultrasounds during my pregnancies -- ...

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What defines a competent psychiatrist?  To staunch critics of the field, perhaps nothing.  Some believe psychiatry has done far more harm than good, or has never helped anyone, rendering moot the question of competency.  What defines a competent buffoon?  A skillful brute?  An adroit half-wit?  Having just finished Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, a reader might easily conclude that psychiatric competency is ...

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Most readers know that an EMR (electronic medical record) is the back-end software that runs a health care organization. EMRs have been around for a while. Recently most large hospitals and health systems have begun building out the patient-facing version of their EMR; allowing patients to communicate electronically with their doctors, refill prescriptions, schedule appointments, and view clinical information. I’ve written at length about the differences between B2B software and B2C ...

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When my husband and I stopped watching television a few months after we were married, we often didn't notice what had changed until we'd compare notes with friends.  "I miss my old hobby," a neighbor might complain, "but I just don't have the time."  And yet we'd see his head just above the back of the couch, silhouetted against his big screen TV for hours.  Not only did we regain ...

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In the past half century or so, medicine has changed the complexity of the human population as it has never been seen in the past. Think about it, there are people walking around today that fifty years ago, wouldn’t even be alive.   This evolution in medicine has not only brought about transformation in the human population, but it is also changing the approach of how clinicians need to treat these complex ...

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medpagetodayFrom MedPage Today:

  1. Managing Diabetes in Elderly: How Safe? Many older people with diabetes who have compromised health have been kept on intensive treatment regimens, which increases the risk of hypoglycemia.
  2. Supreme Court Battle Brewing Over Medicaid Fees. Rita Gorenflo's 7-year-old son Nathaniel was in severe pain from a sinus infection.

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I think it’s fair to say that digital health is warming up. And not just in one area. The sheer number and variety of trends are almost as impressive as the heat trajectory itself. The scientist in me can’t help but make the connection to water molecules in a glass -- there may be many of them, but not all have enough kinetic energy to ascend beyond their liquid state. ...

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