I was recently at a meeting where some very influential physicians were discussing a question that I’ve been thinking about for a while: how do we find medical staff for rural emergency rooms and hospitals? It’s a tough question, because, increasingly, it seems that young physicians are trained to work in urban hospitals. Those are also the places these young doctors prefer to practice. Big hospitals and teaching centers in ...

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I’m three weeks into my second year of medical school, and my classmates and I are sharing feelings of being “old” compared to the first years on campus, who are “bright-eyed eyed and bushy-tailed” -- not yet jaded by med school bureaucracy, and (rightfully) excited by all the opportunities that lie ahead of them. I’ve also heard a few of them use an often-judgmental term that has always confused me: ...

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I have spent the last year doing a deep dive into my personal leadership style. I've done this for self-improvement and because some great leaders and mentors have challenged me to take a look at my skills. I’ve read countless blogs and books on leadership, specifically women leaders, and how they have succeeded at the helm. There are a million different things books will tell you to be if you want ...

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America’s opioid crisis is getting worse. The role of prescription opioids has both the medical establishment and the government justifiably worried. In response, the National Academies of Science, Engineering and Medicine released an official report on the crisis earlier this year. And, on September 21, the National Academy of Medicine released a special publication calling clinicians to help combat the crisis. As a ...

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When a drug is especially dangerous, or even potentially-maybe-especially dangerous, the FDA requires manufacturers to put a black box warning on the product insert. A black box warning is supposed to very explicitly say “buyer beware," more than just the typical list of potential side effects mumbled by Mr. TalkFast at the end of a drug ad.  It’s easy to ignore the wordy mumbling. The black box: That’s supposed to ...

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This past spring, I sat in a lecture hall at the Warren Alpert Medical School at the third annual Transgender Conference. A graduate of the Brown family medicine program, Alexis Drutchas, MD was the co-founder. I remember interviewing for residency and asking her what she was working on; she casually mentioned that she was creating a conference for the transgender community and medical community in the Blackstone Valley. Three years later, ...

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The current conversation regarding health care reform in the U.S. is essentially pointless. It can be boiled down into four statements: Obamacare stinks, so we need to get rid of it; Obamacare doesn’t stink, so we just need to improve upon it; the insurance companies are to blame, so a government single-payer system is the best idea; the government is to blame, and only the free market can fix health ...

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An excerpt from Born to Be Wild: Why Teens Take Risks, and How We Can Help Keep Them Safe. According to the National Sleep Foundation’s Sleep in America Poll of 2014, 75 percent ...

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American physicians deserve to be paid well for their work. As a physician, myself, I know what it takes to become a doctor in the U.S. Four years of late nights in the college library in hopes of achieving a GPA commensurate with medical school admission; then four years of medical school, which makes the college work load feel light in retrospect; then, in my case, three years of residency ...

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This week is National Primary Care Week, an opportunity to engage medical students and healthcare stakeholders in a national discussion around the tremendous role that primary care plays in our health care system. With so much debate about the high price of health care in the United States, too often one of the most effective methods of controlling costs is overlooked: primary care. A wealth of research continues to show that ...

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The news cycle over the last several days has been dominated by President Trump’s interjection into the row about NFL players refusing to stand during the national anthem.The media went into hysteria following his curse remarks, and a full-blown row has gone on to develop. Turning this issue into a national political one is a great shame on so many different levels, including not least the reality that ...

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“The fool doth think he is wise, but the wise man knows himself to be a fool.” – William Shakespeare I learned about the Dunning-Kruger effect at a medical conference recently. It certainly seems to apply in medicine. So often, a novice thinks he or she has mastered a new skill or achieved full understanding of something complicated, but as time goes on, ...

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asco-logo Starting a new job is always stressful -- the move from one institution to another, getting hospital credentials, obtaining provider credentialing for various insurances, meeting new staff, and adjusting to a new work “culture”. Having done my share of moves, these are nearly universal experiences.  However, as I find myself walking around the hallowed halls ...

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An eleventh nursing home resident has died after an air conditioning failure following last week’s Hurricane Irma. The Rehabilitation Center at Hollywood Hills, located outside of Fort Lauderdale, was one of 160 nursing homes that had no electricity and no air conditioning, as power lines across the state were decimated by the storm. Yet, it was the only nursing home facility in the state of Florida where multiple deaths occurred ...

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The day drags on; you hang in there until the job is finally complete. You are exhausted, tired, and sure something is clearly wrong. Arriving in the emergency department is never one of those moments you expect. Staff greetings are quickly followed by people taking your vital signs, pressure on various parts of your body, and placing you under X-ray machines. Symptoms come and go, and verdicts are read. Good ...

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Fatal police encounters can engender PTSD in non-white communities and forever impact interactions with police. In​ ​the​ ​last​ ​few​ ​years,​ ​we​ ​have​ ​witnessed​ ​in​ ​horror​ ​the​ ​erosion​ ​of​ ​trust​ ​between​ ​public​ ​servants charged​ ​to​ ​protect​ ​the​ ​community​ ​and​ the non-white ​communities​ they serve.​ ​The​ ​killing​ ​of​ ​Philando​ ​Castile​ ​and​ ​Charleena​ ​Lyles​ ​compounded the​ ​horror,​ ​as​ ​their​ ​violent​ ​deaths​ ​were​ ​witnessed​ ​by​ ​their​ ​young​ children,​ ​spouses and,​ ​for​ ​Philando,​ ​social​ ​media. ...

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The main character in the popular film Groundhog Day is caught in a time loop where he must repeat the same day over and over again. The U.S. Senate is now having its own Groundhog Day moment as it debates (yet again) a law to replace the Affordable Care Act. To add to the drama, Senator Bernie Sanders (I-Vt.) is promoting his single payer alternative popularly branded as “Medicare for All.” In a 
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As someone who talks to many physicians about burnout and life in medicine, I find myself having a lot of discussions about the circumstances of people’s jobs. Almost inevitably, there comes a point in the conversation where someone expresses dissatisfaction about an aspect of their contract or an additional responsibility that was placed on them. As physicians, we’re groomed to take care of patients. During training, we don’t talk about compensation, ...

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Replace like with like -- that is the basic principle of reconstructive surgery since its conception in the mid-1500s. Borrow from the healthy part of the body to rebuild the damaged part ... But what do you do when you have run out of places to borrow? What if there simply isn’t anything like it anywhere else on the body? How do you reconstruct something as complicated as the human ...

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RRegardless of specialty, no physician can truly provide patients with the care they deserve if they practice in isolation. In recent years, the health care system has acknowledged this reality by embracing greater collaboration and team-based care. With an aging population increasing the prevalence of chronic disease and life-threatening conditions, the timing couldn’t be better. For the field of dermatology, the American Academy of Dermatology’s recent Burden of ...

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