The e-patient movement represents everything that is positive in medicine today.  This grass roots force has introduced shared decision making and empowered both physician and patient.  The quality of health care dialogue has risen meteorically both in the exam room and out.  Today's health care "consumer" is more engaged, more intelligent, and more agile at wending their way through the confusing maze of sickness and health. It's awfully sad that it ...

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As Ebola spreads, what can we do to help? Last week, after dinner, as I was rinsing the dishes, I casually mentioned to my wife, "I spoke with the volunteers at Doctors Without Borders today, and they need help." This was before the first case of Ebola was diagnosed on U.S. soil. A pregnant silence fell in the kitchen except for the clattering of dishes and the boiling of water as ...

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It’s funny to think that the internet and the online world, so entrenched in our modern day lives, is still a relatively new phenomenon. When I first started medical school (not really that long ago) we hardly used the internet and the concept of a web search barely existed. It only became widely available on home computers shortly after that. The invention of social media is newer still. If any of ...

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Recently, I have been reflecting more about my musical journey as an organist over the past 15 years. It has been great to learn how to continue my medical training to the best of my ability while still trying to keep my musical interests alive. Despite the busyness of medical training, I have thankfully had opportunities to perform publicly, as well as meet other musicians. I began ...

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To be or not to be: An artist in medicine “Why would an artist want to go to medical school?” It was a good question, and one of my favorite questions asked of me during my medical school interviews. I am what one might define as an artist, and yes, I really wanted to go to medical school. I was a photographer, musician, composer, and actor. I loved the arts and they ...

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The EHR report card 2014: Has it gotten better?A guest column by the American College of Physicians, exclusive to KevinMD.com. A little over two years ago in this blog, my “EHR report card” evaluated the effect of the electronic health record (EHR) on my practice. I thought it would be interesting to see how things have changed.  As in 2012, I will not identify my ...

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Top stories in health and medicine, October 16, 2014From MedPage Today:

  1. Pfizer, FDA Square Off on Chantix Psych Risk. The maker of the popular stop-smoking drug varenicline (Chantix), Pfizer, says new data indicate the risk of suicidality and other serious psychiatric events is not as great as once thought, and has applied to the FDA to remove a boxed warning on those ...

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I had little doubt the long-rumored Apple Watch would be cool. U2′s live concert and surprise album announcement at Apple’s unveiling a few weeks ago only reaffirmed the company’s ability to launch a product unlike anyone else. Cool or not isn’t the question. Usefulness is. The iPhone and iPad radically changed how people lived their lives. The first generation of the Apple Watch won’t. The health application One way Apple hopes to increase ...

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Happy BRA Day! October 15 is officially Breast Cancer Reconstruction Awareness Day. It’s a natural time to discuss commonly-asked questions about breast reconstructive surgery. Breast cancer is a devastating diagnosis and the treatment tends to have a direct impact on a woman’s self-esteem, especially if there has been a mastectomy or partial mastectomy. Just knowing breast reconstruction is an option is consoling; it offers hope for many patients. Yet physicians and ...

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Is it about physician drug testing?  Is it about allaying the pain and suffering of families of patients whose outcomes have been devastating and tragic?  Is it about the compensation of the legal counsel who represent those families and patients? Truthfully, I don't want to talk about 46.  I think the issue is very much deeper and the process that underlies medical malpractice litigation has consequences for individuals and society that ...

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Nurse Nina Pham is a hero: Stop blaming her The director of the Center for Disease Control (CDC) in Atlanta, Georgia apologized for implying that the nurse in Texas was responsible for her own infection with the deadly Ebola virus. This comes less than two weeks after hospital officials from Texas Health Presbyterian Hospital and other prominent officials blamed a different nurse for releasing the patient with Ebola from the emergency ...

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Breast cancer awareness: Its more than mammogramsIt's October and that means we are about to see a lot of pink for the next 31 days. And virtually all of the work comes down to one simple -some might say overly simple-message: Get a mammogram. But as National Breast Cancer Awareness Month (NBCAM), begins, I find myself one again asking some difficult questions: Are we ...

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As part of the admission process for a hospice patient, the admission team will ask the patient about their spiritual orientation and/or religion. Because there is so much information and education to convey at the admission, the discussion of a patient’s spiritually may only be minimally discussed. It is important for the hospice team to be aware of a patient’s spiritual orientation because it can affect their choices regarding treatment ...

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Ebola in Texas: A fascinating story of system errors Ebola is in the United States!  Everybody (please don't) panic!  Quarantine all Texans!  Though that might be a good idea anyway (just kidding).  More on Ebola in general in another post if I have time. First off though, we've found out more information about the sequence of events leading to the hospitalization of the patient, Thomas Duncan.  Apparently, he came ...

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Top stories in health and medicine, October 15, 2014From MedPage Today:

  1. Ebola: Are Community Hospitals Up to the Task? With the announcement that a nurse in Dallas contracted Ebola while caring for an infected patient in a community hospital, calls are increasing to treat the disease only in centers specializing in treatment of highly contagious and highly virulent diseases.
  2. Unneeded ...

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See Ebola through the eyes of the virus As you no doubt know, Ebola has been brought to the U.S. Predictably, this has resulted in a media feeding frenzy, rumination, recrimination, and the familiar blend of hyberbole and hysteria that tends to populate those infamous 15 minutes during which any given crisis holds our attention. No, we are not suddenly at risk. As the media coverage spells out, the ...

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An ER missed Ebola.  Heres how it could happen to you. How did the emergency department staff of a Texas hospital see, and discharge, a patient infected with Ebola? Despite the fact that blame spreads through hospitals faster than hemorrhagic fever viruses, I’m not interested in pinning down a single person, or a single thing, which may have allowed that to happen. I am very interested, however, in offering a few insights ...

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Earlier this year, our hospital staff was weighing a new 24/7 family presence policy to allow immediate family members to stay with  patients 24 hours a day. We knew this was a step in the direction of delivering patient- and family-centered care. We presented the proposal at a meeting of our patient and family advisory council.  One of the members of the council told a story that drove home the importance ...

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During most of my career as a psychiatrist, I haven't often dealt directly with death. For the past five years, though, I have had the privilege of spending two days a week treating service men and women returning from deployments in Afghanistan and Iraq. Listening to their stories and talking with them about their war experiences, I've spent much more time thinking about death and dying. Despite this, I was shocked ...

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In August, I posted this: "A paper of mine was published. Did anyone read it?" A recent comment on it raised an interesting point. Dr. Christian Sinclair at Pallimed said the site had received almost 2 million views since 2005. He then made the following calculation: Two million views with an average of 1:30 minutes on a page = 3 million minutes = 50,000 hours = 2,083 days = 5.7 years ...

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