Inscribed on a plaque just below a statue of an eagle in front of my hospital is a famous quote from President Abraham Lincoln that begins, “To care for him who shall have borne the battle ...” It is the reason why the Veterans Affairs (VA) system exists. It is the reason why we VA physicians come to work each day. I am honored to care for our special patient population, ...

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As a primary care provider practicing in the safety net, I work with incredibly diverse patients with chronic illness. My patients have a wide range of beliefs and preferences about how to best manage their health. I believe their varied perspectives, if more widely shared, could meaningfully improve health care. I also do research on health information technology, and in that sphere I have listened to talks and spoken with many ...

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I had two experiences recently that reminded me that many doctors and nurses remain resistant to measuring and improving how patients experience the care we provide. One was a face-to-face discussion with a senior physician. The other was reading an article by a nurse. Both the doctor and the nurse denounced the growing focus on the patient experience by citing the threat to the quality of care, and I believe ...

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shutterstock_132480524 LabCorp, one of the largest outpatient lab providers in the USA, is soon going to let you skip the tedium of a doctor’s visit to get lab work done. Want some tests? Come on down! I’ve got mixed feelings about this. While there are some tests that seem reasonable for people to do on their own -- pregnancy and HIV ...

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We received the report of the 2015 Dietary Guidelines Advisory Committee some weeks ago. Some months from now, that science-based report, politics, and a whole lot of pestering will come together, and we will get the actual Dietary Guidelines for Americans 2015. That's how it works, which I presume most people in this country at least already know. We have Marion Nestle to thank for first shining ...

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google-autocomplete

While Google's autocomplete can be quite convenient, albeit creepy, it can also be pretty mean. I decided to see how Google's autocomplete felt about various medical specialties. Apparently a lot of specialties are stupid and useless.

anesthesia

cardiologist

derm
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Imagine patient-centered care explained as a kind of updated Norman Rockwell painting. What you’d get is a recent PBS documentary, Rx: The Quiet Revolution, which, yes, uses a famous Rockwell image of a kindly family physician (Doctor and Doll) to set the stage for what follows. Putting patient-centeredness into practice The 90-minute film, available for viewing online, features four extraordinary stories of inspiring health care providers working in Maine, Mississippi, ...

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shutterstock_150470876 I became a doctor because I was excited by the idea of helping people every day. Following a lifelong fascination with science, I found myself in medical school, surrounded by bright classmates. We bonded over late night study sessions at the library and kegs of beer after each exam. As all medical students do, we memorized the 640 skeletal muscles that ...

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As an internist, working in the emergency room feels at times like the dark underbelly of medicine. The frenetic pace, the need to make decisions within highly uncertain conditions, and reliance on technology all cut against the grain of the internists credo of “being a doctor’s doctor.” If internists are biased in how they arrive at diagnoses, emergency medicine doctors face such bias on an exponential scale. Clinical decision-making is ...

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medpagetodayFrom MedPage Today:

  1. How to Rein In Out-of-Control Healthcare Costs. We all know the medical bill horror stories, but now we have to act on them.
  2. More ED Visits Since Obamacare. One objective of the Affordable Care Act was to increase access to primary care and curb visits to emergency rooms. Now ...

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Scalability is the end goal of nearly every tech start-up, systems innovation, and teenager you-tubing their cat -- it’s going viral, business-style. And traditionally, it’s been seen as a marker of relevance and success. Growth is good, right? But in health care systems transformation, do we lose something meaningful when we measure the value of our work by its national impact? Take Iora Health, a new health ...

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The government has doled out nearly $20 billion in incentive payments since 2010 for its meaningful use program in order to nudge physicians towards adopting electronic health records (EHR). U.S. hospital systems and physician practices pay billions annually to EHR vendors in order to qualify for those meaningful use incentive dollars and prevent penalty payments in the future. EHR adoption has modernized the practice of medicine in innumerable ways. However, documentation ...

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“It’s good to see you brother!” I had never met this man, but I knew exactly what he was talking about. With a large smile on his face and a look of pride, he extended his arm to give me a handshake. “There aren’t too many of us doing what you do. I’m glad we got some representation in here.” I am a black man in the medical field. When I ...

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Patients are gradually becoming more aware of the value of second opinions on their pathology slides. When there is a significant change in the diagnosis, the decision to get a second opinion can be life altering and even life-saving. A recent example is the case of Rita Wilson, where the self-initiated second opinion of her breast biopsy resulted in a change in diagnosis from a non-invasive lesion ...

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When a terminally ill but mentally competent patient wishes to die, should a physician be allowed to bring about such wish? The California legislature is considering that question, and physicians will soon be asked to weigh in on it. Until recently, so-called “physician-assisted dying” (PAD) garnered little support among doctors. Currently, however, enthusiasm in its favor is growing. What are the reasons given to justify this emerging practice? Do they ...

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Recently there has been a great deal of controversy surrounding the American Board of Internal Medicine (ABIM), and its board certification requirements. Currently, the board require physicians to take an exam and recertify every ten years in a process termed MOC, or maintenance of certification. The process is time-consuming and costly, and many physicians claim it does not improve their day-to-day practice. Doctors have become more vocal in their grievances ...

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medpagetodayFrom MedPage Today:

  1. Extra Weight Good for Type 2 Diabetes Patients? Overweight patients with type 2 diabetes were less likely to die in a decade-long study than otherwise similar normal-weight patients.
  2. CMS Touts Pioneer ACO Results. The "Pioneer Model" of an accountable care organization (ACO) saved Medicare about $385 million in its ...

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There she lay: a 59-year old woman who had become increasingly disoriented and confused. Not only did she have an infection in her bloodstream, years of alcohol abuse had taken its toll on her liver, leaving her skin yellowed. “Welcome to the ICU,” I thought. In contrast to my previous clinical experience, I found this patient encounter unsettling. No conversation. No personality. No interaction. She was nothing more than a body in a bed punctured ...

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One night while on call, I was sitting in a loud downtown restaurant when I received a phone call from the hospital. I didn’t think I would be able to hear the call, and so I scurried around to find a place to speak. The bathroom appeared straight ahead, so I rushed into the first empty stall, locked the door and took the phone call. After wrapping up with the ...

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shutterstock_166178981 At a recent block party, neighbors asked me questions about the life of a resident. It amazed me how little the general public still knows about the hours a resident works. Over the years, TV shows have shed some light on what the experience of a resident is like, although none are quite realistic, but it is hard to appreciate from ...

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