After years of declining rates of colorectal cancer (CRC), a study from the American Cancer Society raises the specter that not all is going as well as we would have hoped, especially among younger folks born since 1990. And that raises the question of what the future holds for this frequently preventable form of cancer, ...

Read more...

On my first trauma shift as a fourth-year medical student, a young, disheveled man with blood-soaked pants hobbled into the emergency department. Wincing in pain, he offered me a bizarre history of being shot in the leg by a nail gun that went off after he dropped it on some stairs while helping a friend move. He lifted his right pant leg and removed the bloody, tattered bandana wrapped around ...

Read more...

Two years ago, former President Barack Obama announced the Precision Medicine initiative in his State of the Union Address. The initiative aspired to a “new era of medicine” where disease treatments could be specifically tailored to each patient’s genetic code. This resonated soundly in cancer medicine. Patients can already manage their cancer with therapies that target the specific genes that are altered in their particular tumor. For ...

Read more...

After Michael Uvanni’s older brother, James, was diagnosed with a deadly form of skin cancer, it seemed as if everyone told the family what they wanted to hear: Have hope. You can beat this, and we are here to help. The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence. Michael Uvanni was in awe when he visited the University of Texas ...

Read more...

Congress has returned to DC in the wake of the defeat of Paul Ryan’s American Health Care Act. And while shouting "repeal and replace" might win elections, this debacle proves that the American people will not tolerate their families, friends, and neighbors losing healthcare coverage just so rich people can get tax cuts. Yet, Congress will certainly revisit health reform again. With the Republican caucus fractured, Paul Ryan should seek out ...

Read more...

There has been much talk over the years about resident work hours. How long is a safe shift? With safety being considered for both the patient and the resident. But no one ever discusses attending work hours. If putting in a 24-hour shift is bad for a resident, isn’t it bad for an attending as well? When I was working in critical access hospitals, I usually was on call for ...

Read more...

STAT_Logo

As New Jersey Governor Chris Christie takes the lead in crafting the Trump administration’s response to the opioid crisis, he and his colleagues need to understand that we can’t fix the problem until we kick our long-term addiction to the war on drugs and accept overdoses for what they are: a health ...

Read more...

Walk with me, why don’t you? It’s time, don’t you think? We have been avoiding this for quite a while. But it's best to bring this out from the shadows and into the light. Let’s take a walk through part of my day. Be careful. You won’t like what you see. I don’t like this much, but I just keep moving forward, one foot in front of the other. Don’t stop. Can’t ...

Read more...

Physicians spend a lot of time counseling patients on the phone. Often, these conversations occur at night with patients we have never met before. When I am on-call in the evenings or on the weekends, these are some typical phone calls I receive from patients I have never met.

  • I have a very bad stomach ache for the last hour.
  • I started having rectal bleeding an hour ago.
  • My wife tells ...

    Read more...

The New Scientist wonders if Serena Williams pregnancy is making her a better athlete?|This is a new low in “pregnancy angles.” I often get asked to comment on celebrity/athlete pregnancies, and I always decline. Why? Partly because I don’t want my name in articles like this, but also I don’t care what anyone does in their pregnancy and neither should you. If a celebrity or athlete is offering ...

Read more...

Recently, someone close to me was diagnosed with cancer. Due to a series of missed phone calls on both sides, he had not heard the results of his biopsy prior to his follow up appointment. When his young doctor walked in, he started with, “So you know you have cancer, right?” I just wanted to scream, “What the f*ck!”  It is never easy to give someone bad news, but this ...

Read more...

This is an open letter to everyone everywhere, especially people who live in small communities such as mine: If you drive to work, you are missing out. If someone offered you an opportunity to improve your health, enhance your happiness and creativity, boost your self-esteem and even make you richer, what would you say? Many might think it would be an offer that was too good to be true — a ...

Read more...

The consultant note read:

Weight 250 lbs. BMI 40.3.  Patient is morbidly obese.  Counseled on the dangers of excess weight.  Counseled to increase exercise and decrease calories.
I walked into her room.  She smiled at me as I walked in, a lovely smile that reached her eyes.  I scanned her record.  She was in my office for an ankle injury.  Blood pressure normal.  Weight 248 lbs., BMI 40. When I looked back at ...

Read more...

Recently, our three-year-old wandered into our bedroom around 4 a.m. waking me up, saying he was scared. As I did the previous few nights when he did this, I muttered a curse word to myself and picked him up to carry him back to his room. Upon lifting him, a wrinkle in the routine emerged — he was naked below the waist. At some point, before he entered our room, ...

Read more...

Patient-centered care (PCC) seems to be a popular buzzword among policymakers and administrators in recent years. Indeed, many physicians see our health care system as payer-centric, many patients see it as physician-centric, and no one seems to see it as patient-centric. While putting the patient at the center of what we do as physicians is critical to improving the triple aim of better care, better health, and lower costs, it ...

Read more...

I met “Samantha” during my first rotation as an intern. She was a strong-willed and optimistic lady who weighed about 100 pounds. She was dependent on a tube in her stomach for nutrition, and she appeared 10 or 15 years older than her age of 44 years. Pictures of her children were next to her bed. I asked her how we could help her. She cried. Her husband of 20 years ...

Read more...

The Affordable Care Act Medicaid expansion resulted in unanticipated negative consequences for many patients and physicians in rural, underserved or medically isolated communities across America. Consolidation of health care entities was financially incentivized by the ACA, and slowly my beloved corner of the Pacific Northwest is becoming a medical wasteland. In a beautiful community on the Olympic Peninsula, just north of where I live and practice, it happened again; another private ...

Read more...

The Trump administration has made clear its intentions to drastically reduce the size and intrusive nature of government. Let’s hope that extends to the Medicare Access and CHIP Reauthorization Act, otherwise known as MACRA, the heavy-handed new government “value-based payment” program for medical care, enacted in 2015, and set to rear its ugly head beginning this year. MACRA must die. MACRA is administrative overkill in an industry already overburdened by ...

Read more...

Recently, I watched a disturbing video of a fellow physician being dragged out of an airplane. I find it hard to understand how these events unfolded despite Dr. Dao being a customer who chose to fly United, paid hundreds of dollars for his ticket and legally boarded his flight. Whether blame belongs with United or the Chicago Department of Aviation, this was an unsettling occurrence. Yet somehow — I wasn’t ...

Read more...

The media is quick to point out the important role of American Medical Association (AMA) and other professional bodies in shaping the future of health policy in the United States. While these organizations have a certain responsibility, it is becoming increasing clear that medical and public health students will shape the future of post-Obama health care landscape. Recognizing their role is pertinent. While physician members from AMA are the practitioners of ...

Read more...

Most Popular