So let’s step outside our traditional arguments when discussing the health care problem of gun violence in this country. We all know the entrenched opinions of both sides: The second amendment is inviolable vs. there are over 30,000 deaths from guns per year in this country, and why on earth does anyone need an assault weapon? But the city with the strictest gun laws, Chicago, has the most gun deaths, ...

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Every medical couple knows that the lifestyle and career choice brings with it adjustments and sacrifices. Physician spouses and partners often take on more housework and childcare to accommodate long working hours. Physicians may work unusual hours that lead to late-night arrivals, missed bedtime tuck-ins, and less face-to-face time. This can lead many couples to blame medicine for their struggling relationship. Take the example of a resident who has been working ...

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Cancer. The ominous word instantaneously triggers fear and anxiety. According to the American Cancer Society, cancer is the second most common cause of death in the United States, accounting for one in four deaths. Despite the attention cancer has garnered, an inequality exists. Patients without Internet access may not learn about possible therapeutic interventions. As we proceed with the “Moonshot” to better control cancer, we must assure that all patients ...

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It was 1 a.m. on a Sunday night on call, and we were waiting patiently for admissions in the resident workroom. We were four near-perfect strangers, yet we had one thing in common: our challenges we faced in maintaining relationships. Was it truly because of our shared profession of medicine or because of our similar personalities that led us into the field? We realized we struggled preserving our current relationships ...

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Dear future colleague, What a tremendous thing it is to know you are becoming a physician!  You are devoting your life and talents to the betterment of the health of your future patients, your local community, and our entire society.  You have responded to the call to serve in a profession that is hundreds of years old, steeped in tradition but vehemently progressive, always changing, and vowing to remain abreast of ...

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Burnout is a tragedy.  It terminates careers, friendships, marriages and sometimes lives, prematurely.  It threatens the well-being of individuals, families, patients, organizations and our society. The current media focus on the crisis of physician burnout is appropriate and timely, but the industry itself needs a reality check.  While burnout is experienced by the individual, it is the manifestation of a dysfunctional environment that only we as physicians and leaders in ...

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I recently gave a teaching workshop focused on giving feedback. Thrilled to share my passion for medical education, I excitedly prepared my slides, ready to discuss tools that can help make someone a more effective educator. Despite the evidence and the recommendations from well-known educators I presented, there was an attendee that was dubious. The inevitable question arose, “But, why?” Why, this person asked, take the time to give feedback when ...

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One of the most common questions that I receive from patients diagnosed with celiac disease is if they should take a probiotic. The only available treatment for celiac disease, an autoimmune disease characterized by destruction of the absorptive surface of the small intestine which develops in genetically compatible individuals, is a gluten free diet. However, patients and providers often question whether supplementation with probiotics may hasten the healing process. Probiotics are ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated in the hospital for a right intertrochanteric fracture sustained in a mechanical fall. He reports right hip pain but no other symptoms. He has hypertension and type 2 diabetes mellitus and was in his usual state of health prior to the fall. He checks his blood glucose ...

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Ejiofor Ezekwe, Jr., PhD, is a medical student. Watch his compelling story on Black Men In White Coats.

In the interests of full disclosure, I acknowledge with delight that I have a non-time limited board certificate from the American Board of Anesthesiology (ABA), issued before the year 2000. I can just say “no” to recertification. The more I learn about the American Board of Medical Specialties (ABMS) and its highly paid board members, the more disillusioned I’ve become. It’s easy to see why so many physicians today have concluded ...

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Our recent paper on differences in outcomes for Medicare patients cared for by male and female physicians created a stir. While the paper received broad coverage and mostly positive responses, there have also been quite a few critiques. There is no doubt that the study raises questions that need to be aired and discussed openly and honestly. Its limitations — which the paper highlights — are important. Given the temptation ...

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The day I got into medical school, my uncle said to me, “You are going to be a doctor!  We finally have a doctor in the family.  You are going to take care of your uncle in his old age.”  Other family members echoed the same sentiment.  First doctor in the family.  Now, we will all have free medical advice. As I progressed through medical school, then internship and residency, then ...

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asco-logo One of the privileges of medicine is the chance to meet people from every walk of life — many of whom you might never get a chance to know otherwise. Of course, such meetings are never spontaneous. In medicine, we are brought together by illness, and the people coming to see me are seeking advice on treatment for ...

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The market for medical tourism grows as Americans increasingly seek medical care outside of the United States and pay cash for services.  Patients know they can obtain adequate quality care in Mexico for out of pocket costs far lower than their insurance plans with high deductibles would cover.  Posting basic outpatient visit and simple procedure prices could benefit our independent practices in the same way.  The only thing worse than ...

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If you Google “misophonia” you might be shocked to find numerous articles discussing the tragic suicide of 52-year-old Russian-born scholar, Dr. Michelle Lamarche Marrese. Journalist Joyce Cohen was the first to report Marrese’s suicide in the New York Post piece “She could hear everything and it cost her her life.” Cohen explains that she and Marrese had been corresponding about Marrese’s struggles with misophonia for over 14 months, and that ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. If you are a primary care physician, chances are that you’ve had patients ask you to complete forms for work as part of their employer’s wellness program. Workplace wellness programs have been around for several years, but it seems that more of my patients have ...

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Dear hospital executive, If you are like many of the hospital leaders with whom I regularly talk, you’re probably concerned that your hospitalist program isn’t delivering the value you need in this metrics-driven and cost-constrained environment. You may see your hospitalists as disengaged free agents who either don’t know or care too little about contributing to the success of your organization beyond seeing the patients on their list. They may repeatedly ...

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In the year it has taken for me to finish my medical residency as a junior doctor, two of my colleagues have killed themselves. I've read articles that refer to suicide amongst doctors as the profession's "grubby little secret," but I'd rather call it exactly how it is: the profession's shameful and disgusting open secret. Medical training has long had its culture rooted in ideals of suffering. Not so much for ...

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It's been a rough past couple of months not only for millions of Americans whose health care futures depend on decisions to be made by the new Congress and the Trump administration but for those of us who teach about the U.S. health system for a living. As one health policy expert I follow tweeted only half-facetiously, on election night: "Dear students: all that stuff I taught you about the ...

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