As a researcher, there may come a time when you interact with the media. It may make you cringe; for traditional research publications, we have the protection of editing, and feedback from mentors and colleagues. Interviews feel much more risky: Questions are unpredictable, and there is seldom an opportunity to polish the product before it goes into the wild. Yet, interacting with the media offers an opportunity to garner attention ...

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Transparency -- or its absence -- continues to fascinate health care analysts and health care economists.  A study published in the Annals of Internal Medicine addresses the effects of public reporting of hospital mortality rates on outcomes.  Its senior author, Dr. Ashish Jha, offered his perspective on the study results and on the topic. According to the study investigators, mandatory public reporting of hospital mortality is not improving outcomes.  The result of their analysis surprised them ...

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Last week, when I stubbed my toe on our family room coffee table, a throbbing pain ensued. Over the next two to three days, as the bruise turned pink and then purple, the pain persisted. During the same time, I had a case of the blues. I am overstressed at work with several staff on vacation, my college-age children had come home and then left to start their internships, and my ...

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As a member of the general population, we see physicians as those who were born with a calling. Though society acknowledges that becoming a doctor is difficult, it is near impossible to fathom exactly what that title entails. I was raised in a small rural community in which resources were quite limited. The nearest grocery store was a 35-minute drive away, there were no coffee shops or traffic lights, and we ...

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I grew up thinking an “illness” was either a fever or croup. Illness was a stuffy nose -- a sick day, an excuse to miss a day of school. At 18 years old, “illness” took on an entirely different meaning. Illness meant waking up from a coma, learning that my stomach exploded, I had no digestive system, and I was to be stabilized with IV nutrition until surgeons could figure ...

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Get a group of health policy experts together and you’ll find one area of near universal agreement: We need more transparency in health care. The notion behind transparency is straightforward; greater availability of data on provider performance helps consumers make better choices and motivates providers to improve. And there is some evidence to suggest it works.  In New York State, after cardiac surgery reporting went into effect, some ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman presents for follow-up evaluation after being diagnosed with type 2 diabetes mellitus 6 weeks ago. Her initial HbA1c level was 8.0%. Management at this time is with lifestyle modifications. She has worked closely with a diabetes educator and a nutritionist since her diagnosis. She has lost 3.2 kg ...

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Diagnostic tests such as CT scans are not perfect. A test can make two errors. It can call a diseased person healthy: a false negative. This is like acquitting a person guilty of a crime. Or a test can falsely call a healthy person diseased: a false positive. This is like convicting an innocent person of a crime that she did not commit. There is a trade-off between false negatives and false positives. To ...

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The USA trains its physicians differently from every other Western country I know. Everyone (with rare exceptions) who goes to medical school first must get a four-year undergraduate college degree in something. There are no such degrees in medicine, although the overwhelming majority of students going on to medical school major in one of the sciences, such as chemistry, biochemistry, and biology. If they don’t major in a science, they generally ...

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One of the topics’s that I’ve written most about, and also do a considerable amount of non-clinical consulting work on, is how we can improve health care information technology and electronic medical records. As they currently exist, there are unfortunately many drawbacks to health care IT systems, and they have as yet failed to fulfill their immense promise. I’m not a technophobe by any stretch of the imagination. I embrace technologies and ...

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When my father died three years ago,  my comments at his funeral noted that the greatest aspiration any of us can have is to make a difference in the world.  My father’s life made a difference. I’m always self-critical and analyzing my own life.  I moved to Boston 20 years ago this month.   In those 20 years of service to Beth Israel Deaconess Medical Center (BIDMC), Harvard, numerous federal organizations, ...

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Most primary care physicians (PCPs) who admit patients to a hospital are family practitioners or internists. Since medicine becomes more complex each day, PCPs must remain up-to-date on the latest treatment related to drugs, surgery, procedures, risks, complications, and costs. This might require your PCP to be a quarterback bringing together a team of consulting specialists to guide you through your hospital stay. The economics of hospitalization are changing, and since ...

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"Was the delay in deciding to open influenced by the presence of an audience of 100 surgeons expecting to see a laparoscopic liver resection?" “In addition to his tumor, the patient had hepatitis and cirrhosis. Was he a good candidate? A major complication was inevitably to occur during a live broadcast.” As I predicted last year, it had to happen sooner or later. In that post, I wrote, “A major complication ...

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I love being an academic pediatrician.  I didn’t start out to do that; I thought I would be writing novels and working part-time in an inner-city clinic.  I wrote with Robert Penn Warren in college and my first (and only) novel was published when I was a senior in medical school.  But things don’t always turn out the way you expect them to.  In my case, I didn’t expect to be ...

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Ever wonder where tissue samples go after they're taken? The College of American Pathologists shares their journey in this video.

When, aged thirteen, my best friend died of complications from sickle cell disease, her parents could not attend her funeral, or find out where she was buried. My mom explained to me that in the Yoruba culture, because parents are not expected to survive their children, it is considered an abomination for a parent to know where their child is buried. So, the young adults in the extended family attended ...

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The American medical establishment has systematically clogged his arteries with paperwork, lined his lungs with rules, and filled his intestines with, that’s right you guessed it, shit. There he lay, in a comatose state, awaiting to be pronounced. Only one thing is sustaining his overworked body. Idealism. Four months into my intern year and I’m just realizing how crucial maintaining my idealism -- as unrealistic as it may be -- is to ...

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They played Taps at my dad’s funeral. Two teenagers on trumpets. First, the girl, positioned to the back and left of the crowd. Ta-ta-dah, she starts boldly, without the unease of her youth. Each simple note pierces the dry winter air. Yes, you have our attention. Not another sound. Not even a breath by gathered friends and family. In time, the second musician’s reply from the front. Ta-da-dah. And a pause. Their ...

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Wes Fisher recently took his case against MOC to the AMA House of Delegates.  Watch how it went.

“Hey, doc, you’re killing me.” Or, more specifically, us. A recent report from researchers at the Johns Hopkins University School of Medicine points to medical errors as the third leading cause of death in this country. Despite the many safeguards put in place by the government, hospitals, and doctors, themselves, more than 250,000 people a year in the U.S. die from hospital-acquired infections, wrong-site surgeries, medication mistakes and a host of ...

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