shutterstock_271375967 California is in the middle of an historic drought, with the government setting limits on how long people can sing in the shower. Farmers in the state may soon need to cut back on planting or production, as ground water dries up. But California is still fruitful ground for testing promising ways to improve how health care consumers, otherwise known as ...

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shutterstock_50320798 The scalpel hits the skin immediately, splaying it open with one smooth swipe. Two more swipes through yellow globular fat and I hit the glistening white fascia layer. If this weren't an emergency, I would stop to carefully cauterize the small bleeding blood vessels in the fat layer, but there is no time for that now. I nick the middle of ...

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shutterstock_113731288 I never really watched medical shows, even before and during medical school. I watched maybe one season of ER, a couple of seasons of Grey's Anatomy and House MD and maybe one episode each of Private Practice, Chicago Hope, Emily Owens MD and other random medical shows. The only medical show I made an exception for was Scrubs, because it was ...

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shutterstock_125243891 Patient-doctor communication often has many facets, wrinkles, and twists.  Medical school prepares a doctor minimally for the ups and downs of these patient interactions.  There is no mannequin who can train each medical student how to deal with every personality, response, or even outburst by each patient.  On the job training is sine qua non. During and after medical school, it took ...

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As a practicing gynecologic oncologist, I have spoken the words, “I’m sorry, you have cancer,” or some version of that sentence thousands of times. And although my delivery is fairly consistent, modified only slightly to improve understanding, my patients’ responses vary from stunned silence to uncontrollable, overwhelming cataplexy. The stalwart emphatically reply “I’m gonna beat this thing,” but the vast majority tentatively wonder “How long do I have?” and retreat ...

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When my sister, Jessica, was a nurse anesthetist student at the University of New England, she had the opportunity to rotate at Johns Hopkins, and she seized it. She was young and fairly new to the medical world and so she did not recognize at first the name of the neurosurgeon with whom she would be working -- Dr. Ben Carson. After receiving multiple comments from numerous people about how great it ...

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My patient had suffered a terrible, crushing injury to his chest leaving many ribs and his sternum fractured, his lungs and heart badly bruised and his body on the edge between life and death. He was on a ventilator, the tube through his mouth into his windpipe pushed air into lungs that couldn’t draw for themselves. He was on constant medications for pain and to sedate him while we used ...

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Recently, health insurance companies across the nation have petitioned to increase premium rates for customers covered under the Affordable Care Act (ACA). In North Carolina, Blue Cross Blue Shield (BCBS) has proposed a 25.7 percent raise in premiums; in New Mexico, BCBS requested a 56.1 percent raise; and, in Georgia, Alliant Health Plans has submitted a proposal for a hike as high as 85 ...

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Healthcare Not Fair is a web series taking a satirical look at our dysfunctional health system.  Taken from the perspective of the beleaguered physician, real-life internist Waqas Khan shows you why the American dream for physicians is threatened now, more than ever. (Warning: Explicit language.)

shutterstock_193162472 November of last year found me living as best I could with several health issues, the most debilitating of which stems from never having recovered from a serious viral infection in 2001. I’ve been diagnosed with chronic fatigue syndrome, a little understood and much-misunderstood illness. It keeps me virtually housebound. For the most part, I’ve made peace with feeling sick all ...

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Do you remember Mad Libs from when you were a child? A story is filled with blanks, and as you fill them in with inappropriate and ridiculous words, you laugh until you can't see straight. You laugh until you can't breathe, and your parents beg you to stop! Let's be children again. Share these with the nurses, and give the shift a little levity. Pain medication. You see, doctor, my pain specialist ...

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shutterstock_202325860 The current state of telemedicine -- that is, teleconferencing with a physician over one’s smartphone -- worries many critics because it assumes patients can be evaluated without a physical exam.  The critics are right that those with a financial interest in “disrupting” health care typically minimize the trade-offs.  Convenience and lower cost are trumpeted, while risks of misdiagnosis and mismanagement are waved off.  The concerns of practicing physicians are dismissed ...

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"Welcome back health care fans!  I'm Dr. Rob." "And I'm Dr. Rob's evil twin." "Good to see you again, Dr. Evil" "Nauseated, as always, to see you, Dr. Rob.  We've got a thrilling lineup in store for you tonight, as the Washington Senators take on the Mighty Docs in the third round of the meaningful use playoffs." "Don't you mean payoffs, evil twin?" "Hilarious, Dr. Dufus.  The meaningful use series did promise big payoffs and better care. But ...

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shutterstock_272222642 The selfie, for those of you living under a rock, is a photo of yourself, taken by yourself, by holding your phone out in your outstretched arm, pointing it at your own face, and snapping away. You then post it on your Facebook or on your Twitter for all the world to see and admire. Let me pick out the key words ...

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shutterstock_223709917 I’m a physician, and I’m adrift. I am pretty much lost at sea. I’ve often thought of writing this column, but afraid I’d be recognized, I’ve hesitated for years. Even now, I’ll most likely remain anonymous, because I’m in a vulnerable position. Let me preface my remarks with the reassurance that I’m not a bad person. I developed dependence on opioids several ...

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shutterstock_86779999 Despite rates of drug use similar to white counterparts, black men are 11.8 times as likely to be arrested for drug offenses compared to whites. African Americans constitute 14 percent of regular drug users, and yet represent 37 percent of people arrested for drug offenses, 55 percent of drug convictions, and 74 percent of people sent to prison for drug possession. One in 
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man is admitted to the emergency department with a 1-day history of headache and epistaxis. He has had type 1 diabetes mellitus requiring insulin for 30 years and two episodes of ketoacidosis in the past year. On physical examination, temperature is 36.0 °C (96.8 °F), blood pressure is 100/70 mm Hg, ...

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shutterstock_125513645 I came across an article featured on NPR and it immediately grabbed my attention.  Traditionally medical student education is accomplished in a four-year program in medical schools nationwide but University of California, Davis is now offering their medical training as a three-year obligation.  A three-year medical school as opposed to a four-year program is intriguing, thought provoking and possibly controversial. ...

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Doctors4th-640x480 It’s July 4th! All across the country, Americans are celebrating freedom, liberty, and the pursuit of happiness. Families and friends are relishing potato salad, apple pie, barbecues and parades. Is your doctor decked out in red, white, and blue enjoying fireworks from his yacht? Probably not. Have you seen any medical students waving little flags? Unlikely. The truth is American medicine has little to ...

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shutterstock_168921674 1. You don’t have to make an appointment with your doctor, or sit in a crowded waiting room for hours, to get music -- you can just download it instantly from iTunes or pick up an instrument and play it. 2. Music costs far less than a medical office co-pay or out-of-pocket fee-for-service charge. And for many acute conditions, outcomes are probably pretty ...

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