Complicated medical procedures can be dangerous, even when done by highly skilled and experienced people. Why? Because, irrespective of the procedural risk itself, all of us are human and we can overlook or forget things, no matter how many times we have done the procedure. This was recognized many years ago in the airline industry. Flying an airplane is a complicated and potentially dangerous activity and their are many steps ...

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Top stories in health and medicine, July 1, 2014From MedPage Today:

  1. Supreme Court Issues Hobby Lobby Decision. The Supreme Court has struck down the Affordable Care Act requirement that employers must include no-cost contraceptive coverage in employee health insurance plans.
  2. Some States See New Insurers on Exchanges. Washington state's health insurance exchange is looking to be an attractive marketplace for ...

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I recently talked about how we might approach the idea of our own death. I wanted to start a discussion about how individuals engage with, think about and plan for the end of their life. In offering a medical perspective on what death is like, I hoped to stimulate self-reflection about this scary and foreign topic. However, when we think about death, we don’t just think about our own ...

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Dear Mr. Will, I read your recent column on the “supposed campus epidemic of rape, a.k.a. sexual assault” and am somewhat taken aback by your claim that forcing colleges to take a tougher stand on sexual assault somehow translates into a modern version of The Crucible that replaces witchcraft with rape hysteria. I was specifically moved to write to you because the rape scenario that you describe somewhat incredulously is not unfamiliar to me. ...

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In this Daily Show segment, "An Outbreak of Liberal Idiocy," correspondent Samantha Bee likens the anti-vaccine crowd to right-leaning climate deniers.  I've been saying this for awhile: The anti-vaccine mentality crosses party lines.  Remember, Jenny McCarthy got her start from the progressive-leaning Huffington Post.

While rotating through the local Veterans Affairs (VA) hospital during my residency in radiology, I noticed a curious phenomenon. When the weather was pleasant a large number of veterans would not show up for their scheduled CT scan or MRI. When the weather was miserable or dangerous the attendance would be maximum. We named this phenomenon the "VA paradox": a paradox because this is the opposite of what usually happens. After deeper ...

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Comedian John Oliver with a must-see takedown of Dr. Oz, after his disastrous performance at the recent Senate hearings: "It's easy to fill a show with shameless pandering without dangerously misleading medical information."  And at the 13:44 mark, he shows us how it's done.  Epic.

The California ballot initiative: Protecting patients or letting in a Trojan horse?A guest column by the American College of Physicians, exclusive to KevinMD.com. Physicians in California are mobilizing to oppose an initiative on the November ballot that will raise the cap on non-economic damages in medical malpractice cases. The current cap of $250,000 is part of California’s Medical Injury Compensation Reform Act, or MICRA. Adopted in ...

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Top stories in health and medicine, June 30, 2014From MedPage Today:

  1. FDA Finally OKs Inhaled Insulin. After several denials, the FDA announced Friday that it had approved inhaled insulin (Afrezza) to be used for improving glycemic control in adult patients with diabetes.
  2. ADHD Meds Tied to Cardio Risk. Danish children taking stimulant drugs for attention deficit-hyperactivity disorder (ADHD) had roughly ...

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It's a cold and rainy morning, and we've traveled to the middle of Central Pennsylvania to see a presentation at a conference about a patient-centered medical home product produced by one of the largest health care systems and insurers of the region. There are clinicians and administrators from all over the eastern half of the U.S. (plus one from California), and also a large contingent visiting from the U.K., on a ...

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If only our lives were more predictable and certain, we’d feel a greater sense of security and safety. Yet, much of what happens to us is beyond our ability to control. This is true whether we live in a third-world country or in the most advanced scientific and technological environment. It’s also true whether we’re struggling to make ends meet or living in the lap of luxury. No one is immune ...

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I’m 34 weeks pregnant and working hard to keep this baby inside me for as long as possible. As with my last pregnancy, there’s a real risk that the baby could come too early. But we’re both holding on so far, thanks to a combination of luck, modified bed rest and medical science. The science is my biggest concern right now. I will spare you much of it because, man or ...

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What if healthy pregnancies were treated like special needs pregnancies? Mr. and Mrs. Johnson, good afternoon. I’m Doctor Dumas, a visiting obstetrician in Doctor Kwak’s practice. It’s nice to meet you. Look, there’s no easy way to say this, so at the risk of sounding blunt, I have some bad news. The technician and I reviewed your scans and we found that you’re about ten weeks along with a human fetus. I’m not seeing ...

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The health care IT space is possibly the most exciting and dynamic industry in the United States right now. Health care is going through a total transformation driven by massive regulatory change, the consumerization of health care and the important shift from a system that manages sickness to a system that manages health. Underlying all of this change is the software that runs large health care organizations: specifically, the big EMR ...

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There is a new emerging health threat to our children: nicotine poisoning. The number of nicotine exposures in children reported to the National Poison Data System has more than tripled in the last year. Here’s the fact every parent should know: 1 tablespoon of nicotine oil can be lethal to a 60-pound child! When doctors were campaigning against tobacco companies through public health legislation, we did not foresee a resultant new market for ...

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We tell ourselves many things about our health each day, every day, all day long. The vast majority are unintentional, uninspired and blunt. A particularly sinful dessert brings admonishment, “You should not have eaten that.” Panting after two flights of stairs call for an exasperated, “I am out of shape!” Receiving a diagnosis prompts mental overdrive of “What if I don’t survive this?” thoughts. Learning my diagnosis of chronic kidney disease ...

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16 questions to ask when choosing a hospice Hospice is a set of services that we all may need someday -- if not for ourselves, for our parents. While death is not an option for any of us, we do have choices about the services we use at the end of life. Hospice is undoubtedly the best option in the last months of life because it offers a whole ...

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Recently, someone asked me on Twitter, “Has the change in classification of obesity as a disease affected how you treat patients presenting w/ the disease?” The classification change in question is regarding the American Medical Association’s declaration that obesity is a disease rather than a comorbidity factor. This change in classification affected 78 million American adults and 12 million children. The new status for obesity means that this is now considered a ...

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A pivotal moment in the U.S. health care system is taking shape. Physicians across the U.S. are wondering what their role will be in this new health care landscape that is being shaped by legislation (from the Affordable Care Act and from meaningful use), by social media, and by technology advancements. It’s an existential moment. Physicians are wondering if we are knaves, pawns, or knights in this chess game called the ...

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It may not be long before a hospital will be the least likely place to find a doctor. Pressures are mounting to replace physicians with computers, guidelines, nurse practitioners and even pharmacists. The assault on the patient-doctor relationship continues to mount. Centers for Medicare & Medicaid Services recently made a final ruling that finds the regulation requiring a doctor sit on the governing board of a hospital to be “unnecessary, obsolete, ...

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