Hollywood needs to make condoms sexy Think of the last few times you watched a popular movie that involved any kind of sex scene?  Not as in pornographic sex, but as in two characters ended up in bed together and had, ahem, conjugal relations. In how many of those scenes did either participant make mention of a condom before the act? We face a public health crisis of sexually transmitted ...

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Growing up, I am sure you heard many “why” questions, such as: “Why is your room so messy?” and “Why didn’t you eat your vegetables?”  I am quite certain those questions made you feel defensive.  Patients also feel defensive when we ask them ”why” questions. In other words, “why” questions set people off.  These types of questions can turn a usually-friendly patient into an angry nightmare. Here is an example.  Your ...

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The story of the surrogate offered $10,000 to have an abortion by the couple who were paying her to carry their pregnancy has been making the rounds. If you don’t know the details, let me catch you up

  • Woman hired to be a surrogate for the fee of $22,000
  • Couple who are paying have 3 children, but had a lot of pregnancy complications. Two children spend months in the hospital ...

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A high calcium diet and calcium supplementation: Is it bad for you? An article from Sweden was recently published showing that in a very large group of women, over 60,000 of them, followed for 19 years as part of an also very interesting study of the effectiveness of mammograms, women who get more calcium, in their diet or as supplements, had a higher risk of dying of anything, but especially of heart attacks. It is ...

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“I HEAR THEM! THEY ARE CALLING ME A CHEAP PROSTITUTE!” Her shouting is like a gas: It completely fills the space, regardless of the size of the container. The sound originates deep in her abdomen and bellows from her mouth before reverberating throughout the room. “THESE DISGUSTING MEN,” she shouts, “KEEP CALLING ME A WHORE! I AM NOT A WHORE!” Her wrinkled hands flecked with liver spots loosely hold a fashion magazine open. ...

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When the American College of Emergency Physicians (ACEP) decided not to join the Choosing Wisely campaign, I was among those who expressed disappointment with this decision, in part because I have long been a proponent of efforts to encourage more cost-effective care in the ED.   In fact I had already independently done a significant amount of work in the Read more...

The practice of medicine is based on a solid fund of knowledge and a physician’s ability to quickly assimilate and organize information during a patient encounter.  However, the process of making a diagnosis and formulating a treatment plan is not always straightforward.  Often, what separates the truly exceptional physicians from the rest is the ability to attack problems from alternative angles–more simply put, creativity. Traditionally, medical education is centered around science. ...

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Brought to you by MedPage Today. 1. SERMs Still Have Value for Breast Ca Prevention. Treatment with selective estrogen receptor modulators (SERMs) led to long-term protection against breast cancer. 2. C. Diff Infection Eludes European Hospitals. Infection with Clostridium difficile – a dangerous and potentially deadly condition – appears to be substantially under-diagnosed in European hospitals. 3. Medicare Panel to Mull ...

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This question was what drove me to graduate school for an MPH degree a few years ago.  I was finishing up my family medicine residency at, arguably, one of the top residency programs in the nation.  I had been well trained in both medical science and doctor-patient relationship skills.  Yet my patients still consistently did not adhere to my advice. I was not disappointed in my MPH studies.  It turns out ...

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Where did the medical community get the idea that Vioxx, Trovan and Baycol were safe and the benefits of Prempro, Neurontin and bisphosphonates outweighed their risks? From research published in medical journals written by drug companies or drug-company funded authors. Scratch the surface of many blockbuster drugs that went on to be discredited, or even withdrawn as risks emerged, and an elaborate "publication plan" emerges, developed by ...

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Having married parents is good for children. That's why the American Academy of Pediatrics (AAP) thinks that same-sex couples should be able to marry. In a policy statement, that's exactly what they said. It's going to put the AAP in the middle of controversy--but it was the right thing to do for children. There are currently almost 2 million children being raised by gay and lesbian parents in the United ...

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What does the 21st century physician look like? I’ll admit that the question on the face of it struck me as a bit absurd, especially when juxtaposed with the term “tomorrow’s doctor.” Tomorrow’s doctor needs to be doing a much better job of dealing with today’s medical challenges, because they will all be still here tomorrow. (Duh!) And the day after tomorrow. (As for the 21st century in general, given the speed at ...

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One of the toughest parts of treating patients is managing their expectations.  We wish that everyone could enjoy a perfect recovery with complete healing, but the medical profession is imperfect and life is unfair.  Some folks cruise by decade after decade without a scratch, while others sag under the weight of chronic illnesses. Accepting reasonable expectations can change the game for patients and their families.  If the patient’s expectations exceed what ...

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The KevinMD toolkit: Blogging A lot of people ask me, “What tools do you use for blogging, speaking, when you’re on the road, seeing patients etc. …” So I decided to start a series that describe what tools I use, and why. The first explored my speaking toolkit.  This one details the technical tools I use to run KevinMD.com.  I’ll discuss what I use to ...

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At some point, this gets to be ridiculous. Online, I can buy any item from anywhere at any price, pay any bill, watch any movie, listen to any song, order dinner, schedule car repair or read about any subject on Wikipedia.  I can determine the weather in Rio, sport scores of Barcelona, Parisian traffic or by GPS the location of my kids, just down the block. However, I absolutely cannot learn ...

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Next in a continuing series. Inside the belly, everything is slippery. The peritoneum is a glistening layer of self-moistening plastic wrap, enveloping the surfaces of all the organs, and the inner aspect of the abdominal wall. Undisturbed, the intestines coil and slither, reptilian. Watching waves of peristalsis makes me smile: there's something always entertaining about those moving contractions, following one upon another, gurgling, surprisingly tight bands of tension moving ...

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As an addiction psychiatrist, I have seen marijuana do far more harm than good. So with the medical use of marijuana in Massachusetts now legal under state law, what should physicians do? Recently, I attended a chilling presentation from Dr. Kevin Hill, an addiction psychiatrist at McLean Hospital, at a meeting of the Massachusetts chapter of the American Society of Addiction Medicine on the topic “Medical Marijuana: What is the Proper ...

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Brought to you by MedPage Today. 1. Fighting Obesity Long-Term Will Save Money. A longer-term budget window for projecting costs in obesity prevention efforts might save the government more money. 2. Medicare Offers Pay Boost to Hospitals. The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule late Friday that would increase payments to the nation's 3,400 acute care hospitals by ...

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Pierre arrives at the construction site, has his morning coffee and croissant, then ascends the scaffold to begin his work.  He felt a little woozy this morning but ignored it.  Becoming more dizzy, he loses his balance and falls two stories fracturing his femur and pelvis.  On arrival the paramedics find his health smart card in his wallet, scan it, and instantly have his medical records including medications, allergies and ...

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As a second year medical student in 1971, I still remember an article in the prestigious New England Journal of Medicine, describing a new phenomenon, The Emperor’s New Clothes Syndrome. It was based upon the famous Danish author, Hans Christian Anderson’s fairly tale from the 1800’s. A vain emperor, who cares for nothing except wearing and displaying clothes hires two swindlers who promise him the finest, best suit of clothes from ...

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