shutterstock_124029454 Jim almost convinced me.  The burning in his chest, after all, could have just been gastroesophageal reflux.  He assured me that the sensation was nothing new; that he got it from time to time after a large meal and took Tums.  I couldn't, however, ignore that it seemed to worsen with activity.  The pain was bothersome enough to drag him into my ...

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Let me be clear. I have spent a career, my adult life, 80 hours a week, 131,000 hours, fighting the dread disease: every method, every drug, every machine, every medical technique, every sinew of my being, to control or cure malignancy. A synopsis of my existence will say, “fought cancer.” Nonetheless, let us take a step back, if just for a moment, and reflect on the idea of saying, “no.” In ...

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shutterstock_85837342 I thank God every day that a doctor had the audacity to say to me, “You are going to have to learn to live with this.” I was 21. Newly married. And covered, from head to toe, in a burning, painful, itchy rash. I was sitting on a table, decked in a gown, with my husband in a chair by my side. I was ...

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When a doctor makes a mistake, it’s rarely out of ignorance.  We usually have the knowledge we need. Instead, most medical mistakes happen because we’re tired, distracted, hurried, or indifferent -- or maybe some combination of those things. Since physicians rarely publicize their personal frazzled-and-frenzied, pooped-out or burned-out quotients, health care consumers shopping for a doctor often consider Board certification as a kind of Good Housekeeping seal of approval. The “board” ...

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shutterstock_211066027 Ask any frontline physician at the moment what one of their biggest daily frustrations is and you will probably hear a very similar thing whether you are talking to a primary care, emergency room, or hospital physician. The thing that most takes them away from patients and makes them forget the reasons why they went to medical school in the first place, ...

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shutterstock_153912641 Recently, Marshall Allan and Olga Pierce, two journalists at ProPublica, published a surgeon report card detailing complication rates of 17,000 individual surgeons from across the nation. A product of many years of work, it benefitted from the input of a large number of experts (as well as folks like me). The report card has received a lot of attention … and a ...

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shutterstock_256955077 The number of African-American physicians in academic medicine is dismal, and this leads to an abundance of problems.  Academic hospitals (teaching hospitals associated with universities) generally do not have a proportionate representation of underrepresented minority faculty as compared to the surrounding population. According to a U.S. News & World Report article, the number of African-American faculty increased by 0.2 percent ...

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An excerpt from The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age (McGraw-Hill, 2015). The YouTube video opens to show a balding middle-aged man sitting on a stool, strumming a guitar. In a gentle, twangy croon, the man, Robert Schwab, chief quality officer for Texas Health Presbyterian Hospital in Denton, Texas, sings “The Ballad of Go-Live,” ...

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A continuing series on physician online reputation.  Created in partnership with The Doctors Company as part of their social media resources for physicians Once you establish online reputation, you have to protect it. I was once reading a newspaper article where an emergency physician in Rhode Island decided it was a good idea to post interesting cases that she had seen ...

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shutterstock_226271230 If you want to know who the best surgeon in the hospital is, ask the surgical nursing staff. If you want to know who does the best job opening up coronary arteries using catheters, balloons, and stents, ask the cardiac catheterization lab nurses and technicians. Unfortunately, these approaches to comparing physicians’ skills are only available to hospital personnel. They are the only people who are ...

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shutterstock_284554253 Dear future Pranay, By the time you read this, time will have passed with the same explosive inevitability that C. diff diarrhea passes from unfortunate rectums. I’m not sure where life has taken you -- you might be a serious senior resident physician, frazzled fellow, or -- maybe -- living your dream of being an eccentric train conductor with an affinity for shoe ...

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shutterstock_171708149 I attend pharmaceutical dinners every once in awhile because: 1) I like to stay up to date with all the new drugs (or just a slightly modified version of the generic, but with a much fancier name and packaging); 2) Though I’m several years out of medical school/residency, one thing I have maintained from those formative years is the mentality where I’d never pass ...

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shutterstock_128042738 The Men Against Breast Cancer Fund and several cancer advocacy and physician organizations have posted a petition on Change.org asking Congress to place a two-year moratorium on finalizing the U.S. Preventive Services Task Force's draft recommendations on screening for breast cancer to forestall the possibility that health insurers will stop covering screening mammograms for women younger than age 50. ...

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Thank you for your feedback regarding Healthcare Not Fair's latest video, "Ms. Fatty." First off, I encourage a diversity of opinions on KevinMD, and please note that I don't necessarily endorse all the content that I post. Now, regarding the video.  The sentiment presented is shared, unfortunately, by a number a physicians, and the satire was posted to ignite discussion regarding how some doctors perceive obese patients in the exam room.  To that extent, posting the video ...

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shutterstock_182066816 It’s often said that we learn from our mistakes. Indeed, many a business course in leadership offers that premise as a given. I’ve glibly repeated this often in my classes, speeches, and advisory work. “You don’t learn from your successes,” I point out, “but rather from your errors.” But do we really learn from our mistakes as a matter of course? My friend and colleague ...

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shutterstock_239583778 A few months ago, the father of one of my best friends was diagnosed with cancer. He had to have surgery to remove the tumor. His father, being someone I’d known since childhood was like an uncle to me. After the surgery, I sat across from him in an otherwise empty hospital room on a sunny day in beautiful San Diego. It ...

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White coat in public place edited People can wear what they want in America. Whether you want to debut the latest vogue or your midriff rife with adiposity, you are free to do so. But just because you can, doesn’t mean you should. In the span of one week, I found two people -- on two separate occasions -- wearing white coats, each ...

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shutterstock_287266676 When report cards of performance became available, cardiac surgeons in New York and Pennsylvania avoided high risk patients. Could something similar happen, nationally, after the forthcoming revolution in transparency inspired by ProPublica’s data release? Take two fictional orthopedic surgeons, Cherry Picker, MD and Morbidity Hunter, MD. Cherry Picker lives in the Upper East Side of New York. His patients give ...

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shutterstock_157734158 The drug test came back abnormal.  There was THC present.  I walked back to Mrs. Johnson and raised my eyebrows. "What's wrong?" she asked, not used to whatever kind of look I was giving her. "Uh, you forgot to mention to me that you smoke weed." She blushed and then smirked.  "Well, yes, I guess I forgot to put that down on the sheet.  I don't ...

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shutterstock_139886491 1.  Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse. Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to ...

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