A woman delivered a baby boy at 30 weeks’ gestation at a Boston hospital.  After birth, the infant required a ventilator for 3 days.  The family visited every day, traveling over 45 miles each way, for the first 2 weeks of their baby’s life.  After her husband went back to work, the mother  visited infrequently because she relied on friends and family members to transport her to the hospital as ...

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He was known to the hospital as someone who would try to manipulate his caregivers. And I fell for it anyway. Frequently admitted for pain crises associated with a chronic illness, he spent most of his hospital course avoiding eye contact with the team. So, too, were avoided answers that involved more than a few words. Providing care for him was business-like; we knew better than to expect pleasantries. The day of ...

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As I sit home spending Christmas with my family this year, I look back on the past few years of my practicing medicine and realize how much of a luxury this is. While most jobs allow employees time off for particular holidays, health care is a profession where we are called on numerous occasions to sacrifice our time in order to care for others. Frequent are the calls we make ...

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It is a heart pounding, head spinning, edge of your seat page-turner; the sort of rare saga that takes your breath away as it changes you, forever.  It hints at a radically different future, a completely new world a few years away, which will disrupt the lives of every man, woman, and child.  Available now, from the National Coordinator for Health Information Technology (ONC), Office of the Secretary, United States ...

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My brother wears a scar around his neck. It represents his second surgery for papillary thyroid cancer. The first started off the same way. Ugly, red and angry. Curving like an ominous smile around his neck, like a noose. That’s how it felt too -- the lump in his throat growing as he sat quietly, alone in a doctor’s office. It’s interesting how physical scars are a visual manifestation of ...

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I tried to order an echocardiogram yesterday at work.  But it turns out, they only do them on Monday, Wednesday and Friday.  Fair enough.  It’s not an unknown phenomenon.  Some places, surgeons are only available on Tuesdays and Thursdays, cardiologists on the second Wednesday of months with an R. After hours, most hospitals now struggle to have ultrasound at all, unless, of course, one has a first-born child to offer up.  ...

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medpagetodayFrom MedPage Today:

  1. For Better Medication Outcomes, Help Patients Do the Math? One-third of patients in private rheumatology practices can't follow dosing instructions for ibuprofen correctly, and one-fifth can't follow instructions for methotrexate.
  2. Metformin: A Great Lakes Disaster? There is more than one way to measure prescription drug use in modern society.

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shutterstock_152411498 Dr. Mehmet Oz, also known by many as America’s doctor, is a very influential face within American medicine.  An accomplished cardiac surgeon and Columbia University faculty member, Dr. Oz has impressive academic credentials. However, in the last year, Dr. Oz has received significant criticism for claims he has made about nontraditional medical treatments on his nationally syndicated television show where he has ...

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In the United States, we train health care providers on poor people. This is no secret -- most medical schools and residencies are in lower income areas. If you have Medicaid or no insurance, you are more likely to find care in an office or hospital where medical students, residents, nursing students, and other trainees rotate; Blue Cross patients don’t let interns watch their childbirth. Even though my residency emphasized ...

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In our transition to medical school as first-year medical students, one significant part of our learning has been adopting the dress of the medical profession. Twice a week, in our first-year practice of medicine course, we wear professional attire and don our white coats, the famous symbol of the medical profession. As we learn how to interview and interact with patients, the white coats encourage us to fully embrace our ...

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shutterstock_213079828 Question: We are currently in the last year of med school, and I’m wondering; what are some practical, everyday things we can do to keep our marriage strong? Especially with intern year coming up. Answer: Don’t confuse character with situation. When the demands of life become overwhelming, it is easy to attack your spouse’s personality when in reality it is the situation you are angry ...

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Doctors and hospitals often exist in a universe parallel to the consumers, patients, and caregivers they serve, a prominent chief medical information officer told me last week. In one world, clinicians and health care providers continue to implement the electronic health records systems they’ve adopted over the past several years, respond to financial incentives for meaningful use, and re-engineer workflows to manage the business of health care under constrained reimbursement. In ...

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I was on call over a holiday weekend and Friday night at 10 o'clock I was paged by the emergency department about a nosebleed. A man in his 30s had a bloody nose Friday morning and over the course of the day had developed red spots all over his legs. The ED checked his blood and his platelet count was near zero. Blood looks red because of the oxygen-carrying red blood cells, ...

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A lot has been written about how awful electronic health record (EHR) systems are. They are overwrought, overengineered, dreadfully dull baroque systems with awkward user interfaces that look like they were designed in the early 1990s. They make it too easy to cut and paste data to meet billing level requirements, documenting patient care that never happened and creating multipage mega-notes, full of words signifying exactly nothing. They have multitudes of ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man is evaluated for vague abdominal pain of several months' duration and a 10-kg (22-lb) weight loss. He drinks alcohol socially but does not smoke. The patient is otherwise well, has good performance status, and takes no medications. On physical examination, vital signs are normal. No lymphadenopathy is noted. Cardiopulmonary examination ...

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Water births, delivering a baby so it is born underwater, are controversial medically because while they are promoted as safe and natural by some midwives and lay midwives they are not recommended by the American Academy of Pediatrics and the American Congress of OB/GYN. (Laboring in a tub in an entirely different thing.) The January 2015 issue of Emerging Infectious Diseases is reporting the death of a newborn from to Legionella acquired during a water ...

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The enormous push continues to reduce readmissions, due in no small part to stiff financial penalties from CMS for the worst performing hospitals. The most commonly cited statistic is that about 1 in 5, or 20 percent, of Medicare patients are readmitted within 30 days. A staggeringly high number when you think about it. Having discharged thousands of patients and seen the characteristics of those patients that are frequently readmitted ...

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shutterstock_145891655 Have you ever eaten a healthy meal, maybe some brown rice and stir-fried veggies, and found yourself ready for another meal just a short while later? Or, more often couldn’t overcome a hankering for a satisfying dessert to top off (and undermine the healthiness of) that meal? As it turns out, this lack of satiety is not merely a function of the ...

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Nurses rock! What would doctors do without them? Watch ZDoggMD's ode to nurses.  Enjoy.

A few years ago, the United States Navy launched a new recruiting and marketing campaign using the slogan: “America’s Navy: A global force for good.” The line was apparently a flop, and the Navy threw it overboard for “protecting America the world over,” but I liked it. I thought it captured a deep truth about the Navy, which is that it is undoubtedly a global force and that the force exists for ...

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