“Hefur þú lært um Staphylococcus aureus?” I almost don’t recognize the bacteria name because my grandmother pronounces it differently in Icelandic. “Já–” I’m about to translate my microbiology flashcard for her when she interrupts, her hands busy kneading the cookie dough and her eyes on my little sister near the oven. That’s the bacteria that almost killed her eleven years ago, she tells me. I can hear her words building up. This ...

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In medicine, the seemingly simple questions become the complex ones. “How’s it going?” It is a question that is frequently asked whenever we encounter friends and acquaintances. In a given day, we ask this question many times out of courtesy and we expect to hear short, affirmative answers, such as “Things are good,” or “It’s OK” as we continue to walk to where we need to go since we are pressed for ...

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Rural hospitals are fighting for their lives. Over the past five years, more than 40 rural facilities have closed their doors due to lack of funding. And because the majority of their funds come fromMedicare and Medicaid -- two government programs facing potential cutbacks in 2015 -- many rural hospitals may be fighting a losing battle.   Understandably, small-town residents fear hospital closures or downsizing may leave them vulnerable when serious ...

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shutterstock_223878937 gomerblog The Rübler-Koss model or 7 stages of grief is a series of emotional stages an admitting provider experiences when faced with an impending admission. The 7 stages are best remembered by the acronym DABDDAH, which stands for denial, anger, bargaining (or blocking), deflection (or delaying), depression, acceptance, and ...

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When I entered the profession of being a family doctor, like many aspiring physicians, I had a more altruistic vision of what it would be like. However, the reality of that picture over the last 10-years has resulted in frustration, disappointment, and, above all, the realization that health care has changed for the worse. It has become unaffordable for the masses and institutionalized for the benefit of corporate America, not ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated for dyspnea at rest. He has end-stage COPD and is on a home hospice program. He has weight loss, reduced functional capacity, and muscle atrophy. His medications are ipratropium, salmeterol, fluticasone, albuterol as needed, and prednisone. He is uncomfortable, with chronic air hunger that has gradually increased ...

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Why should you get the HPV vaccine? Here's why, ZDoggMD-style.

The really incredible advances in the treatment of hepatitis C bring to life several relevant questions as we move forward into 2015. First, who should be treating hepatitis C patients (primary care providers, gastroenterologists, infectious disease specialists)? Second, can we really afford to use these new treatments? I recently discussed this topic with my GI and hepatology colleagues in AGA Perspectives, the bi-monthly opinion magazine of the
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plastic surgery In 2012, in a remote town of San Jose, on the southern part of Occidental Mindoro province in the Philippines, I met a little boy and his desperate, but courageous mother.  The boy was just a few months past his first birthday.  He was born with a facial congenital defect known as bilateral cleft lip, so commonly seen in ...

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For many years, I taught a sizable chunk of our local medical school’s second-year pathology course.  I was always energized by the students’ enthusiasm and desire to learn more about medicine.  On the other hand, I remembered feeling their same frustrations regarding the lack of fundamental practice skills included in today’s medical school curriculum. In fact, at our university, a group of students started a business in medicine interest group, where ...

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It’s the beginning of February and this year’s residency interviews are wrapping up. It is widely known, even encouraged, that medical students change their social media profile names or deactivate their accounts while applying and interviewing for medical residencies.  David becomes AviD, Jessica is now Jes Sica, and Sarah morphs into Miss S; students are leery of admissions committees stumbling upon their accounts, changing their profile names to something that would ...

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“So, I told the doctor at the nursing home that I loved my father more than anything. Dad was my friend and the most wonderful man I had ever known.  I wanted everything for him. But, I said, Dad was sick, weak, confused, and he never wanted to live like that. The next morning he was dead.  That was OK by me.” I once participated in a panel discussion about hospice, ...

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If I could drop our health insurance altogether, I would. With a high deductible of $4,000 for in-network providers, my family of three has yet to reach our collective deductible over the last three years. This means we have to pay out of pocket for medical care until we reach that amount. To make matters worse, our health insurance premiums increased by 10 percent, forcing us to find a less ...

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Primary care is a messy business. Nobody has just one simple problem, and no patient has all the typical symptoms for their diagnosis. Most don’t even tell us everything that’s going on. And most don’t follow their treatment plan completely. But this may be OK, since we often change our minds about what is right or wrong in the practice of medicine. Knowing what constitutes success in front line medicine is ...

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medpagetodayFrom MedPage Today:

  1. What Is the Real Cost of a New Knee? Assuming current eligibility criteria for total knee arthroplasty (TKA), the per patient lifetime cost attributable to symptomatic knee OA is $12,400, which represents about 10% of total direct medical costs in patients with OA.
  2. Attitudes Affected Outcome in HIV Prevention ...

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Doctors prescribe way too many medicines for patients who don't really need them. A lot of the pressure comes from intense drug company marketing. Some comes from patients who aren't happy leaving the office without a pill. And doctors have too little time with each patient to explain non-pill solutions to problems. Wild prescribing is not new. For thousands of years, doctors have given patients useless (and often quite harmful) ...

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The serious diagnosis is a polite middle-aged woman with a hopeful smile sitting on the side of the bed, with her husband in the chair across from her, as you carefully tell them what it means to have ovarian cancer. The serious diagnosis is the teenager who just found out he has lupus nephritis -- without any other signs or symptoms of lupus -- and that he might be on hemodialysis ...

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Living in the trenches of a surgical internship can be a gut wrenching, lonely experience for many.  The journey from medical student to resident to surgical attending is a notoriously steep trek, necessitating our long 6+ years of training. Surviving intern year remains as hard as ever despite the significantly greater resources and awareness that exists among residency programs today. These burdens are felt by all specialties and have tragically led ...

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“Katie, If you go into surgery, you’re going to miss patients.” It was three in the morning in the ED; the resident was feeling the strain of a 24-hour trauma call, and I was loving it. I had spent the past half hour with a lovely, older woman whose foot had gone through the floor of her vehicle in a crash. We chatted about where she had been traveling, and ...

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In his State of the Union address, President Obama announced a precision medicine initiative “to bring us closer to curing diseases like cancer and diabetes.” The goal of precision medicine is to more accurately identify diagnoses and treatments based on a patient’s genetic information. This information will hopefully lead to better screening, earlier diagnosis, and more personalized treatment. But it’s hard to imagine that patients will get this kind of medical ...

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