I am old enough to remember when physicians did not advertise. It was considered a professional ethical issue. Hospital advertising consisted of institutional “We’re here” ads.  Anything aggressive by docs or hospitals was considered bad taste… but that was before health care became as competitive as any other type of business. I have been barraged, as have many of you, by a wave of hospital advertisements as our health care marketplaces ...

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An important study in the Journal of the American Medical Association finds that misdiagnosis is more common than you might think.  According to the study, almost 40% of patients who unexpectedly returned after an initial primary care visit had been misdiagnosed.  Almost 80% of the misdiagnoses were tied to problems in doctor-patient communication, and more than half of those problems had to do with things that were missed in the ...

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Ensuring that Americans who live in rural areas have access to healthcare has always been a policy priority.  In healthcare, where nearly every policy decision seems contentious and partisan, there has been widespread, bipartisan support for helping providers who work in rural areas.  The hallmark of the policy effort has been the Critical Access Hospital (CAH) program– and new evidence from our latest paper in the Journal of the ...

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Not long ago I noted a certain older patient's name on my schedule. I really dreaded seeing her. It's not that I dislike her--in fact she's one of my favorite patients. It was just that I hated the prospect of seeing her looking as poorly as I knew she would. She'd been through so much: an accident resulting in devastating injuries followed by painful surgeries, and, worst, in the middle ...

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There's this weird feeling I get when I hear bad news, or even not that bad news, or even the possibility of bad news: a tingling that spreads across my forehead, down my face, into my jaw, and then to my chest, where it settles like a...no, not a lump...a void. I get the feeling every time I go for my annual mammogram or any other medical test, I wonder ...

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A city is free. A town is celebrating. I sat and watched the local news station announce that the second suspect in the 2013 Boston Marathon bombings had been taken into custody and was being transported to a nearby hospital. I am relieved. And thankful. Then I wonder. I wonder about the hospital that this suspect is being transferred to, and I wonder about my colleagues. What are the nurses, the doctors, and ...

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The final day of last week’s TEDMED 2013 consisted of two sessions, tastefully interspersed with self-reflection and humor by the curators. The first session, “Hiding in Plain Sight,” looked forward to new developments in technology, and data analysis in particular, that can give us new capabilities in healthcare. TEDMED 2013 recap: Day 4 Computational physicist Mariano Vázquez discussed his work in creating a “computational world” with a supercomputer ...

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It has been weeks since the Boston marathon bombings.  The hospitals in that city, by most accounts, were remarkably well prepared, expertly and compassionately caring for the injured innocents.  Emergency response was fluid and efficient.  As tragic as the events of April 15 were, the health care workers of Boston were beacons of inspiration for a city in shock. Yet these heroics do not represent the most impressive actions performed by ...

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TEDMED 2013 recap: Day 3 Day 3 of TEDMED 2013 kicked off with “Session X,” which was a special session focusing on innovation and entrepreneurship, and consisted of a spirited panel discussion of two hot topics. During the first half of the session, Marleece Barber, Jennifer Kurkoski, Rick Valencia, Geeta Nayyar and Jeff DeGraff participated in a discussion titled “Every Company is a Healthcare Company: Innovating From ...

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Hi. I’m a 44-year old emergency physician. And I’m an addict. My addiction came to light when my Press Ganey scores plummeted after I started to stand up to the chronic pain and frequent ER patients. The fact that I have an addiction was reaffirmed when I went to my state’s Prescription Drug Abuse Summit. When I saw so many professionals from varying fields (medicine, law enforcement, pharmacy, education) assembled, I realized ...

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Hospitals can save you, but they can also harm you. So how can you stay safe in hospitals? Follow these 12 life-saving tips: 1. Never go alone. Always bring someone else—a trusted family member or friend—with you. That person will be your primary advocate, and can serve as an extra set of eyes and ears to help make sure you are safe. (This tip applies to routine doctors’ appointments too; always ...

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I’m sure that many of you have read the New York Times post  titled "Job Prospects are Dimming for Radiology Trainees." I don’t know about you, but this article made me feel more than ever that in order to choose the right specialty, you have to predict the future of the field. Don’t choose a field that’s going to be heavily affected ...

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We are frequently reminded by the General Accounting Office and CMS that a great proportion of Medicare health costs are incurred in the last three months of a patient’s life. Health care policy experts have tried to reduce these costs by encouraging end of life planning.  Living wills, health care directives and the availability of hospice and palliative services will not put a dent in these costs because of human ...

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I’ve been going about this all wrong. It’s not my dumping of the payment system so I can focus on care over codes, my use of technology to connect better with patients, or my vision of the “collaborative record” that is wrong.  It’s the fact that I am doing this without my most important resource: my patients. I realized this while driving in to work this past week.  My first patient was ...

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As an intellectual female surgeon, I have always resented being pinned down by my gender. Throughout medical school, I refused to join “Women’s Societies”. I felt that these were excuses for disillusioned women to get together and complain that the reason they were not succeeding was their gender. I, on the other hand, did not feel limited by my gender nor did I hide it. Instead, I relished it. I ...

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As of late, patient engagement has been laudably deemed a “miracle drug,” a silver bullet slicing through the tangled morass that is our American healthcare system.  The comparison may be hyperbole, but the potential impact of patient engagement does have merit.  With engaged patients, medical problems can be diagnosed swiftly and treated with higher success rates.  Illness can be prevented and emergency department usage can be abated.  Care can be ...

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Newtown. Aurora. Oak Creek. A year ago, I’d never even heard of these places, and now those names are permanently imbedded in my mind along with the graphic images of suffering and death. And now, people are finally talking about it. What can we do to prevent these tragedies? How can we protect our society from senseless bloodshed? I can’t help but think, though, that all of the arguing over guns misses ...

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A front-page Boston Globe article on a neurosurgeon suing a caregiver for a harsh blog post  is exciting but unrepresentative of the overall state of online doctor reviews. However it caused me to take another look at online physician ratings from the perspective of someone trying to find a doctor. Conclusion: we are still in the early days and there is plenty of opportunity for better, more useful information. ...

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My son has been accepted into medical school, we learned last week, and I must say I’m about as happy a mother and a physician as you could find anywhere.  For everything that’s wrong with the American healthcare system today, medicine is a wonderful profession and it’s still the greatest honor in the world for a patient to have faith in your skills and care. It will be interesting to see ...

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Two of the biggest -selling prescriptions of all time, Plavix, an anti-platelet medication, and Lipitor, a cholesterol lowering medicine, have been available in generic form since May 2012 and November 2011, respectively. However, most retail pharmacies are still charging patients $100-$200 monthly for these medications. Why? And what does this market oddity say about our chances of lowering healthcare costs in the United States? Patients are used to paying a high ...

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