Over 100 million Americans suffer from chronic pain such as spinal disorders (lower back pain, disc disease, pinched nerves and neck pain), complex regional pain syndrome, fibromyalgia and headaches. The cost of chronic pain in human suffering, lost worker productivity and in health care dollars is counted in the billions. Yet despite newer, expensive and invasive treatments like spinal fusions and disc surgery, spinal cord stimulators, steroid and painkiller injections, nerve  "burning" and ...

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My father’s sister Mary died from measles when she was six years old. Her death haunted my grandparents for the rest of their lives. She was one of the thousands who died each year from measles before there was a vaccine to prevent this life-threatening disease. Her story has always stayed with me -- from my days as a child to my years in medical school. And once again I’m reminded of ...

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There’s been a lot written about the measles outbreak and antivaccine parents. Fact is, the current situation is a direct and predictable result of many social/political trends that have emerged in America over the last generation. I am sharing five easy steps to take if you want to create an epidemic just like this. 1. Raise a generation ignorant about science. The majority of Americans are 
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shutterstock_122870008 On Valentine’s Day weekend last year I found myself at Paddles, the local dungeon in New York City’s Chelsea neighborhood, for the first time. I was perched at the alcohol-free bar when a man politely introduced himself as a human carpet. He asked that I tread on him and lay on the floor to demonstrate. A professional dominatrix-in-training stepped onto his ...

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In a followup to his vaccine PSA, Jimmy Kimmel's crew take to the streets and absurdly ask whether vaccines should be a child's choice.  Priceless.

Recently, the American College of Surgeons -- our profession's premier organization encompassing all surgical sub-specialties -- launched its updated website. Included in this website are online communities where surgeons from around the country and even further away, can connect. In my interpretation of these communities, surgeons can connect over shared subspecialty topics (e.g., colorectal surgery, general surgery, orthopedic surgery), shared clinical interests (e.g., ethics, geriatric surgery, surgical safety), or shared circumstances (e.g., surgeons practicing ...

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Hospital leaders who are successful managers today are successful because they manage change. The great hospitals leaders by now have become masters at it. But there’s a difference between change you can see coming (bundled payments, EHR implementations, declining reimbursements) and change that shows up unannounced on the front door. That’s often what it feels like when a huge, publicly traded company acquires a smaller physicians group. It can feel like ...

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medpagetodayFrom MedPage Today:

  1. Don't Like ICD-10? Don't Worry -- ICD-11 is on the Horizon. As U.S. physicians gear up to put the ICD-10 coding system in place by the upcoming Oct. 1 deadline, work is being done elsewhere on the coding system's next-generation product: ICD-11.
  2. Docs Struggle With Vaccine Spacing. Ninety-three percent ...

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Cholesterol pills are one of the great medical advances I’ve witnessed during my professional career. I am talking specifically about a category of medications called statins, drugs like Lipitor and Pravachol. These drugs have prevented probably hundreds of thousands of heart attacks and strokes. Only one problem with these drugs, however: statins won’t help people who don’t take them. And according to a study in the Annals of Internal Medicine, when ...

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shutterstock_232948273 I’m late! I’m late! For a very important date! No time to say hello, goodbye! I’m late! I’m late! I’m late! - The White Rabbit, Disney’s Alice in Wonderland It is in the very words, "running late." It is not walking late, or strolling late, or even meandering late. It is always running late, the phrase itself active, implying urgency and speed, rush and anxiety. The distress, just like the White Rabbit. The ...

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March is colon cancer awareness month.  We have made tremendous strides in the fight against cancer especially colon cancer. Between 1991 and 2011, U.S. cancer death rate decreased by 22 percent (1.5 million lives saved), and colon cancer death rate decreased by almost 50 percent. This decrease coincides with widespread adoption of colorectal cancer screening particularly colonoscopy. Despite this progress, colon cancer is still the 2nd leading cause of cancer death in ...

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Despite the well-known rollout problems for hospitals and clinics across the nation, there are many palpable and welcome advantages to using electronic health records. Chief among these are the ability to access the chart from anywhere, rapidly search for information needed, and reducing the centuries-old problem of illegible doctors’ handwriting.  But with the good comes the bad, and in these still relatively early stages of health care information technology adoption -- ...

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Incentive structures in health care have to change. Right now, we pay for services, or have a so-called, fee-for-service system. The idea is that the more patients doctors see, the more expensive tests doctors order and the more patients doctors hospitalize, the more money clinics and hospitals make. This incentive structure has transformed our health care into sick care. The reality is, in America, we are adept at caring for complicated medical problems that require ...

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Loss is something all humans face in their everyday lives.  As a physician, the effects are often magnified.  People die, they move away, they graduate from your services, or occasionally they pursue care elsewhere.  Parting can sometimes bring relief, and others a deep sense of failure.  But with Clara, I'm not sure we actually parted.  Mostly, I was left with confusion. Clara came to me by way of the nursing home.  ...

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medpagetodayFrom MedPage Today:

  1. Statin Therapy Suppresses Coronary Plaques in HIV Patients. Treatment with potent statin medication appears to reduce plaque burden in coronary arteries of patients infected with human immunodeficiency virus (HIV) while untreated patients experienced expansion of plaques.
  2. Few Women Qualify for 3-Person IVF. Close to 800 women of childbearing age ...

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Come, let us build ourselves a city, with a tower that reaches to the heavens, so that we may make a name for ourselves.  – Genesis 11:4 With these words, so begins the biblical story of The Tower of Babel. The tale was written, at least in part, to explain the origin of different languages. Essentially, a group of earth’s early inhabitants started to build a tower to the sky in order ...

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Jimmy Kimmel gets doctors to say how they really feel about the anti-vaccine movement.  It's about f'n time.  

There has been an outbreak of measles, a vaccine preventable disease, along with an outbreak of people yelling at each other. There have been angry exchanges between people who would like all children vaccinated according to the recommended guidelines and people who support the rights of parents to choose which vaccines to give their children, if any, and when to give them. There has been much focus on the assertion, ...

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shutterstock_94087123 I awoke one Saturday morning to a terribly familiar feeling -- a tight, barky cough, fast breathing, severe shortness of breath and burning in my chest. Another severe asthma attack. I knew I was in trouble. Twenty-three years ago, when I was an internal medicine resident, I went to be evaluated for recurrent pneumonia. I wound up being diagnosed with cough variant ...

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Abuse-Schedule-476x640 A physician in Texas posts this photo on Facebook. Caption: “My schedule one morning in January 2014. Never again ...” Yay! Another physician breaks free from assembly-line medicine. High-overhead, high-volume offices sacrifice the sacred physicians-patient relationship and perpetuate a disease-billing management system. This is not health care. It’s abuse. Patients: Avoid clinics with 10-minute slots. Go for docs who offer 30 to 60-minute appointments. Physicians: ...

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