Medical scribes are a burgeoning field with many institutions and practices exploring their use while the many commercial enterprises who lease out scribes are pushing for their widespread acceptance. There is no accepted definition of what scribes do or what their background or training should be. There is no mechanism for licensure of them in any state. They are poorly defined medical assistants. The field is in its infancy and ...

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The mass media has a long history of covering medical dramas and rarely doing so with any realism.  We’ve gone from Marcus Welby, MD to a host of shows dedicated to portraying medical personnel in the most salacious ways possible.  But at least with all these dramas it is understood that they are fictional.  There are now though a host of shows which pretend to show real life medical stories ...

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It is well known that men see doctors much less frequently than women.  The reasons are multifactorial and not all that well studied.  It’s certainly not because men are healthier than women as they die on the average seven years before women.  Clearly women are accustomed to seeing doctors at an earlier age than men for reasons relating to childbirth and birth control.  Most accept the recommendations to get an ...

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Sports physicals are universally required in the U.S. on an annual or seasonal basis for students wishing to participate in sports.  All states have requirements covering public schools.  The reason for the exams is to ensure that the athletes can participate safely.   These exams are not intended to replace a regular physical.  There are no absolute standards for what should be included in these exams.  Most would agree that ...

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The patient entered her private solo physician’s office and handed her medical ID card to the doctor.  He put the card in his desktop reader and reviewed her medical history.   All of her visits, vaccinations, medications, tests, x-rays etc from all providers were inscribed on the data chip in the card.  The card also included insurance and billing information.  At the end of the visit, he updated her information on ...

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Few patients enter our health care system prepared for the unexpected and embarrassing circumstances that can routinely happen. Most can accept it when we’re treated with modesty and respect.  But not many are prepared for those times when you might be unnecessarily exposed or treated rudely.  The possibilities for embarrassment are endless and it is usually unexpected.   When avoidable incidents do happen, most patients are not prepared to speak up.  Many ...

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Chaperones are increasingly recommended for routine use in Western medicine.  There are semi-official recommendations in both the UK and USA.   The AMA has long had this. The rationale for using chaperones is twofold.  In theory their primary purpose is to protect, comfort and assist the patient.  In reality though, the usual purpose is to protect the physician against claims of sexual assault or harassment. Preferably, chaperones should be real professionals, ideally ...

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Patients’ gender preferences for medical care are a factor that we all know exists yet most physicians prefer to ignore it in daily practice hoping that modern medicine is gender neutral.  Forty plus years ago when I started in medicine this wasn’t a consideration.  Nearly all physicians were men and nurses were women.  Patients simply had no choice.  Male physicians felt entitled to see all comers and present day women ...

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The American College of Obstetrics and Gynecology (ACOG) has just revised their guidelines for Pap smears under some pressure. This resulted from an Annals of Internal Medicine article which documented that only 16.4% of gynecologists followed the College’s prior guidelines. Most did more screenings than indicated, the worst record of the specialties tested. But the ACOG still recommends that nearly all women obtain regular screening at intervals of 1-3 years. The ...

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