More than a century of American medical history was turned on its ear recently by the announcement that the groups that accredit medical residencies will unify their standards. Don’t be too hard on yourself if you failed to understand the significance (or notice at all). But this should be viewed as good news across the land. As someone who trains doctors from both traditions, I certainly welcome a more level playing field. First, ...

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In addition to providing coverage to millions of uninsured Americans, one of the key attributes of the Affordable Care Act (aka Obamacare) is reforming the way that we finance health care in the U.S. Since the rise of the health insurance industry (as a job benefit or under Medicare), we have operated under a system known as “fee-for-service,” in which every little nugget of health care provided (from an operation to ...

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Ever get confused over the names of medicines? I do. There’s Zantac and Xanax. Zanaflex and Zaleplon. But Zanaflex is also known as tizanidine. Tizanidine functions very differently than Zantac and its other name, ranitidine, even though they sound alike. Every drug has (at least) two names -- one proprietary, and one generic. Proprietary names are created to sound catchy by the original manufacturer, almost always under a patent. The generic names are more like chemical ...

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The New York Times ran a fascinating piece about a dusty old medical experiment that was brought back to life recently after one of its perpetrators -- err, researchers, decided to come clean to a medical historian after having read the book The Immortal Life of Henrietta Lacks. The unnamed confessor was a surgical resident in the 1950s under Dr. Perry Hudson, the man in charge of the experiment. Dr. Hudson (a urologist, ...

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I was naive when I decided to enter medicine. My impressions then were that doctors always “did” stuff -- for patients, and to patients. We would do stuff to you (examinations, blood tests, scans, surgeries) in order to help you. A lot of time and education later, I’ve learned that that straightforward paradigm is far from the only way that doctors help people. In fact, following that mostly simple formula (you come to us, we do stuff to ...

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In case you missed it, former President George W. Bush had a stent placed in one of the arteries that feeds his heart. The 67-year-old came through the procedure with flying colors, we are told. Stents are tiny metal mesh tubes that get inserted into clogged arteries, essentially to prop them open. Bush, heretofore thought to be in excellent shape, seems an unlikely candidate for the procedure. We hear tale of him riding his ...

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An interesting conversation recently took place among residency program directors in my field of internal medicine. At issue was the declining pass rate of first-time test takers of the ABIM Certification Exam. It’s a mouthful to say, but the ABIM exam is the ultimate accolade for internists. One is only eligible to take the exam after having successfully completed a three-year residency training period (the part that includes “internship,” right after medical ...

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What Ive learned from calling out my orthopedic colleagues Six months ago I posted a story about a demented 94-year-old patient who’d fractured her hip. She’d lost more than thirty pounds in the preceding months and had already had a collarbone fracture from a previous fall. Her son wanted her to be made comfort care only, and avoid a trip to the operating room since she was likely within six ...

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It was bound to happen. By “it,” I mean that the small group of specialty hospitals (usually orthopedic or cardiology-focused) across that country that are owned by doctors were going to have their “See! We Told ‘ya so!” moment. Doctor-owned hospitals. How many are there? Two hundred and thirty-eight of them in the whole country (out of more than five thousand)–somewhere between four and five percent of the total in the U.S. (numbers courtesy ...

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A loyal reader sent me a doctor-written column with the provocative headline, “My Patient, Killed by The New York Times.” First, keep in mind that the website that posted this, Mediaite, is all about the media covering (really fawning and dishing) itself. The purpose of this story, with its provocative headline, sad outcome, and mea culpa tone, is to generate “buzz.” Then understand that this is a story of one patient who made ...

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