Many doctors roll their eyes whenever patients bring in a stack of research they printed out, stemming from a Google search of their symptoms. A piece by Zachary Meisel in TIME.com describes a familiar scenario:

The medical intern started her presentation with an eye roll. "The patient in Room 3 had some blood in the toilet bowl this morning and is ...

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I wrote last year in USA Today about the impact of physician burnout.  Not only do doctors suffer, but so do their patients. Burnout starts early in residency, with entering interns having a depression rate of 4%, similar to the general public.  But after the first year of residency, that number balloons to 25%. Now, another study adds fuel to this disturbing trend. A paper published in the Archives of General Surgery ...

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Whenever I refer a patient to a specialist, a copy of the patient's recent notes, labs and diagnostic tests is  faxed to the specialist -- in many cases, prior to their visit. And most of the time, after they see the specialist, I receive a fax back describing what happened. You'd think this is standard procedure, but it doesn't happen as often as it should. A study from the Archives of Internal Medicine ...

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There are plenty of instructional videos on YouTube -- in fact, I use them not infrequently to show patients educational videos. But who uploads them, and are they medically reputable? Like most social media sites, YouTube's quality of information is variable.  And no where is that more apparent than in CPR videos. There are videos that use sex to teach CPR (a facetious take), or rap (a legitimate educational video ...

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Radiation from CT scans needs to be better taught to patients, as their risks are real. It's the best way to help curb the rampant ordering of these tests.  Unfortunately, we aren't doing a very good job. In a study from the Annals of Emergency Medicine, most patients underestimate their risk from radiation. When asked to compare the amount of radiation from a CT scan to the amount that Hiroshima ...

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Doctors today are wary about treating chronic pain. One of the main worries is precipitating fatal opioid overdoses.  Indeed, according to the CDC, and reported by American Medical News, "fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006 ... [and] emergency department visits involving opioids more than doubled to nearly 306,000 between 2004 and 2008." Requiring chronic pain patients to sign pain contracts is a way to mitigate this ...

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In a recent New England Journal of Medicine, a perspective piece on what to do with fatigued surgeons is generating debate. The issue of work-hour restrictions has been a controversial issue when it comes to doctors in training, something that I wrote about earlier in the year in USA Today. But once doctors graduate and practice in the real world, there are no rules. As summarized in the WSJ's Health Blog, ...

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Regular readers of this blog know that the mere introduction of an electronic medical record doesn't necessarily guarantee better patient care. There are multiple reasons for that, including the fact that many systems are archaic in nature, counter-intuitive, and doctors are forced to learn multiple systems. Yesterday, the WSJ's Health Blog posted a study showing that hospitals with an EMR don't necessarily have better quality measures. Shocker. According Rand Corp.,

trying to ...

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I've written in the past that more medicine and tests do not necessarily reflect better care. There is no test that is 100% specific or sensitive.  That means tests may be positive, when, in fact, there is no disease ("false positive"), or tests may be negative in the presence of disease ("false negative"). It's the latter that often gets the most media attention, often trumpeted as missed diagnoses, but false positives ...

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Primary care physicians often have to see patients with a litany of issues.  Often within a span of a 15-minute office visit. This places the doctor in the middle of a tension -- spend more time with the patient to address all of the concerns, but risk the wrath of patients scheduled afterwards, who are then forced to wait. And, in some cases, it's simply impossible to adequately address every patient question ...

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