This past weekend I spent time relearning some life lessons. On Saturday, I picked up a couple screens from the hardware store to reinstall them after they were nearly destroyed by our neighborhood bear. The bear seems to think she will find the birdfeeder that used to hang nearby, so she stands on our deck and leans on whatever is nearby (our screened porch) while she looks for it. Then she heads ...

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2 ways technology will improve patient care When I completed my internal medicine residency, my fellow trainees knew I was headed for a rural practice in Vermont. Much to my surprise, they gave me a traditional doctor’s black bag – a beautiful leather bag with pockets inside for instruments, tongue depressors, syringes, prescription pads, and all my tools. It was an extraordinarily meaningful gift that acknowledged a launch ...

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Data from the Dartmouth Atlas show patients with chronic illness in their last two years of life account for about 32 percent of total Medicare spending, with much of that expense going toward physician and hospital fees associated with repeated hospitalizations. Opportunities to reduce medical expenditures during the last 2 years of life are often looked upon as a way to reduce the cost of healthcare while actually improving the ...

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The emerging literature on chronic disease management suggests that successful programs rely on patient self management skills. Having been in the primary care role for 20 years, that initially seemed self evident and a bit “so what?” to me, thinking it meant that we just need to teach our patients a bit more in the primary care office. However self-management skills refer to specific curricula of skills ...

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