Readers know that I am skeptical over the efficacy of complementary and alternative medicine. This is not merely a demonstration of my inborn skepticism, but doubt based on the fact the so much of their claims are untested, unproven and refuted. I don’t regard the above comment as controversial. It is factual. I’ll let readers decide if it is but another example of the arrogance of conventional physicians who worship on ...

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Physicians and patients collaborate to treat symptoms. This is not newsworthy and even sounds appropriate. Isn’t that what doctors are trained to do? It is but I’m not sure this should be a central focus of our healing mission. Treating a symptom is not the same as treating a disease. For example, if an individual is having abdominal discomfort, pain medicine should not be the first responder, even if this would ...

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Sometimes, we play a little politics on this blog.  I am a student of current events and enjoy following the dysfunction and absurdities in American politics.  To paraphrase the legendary former British prime minister, "never has so little been done by so many to benefit so few." Readers know how skeptical I am about medical dogma.  When I was an intern a quarter century ago, I didn’t grasp why routine measurement ...

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In the medical world, when a physician, a scientist, a hospital, a drug company or a panel of experts issues a report, the games begin. If one agrees with the statement or benefits from it, then the report is heralded as breakthrough brilliance. If, however, the report suggests a new medical pathway that diminishes your relevance or reimbursement, then the report and its authors are regarded as misguided. Yes, I am ...

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Autonomy is a bedrock ethical principle in medicine that has supplanted medical paternalism.  Patients have a right to make their own medical decisions and are entitled to know the advantages and drawbacks of all reasonable options.  Clearly, informed consent cannot be given if the patient is only partially informed or has been given a slanted presentation by the physician. When a patient does not have the capacity to provide consent, then ...

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While patients and physicians operate under oral agreements, business agreements are generally established in writing. In these documents, terms are outlined including contingencies in the event that foreseeable obstacles or disputes develop. Oftentimes, the two parties do not agree that a contractual term has been violated. This is when the fun begins. With a little luck, the legal profession enters the arena and can speedily resolve the disagreement in a ...

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Many times over the years, I have witnessed the following scenario in my exam room. Here’s the set up of this one act play. Characters: Elderly patient Attentive daughter The doctor Scene 1 I’m seated at my desktop computer. The patient is seated before me. The patient’s daughter is seated next to her mother. A patient comes to see me in the office with medical issues that strongly suggest that a colonoscopy should be performed. As an aside, ...

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Obamacare has promised to provide all of us with quality medical care that is affordable and accessible. The very name of the law is the Affordable Care Act, which I have maintained will be short on both affordability and quality care. Most of the country agrees with me. The postponement for a year of the corporate mandate to provide insurance in businesses with at least 50 full time employees was a ...

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Everyone is familiar with the acronym HIPAA, which is the 1996 edict called the Health Insurance Portability and Accountability Act.  Isn’t that a smooth and melodious name? These are and regulations that are designed to protect your confidential protected medical information.  I support the mission.  I don’t think that your medical records should be deliberately or inadvertently shared with those who are not lawfully permitted to view them.

I had thought that apologizing was a straightforward act, but I now realize that it is a nuanced art form. We’ve all heard the "mistakes were made" version, usually issued by politicians who attempt to insert a layer of passive voice insulation between themselves and their screw-ups. There is also the ever present conditional apology which by definition falls short of complete responsibility acceptance. The template here is: “I’m sorry for ...

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