If you pay close attention to medical education and training, you have surely read something like this as an goal or learning objective: “Manage inflammatory bowel disease and its complications.” However, this is not exactly what our goals should be. One push in the patient-centered care community has been changing the focus from managing the disease to managing the patient who has (or might have) the disease. The difference in wording is subtle, but it gets more ...

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For just a moment, let's take a scientific viewpoint about gun control here and try to leave emotions (and the Constitutional argument) out. The best type of study to determine whether gun control and/or regulation would be a randomized trial: randomizing a state or country to regulation or not. Since that's not going to happen, the next best type of evidence we have to go by is observational, either case-control or cohort ...

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So you’ve decided to take the plunge (or at least, dip your toes) into the Twitterverse.  Congratulations! Welcome to a vibrant interactive community.  You’ll find plenty of different personalities here and lots of opinions.  But if you are like I was back in January 2011, you currently have no idea how to actually use Twitter, let alone how a physician might want to use it. There are plenty of places to ...

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Until recently, there was a financial difference between performing a "consultation" and a "new patient visit" for office visits (Medicare stopped paying for consultations at a higher rate than new patient visits in 2010). In specialists’ offices, patients often got billed for the more expensive “consults” when in fact the visit was not a consultation at all.  Let’s just use this understanding as the brief background for what I’m about to say. I ...

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Today I became a patient.  If you follow me on Twitter, then by now you know what happened.  Yes, I am embarrassed by what happened, but I’ll relinquish my HIPAA right to privacy for this moment. This afternoon I swam nose-first into the sidewall in the pool.  (I haven't been swimming in awhile and I forgot to bring goggles, so I wasn't really looking.  Laugh all you want ...)  It ...

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As an academic gastroenterologist at a tertiary care university medical center, I often see patients who have failed traditional therapies that many of my colleagues in the community have tried. Over the past several years my practice has evolved, from dealing with predominantly the medical aspects of my patients’ diseases to embracing the biopsychosocial model of illness.  One of my colleagues has been the world leader in patient care and research in the ...

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