Ladies, the moment you have all been waiting for is here!  No, not affordable childcare.  Not equal pay for equal work. Not gun control.  Not abortion rights or paid maternity leave or a female majority in Congress or a constitutional ban on the words “chick lit.”  Girls, it is so much better than all that.  We got pink Viagra! Flibanserin.  Catchy name.  Addyi for short.  Approved by the FDA for hypoactive ...

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shutterstock_249289327 Fifteen months ago, the Federal Drug Enforcement Agency, or DEA for short, began an investigation in four states: Alabama, Arkansas, Louisiana, and Mississippi.  The DEA was looking for illegal drug trafficking, as they do.  But they were looking for prescription drug dealers, not Columbian drug cartels.  And they found them.  They are doctors. Forty-eight people were arrested, seven of them doctors.  DEA ...

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shutterstock_189396983 Out-of-context quote of the day: “We have no malls and no Walmart.  Recruitment is nearly impossible.” These astonishing statements were made by Elizabeth Nelson, a nurse practitioner in Nebraska.  She was not talking about teenage summer jobs.  She was not talking about professional Walmart greeters, addicts of cheap stuff made in China who want an employee discount, or people who really like Cinnabon.   ...

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Humans are social creatures who naturally evaluate where they stand in relation to those around them. I have no idea how this evaluation process evolved, but at some point we noticed that some cavemen brought more food to the cave than others. The idea was born that some people are better hunters than others. We’ve been trying to decide who is “better” ever since. The origin of the word "test" comes ...

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shutterstock_151206914 A few weeks ago I wrote a piece about performance metrics in medicine.  People asked me:  “Well, if you don’t like the metrics, what would you use?”  So I thought about this, and the best way I can think of to explain what I mean is to use an example from a different field: education. Standardized testing has become ubiquitous in schools.  ...

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shutterstock_231666442 I have been blogging now for about three years, posting once or twice a week and accumulating 240 posts.  I have my little flock of loyal readers and have managed to contribute a few drops in the ocean of the health care policy debate.  But just this month two pieces made some bigger waves, one ending up briefly fluttering about Twitter, ...

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New York officials are doing an “experiment” that should strike fear, anger, and outrage in the hearts of doctors who take care of Medicare patients. (New York has the highest Medicaid budget of any state.) As any doctor who has a high volume of Medicaid patients knows, Medicaid pays practically nothing.  Doctors who take Medicaid usually have to carry a bigger patient load to survive.  Medicaid patients are often sicker than ...

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Medicine is obsessed with numbers.  Or rather, journalists and medical administrators are.  Here are two related examples of how large a grain of salt one must put on numbers. Cardiac surgical procedures, like everything else in medicine, have quality indicators.  One of these is what we doctors call “30-day mortality.”  What this term means is that surgeons are evaluated in part on how many of the patients they operated on died ...

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shutterstock_176087576 I was talking to a colleague of mine yesterday. (At least I flatter myself that I am a colleague.  He has a writing job at a prestigious magazine while I, well, don’t.)  We were talking about the doctor-patient relationship, as is our wont, and he said something that stood out to me as the quintessential statement of patients’ expectations about doctors. It ...

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In order to interpret the world, we tell ourselves stories.  All day long.  About everything.  That guy in the grocery store who clipped your heels with his cart?  A jerk.  The car that cut you off at that intersection? A jerk.  A little old lady stopping in the middle of the aisle at the grocery store?  Senile. It is automatic, it takes no effort, and it is completely egocentric.  It is ...

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