A few weeks ago a patient came into my office referred for evaluation regarding surgery on her carotid artery. Although she had no symptoms, her primary physician had performed carotid ultrasound and found a severe narrowing on one side. She presented the results of this examination, and several additional diagnostic studies that had been performed recently. As it turned out, the doppler was inaccurate and she did not have any narrowing. ...

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We are no longer surprised when a patient is asked if they take their blood pressure medicines every day, and we are told "it depends." Yes, it can be amusing to hear how one member of a couple decides that they know more than their physician, and makes decisions based on home blood pressure measurements. Sample quotes may include “she thinks she is a doctor”, or “I decide what to give ...

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I live in New York. Last week my daughter in Chicago called to say that a five dollar charge had been refused at a local coffee shop. My credit card company had identified an unusual pattern of purchases, and had put a hold on the card. No similar process exists for the Medicare system, where cost savings could be realized by systems that identify unusual patterns of charges and outright abuse ...

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