This past April, just after the Centers for Medicare & Medicaid Services (CMS) released the highly-anticipated 2012 Medicare provider charge data, the New York Times published an article,"Sliver of Medicare Doctors Get Big Share of Payout." Almost everyone agrees that transparency in the Medicare payment system will likely lead to more efficient health care delivery with less waste and less fraud. However, thoughtful analysis must be performed so that undue stigmatization ...

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The first lecture in a radiation oncology residency program is “Radiation Oncology Emergencies,” to educate the new residents how to manage inpatient consultations and emergencies. While preparing my lecture this year, it occurred to me how useful this basic information would be to the physicians calling for the consultation. Sharing our thought process in triaging patient explains why we don’t rush to utilize radiation, even in cases of a cord ...

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Top stories in health and medicine, July 25, 2014From MedPage Today:

  1. Vitamin D Megadoses Safe in Frail Elderly. Giving a very high dose of vitamin D -- 20,000 IU per week -- to older patients in nursing homes keeps them sufficient in the vitamin and appears to be safe.
  2. Medicare Tests Exceptions to 3-Day Rule. Medicare officials have allowed patients ...

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As many of you picked up from the tone of my last article, I am feeling much, much better. As more time has passed from the disasters of six weeks ago when I lost my relationship and home (making me feel more physically ill than I had felt this entire time), my body has finally had a chance to recover. I also have benefitted from a three-week break ...

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I have written many columns urging doctors to be honest with their patients, especially about difficult news.  Too often patients are lead on false hope therapy rides, rather than empowered with honest information so that they can cope with their disease and future. Doctors are not the only ones who can keep a painful secret. I admitted Sarah to the hospital late on Saturday night.  For over two years, she had ...

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Kasey sits alone in the examining room, staring at the drug company calendar of a perfect Caribbean beach hanging above the doctor’s desk, but not seeing it at all. She is very frightened.  After three years of treatment for cancer, she is in trouble.   Kasey feels fine: no shortness of breath, no cough, no pain.  Still, she is there to get the report on her CT scan, and she knows ...

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The impact of social media on cancer careI recently had the privilege of participating in a meeting hosted by the President's Cancer Panel on the role of social media in improving cancer control and treatment. The goal was to give advice to the Panel on a planned series of meetings they will be convening to discuss the topic. It was the range and quality of ...

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Only in America can we find a way to scare the bejesus out of a woman with normal breasts and a normal mammogram. Because that’s exactly what happened when New York Times reporter Roni Caryn Rabin read her entirely normal mammogram results letter: "A sentence in the fourth paragraph grabbed me by the throat. 'Your breast tissue is dense.'" I can’t really blame Rabin for being afraid. The information about breast density in ...

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Recently, in front of my family, friends, colleagues, and teachers, I accepted my diploma during the graduation ceremony for the UCLA psychiatry residency program. While it wasn’t my real diploma -- it’s been months since I’ve been able to work, so when I’m better I need to go back and finish some requirements -- my residency program coordinator put together an awesome fake diploma so I would have something to pick ...

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With advanced cancer, there are no guarantees"I just want to know that she'll be able to travel," my patient's husband said. Stan and Jane Jackson (names changed) sat side-by-side on the mauve loveseat in the exam room. A binder filled with sheaths of paper -- copies of Jane's lab reports, CT scan reports, discharge papers, and chemotherapy information handouts -- sat open on his lap. On top ...

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