The non-medical reader may wonder what I am complaining about.  Of course, many of you have to be credentialed in your fields as well, whether law or accounting, law enforcement or public service, education, nursing or a trade.  But those of you in medicine know how difficult it can be to become credentialed as a physician, either by a state for purposes of a license, or by a hospital in order ...

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She is always a difficult admission. The long chart review. The vague complaints. The entitled attitude. The misdirection. These are expected. As is the cake at her bedside after a diabetic crisis. The two-liter soda after an emergent fluid dialysis. The urine toxicology was positive for cocaine. The staff knows her well. I know her well. I give her the attention, kindness and empathy that I give to every patient. ...

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shutterstock_167990879 No one ever wants to meet me.  Well, at least inside of a hospital.  If you are meeting me in a hospital, it is likely because you have been stabbed, shot, assaulted, or in a car accident.  Although the only advice I have about avoiding the first three mechanisms of injury is to stay away from "two dudes" and not try to sell ...

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Remember the Latin phrase “Primum non nocere”? It means “First, do no harm.” Most of us physicians committed to it when reciting the Hippocratic Oath, back when we were first embarking on our careers in medicine. Sadly, today’s technology threatens this sacred physician-patient relationship. Electronic health records (EHRs), although much-needed, have created perverse, unintended consequences for the patient experience. To be clear, EHRs are inherently good.  They’re the backbone of better-coordinated care, ...

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When I was in residency, sexual assault exams were part of our training.  We spent a lot of time learning how to ask the right questions, how to be gentle and empathetic, how to gather evidence appropriately and thoroughly. While many hospitals now have SANE programs (Sexual Assault Nurse Examiner), I have never enjoyed the privilege of working with one of them.  I have, for two decades, performed sexual assault exams on ...

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medpagetodayFrom MedPage Today:

  1. Anthem Data Breach: Potential Game Changer for Healthcare. Anthem Health's massive data breach announced Thursday sent shock waves through the healthcare information technology sector. As many as 80 million people may have had personal data compromised, placing them at risk of identity fraud, Anthem reported.
  2. No Link Between Oxytocin ...

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Walking around the ER in Tiny Community Hospital, I had a few realizations.  In medicine, we hold onto some things very tightly.  We love tradition; we love the known.  We don’t always know why, but we choose "the devil we know," almost every time, no matter how pointy his horns. For instance:  "No cell phones."  First of all, has anyone ever seen a cell phone interrupt anything we do?  No?  Neither have ...

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shutterstock_27236638 I went into an all night pharmacy recently, after getting off of work at 10 p.m. I had to pick up a prescription for my endless, insomnia-inducing cough. Walking up to the counter, I was bathed in the smell of cigarette smoke, carried on the coats of patrons. Eight of us stood by the counter, outnumbering the staff by 100 percent. ...

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shutterstock_154811264 We all went into medicine to save lives. Deep within even the most cynical of us, is still that pre-med hopeful that believes we can and should restart each non-beating heart, make the non-breathing breathe and fill with blood those who’ve bled, filling them back with life. We expect that a patient’s condition will improve while under our care, or at ...

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You live like this, sheltered, in a delicate world, and you believe you are living ... And then some shock treatment takes place, a person, a book, a song and it awakens [you] and saves [you] from death. - Anais Nin On June 12, 2013, my driver and I were on our way to Sierpe, Costa Rica from Manuel Antonio when the road entered a palm tree plantation.  About 50 meters in ...

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