We all want the advantage.  We put our kids in special preschools so they have the advantage.  We work 100 hours a week so our kids can do 8 activities and get the advantage. Tall people have an advantage, we’re told.  Poor people are “disadvantaged.” Well folks, there are a whole bunch of senior citizens in Massachusetts who are about to get disadvantaged starting September 1. UnitedHealthcare (UHC) will be
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There are plenty of examples of direct-to-consumer advertising that the pharmaceutical industry use to lure new customers. These ads almost universally make emotional appeals to the consumer, as well as focusing on the benefits rather than presenting any real discussion of risks. What if someone used a similar concept, but instead of trying to get people to take a drug, they try to convince patients to stop one. That’s just what ...

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It was just a regular hot and humid Saturday morning in Miami, and I was on my way out of a local Walmart after buying a few items. As I walked to my car at the end of the parking lot, I heard a voice asking me “Son, any change?” In a neighborhood that is known to have a disproportionately large amount of vagrants, I did what I usually do ...

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Mr. Katz sat on the edge of his chair in my clinic room, teetering as if he might fall at any moment. He was 86-years-old, and his thin body had become weak and tired. But his angry eyes, like a petulant child, stared at me. “Doc, you should have just let me die,” he said to break the ice. I had just discharged Mr. Katz earlier in the week from the hospital. ...

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A few months ago, the father of a primary care physician came into the emergency department with syncope.   He was 102 years old.  His age was more than double his heart rate.  That may or may not be bad but it certainly is often a reason for more testing.  The senior resident seeing the patient ordered an EKG, a battery of labs, a head scan,  and anticipated admitting the patient ...

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This quarter of medical school has by far been my favorite, because almost everything we do has an explicit clinical correlation. Each week we work in small groups of 10 or so students to go over patient cases, practice respiratory and cardiovascular (our two organ blocks this quarter) physical exam skills, and interface with real patients in the hospital. These experiences have been both exciting and humbling, and two in ...

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Her wary eyes, magnified from her thick-lensed spectacles, watched my every move as I pulled room 21's curtain to the side and entered her room. In her early eighties, it was apparent to me that my entrance into her life was more important than the abdominal pain that brought her to our emergency department. In the corner sat a slight man with wispy gray hair poking out from the border ...

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Agnes was out shopping at her local corner store.  At age 82 her body was beginning to show typical signs of aging.  She had survived breast cancer surgery, a hip replacement, and cataract surgery.  Her doctors told her she had osteoporosis and low vitamin D.  She took medications for her hypertension, cholesterol, and osteoporosis.  Her spine had begun to curve and her gait was a few steps slower. Yet, with her ...

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Today, a patient attacked me. A nurse got kicked. Another punched. I was gouged to the point that blood was drawn. The patient was neither intoxicated nor psychotic. Rather, she was a meek 92-year-old grandmother, and she was terrified. It took five of us to hold her down, as she summoned the strength of a woman fighting for her life. Linda is an elderly woman with moderate dementia. She is blind ...

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You were supposed to die of cardiac arrest as you circled toward home plate. Or of a brain aneurysm in the summer during one of your countless hikes through the mountains. You weren't supposed to die here. Not in a hospital bed, inhabiting this fragile new body, with an oxygen tube in your nose and tumors in your lungs. Two days before you left us, I traveled home to visit you. I'd ...

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