For the last several weeks, I have been working as a medical volunteer on a remote island off the coast of Fiji called Batiki. Home to 234 natives, Batiki has no running water, and no electricity (other than solar generated power). The inhabitants are subsistence fishermen and farmers. They are filled with joy and a real sense of community. While on the island, I found extremely high rates of high ...

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I’m pleasantly surprised to see how a growing number of physicians are finally starting to percolate openly with their extreme dissatisfaction about a just how broken our medical system is. I admire and am proud of these brave vanguards who are a minority but have seemed to pick up steam. I still don’t hear their fearless voices carried in major media outlets (shame on these outlets!), but they are more ...

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One of the biggest points of contention in the ongoing discussion of burnout is that the system of health care is flawed.  The endless bureaucracy, decreasing physician pay, and increasing meaningful use requirements that spawn endless clicking on an already inefficient electronic medical record platform have become unbearable by most practicing physicians today. Furthermore, all the talk about mindfulness only riles up more anger in physicians as they feel they are ...

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Repealing and replacing the Affordable Care Act is on indefinite life support. The political consensus was that President Trump needed to pass health care reform to be able to move forward with his legislative agenda. While this may be true, the passing of any repeal and replacement bill without fundamental reforms has little chance of long-term success, likely defining Trump’s presidency as a failure no matter how successful he is ...

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It’s a health care buzzword for sure, but when we talk about quality, what do we mean? We can compare the quality of similar things and focus on its absence, but otherwise, putting the idea into words becomes complicated. Context is important. And so is perspective: One’s position within the health care system influences how he defines quality to a larger degree than it does at a restaurant, or in ...

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#Tweetiatrician is a common hashtag used by pediatricians as a way I assumed to find advocates for children’s issues. Recently, I used this hashtag to start a new Twitter account. I sought educated dialogue on Medicaid, health care reform, vaccination, and other pediatric topics. I am a pediatric emergency medicine physician and consider myself a strong advocate for children and seldom agree with any political party. My advocacy work in many forms ...

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The McDonald’s cheeseburger is an icon of America. Admit it, you know you love one. A guilty pleasure to say the least, but as far as cheeseburgers go, it is far from the best. In reality, if you were to taste test all cheeseburgers, the McDonald's burger would probably rank near the bottom. The beauty is that no one cares, and they sell these things by the millions. Why? Because ...

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Just a year after the Supreme Court rejected a challenge to race-conscious admissions in Fisher v. University of Texas, this issue is being pushed back to the front of the room by none other than the Trump administration’s Justice Department hauling out hoary tropes about “reverse discrimination.” They are preparing cases against Harvard and the University of Pennsylvania, charging to the rescue of the multitudes of ...

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The writing's on the wall. The last few decades have seen two groups of people: One group that is “dying longer,” yes some might call it living long but not healthy. (As a physician, I call it dying longer). These are folks who are disabled, obese or emaciated and depressed or demented, with multiple medical issues spending a quarter of their life in the medical system, and the last decade of ...

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In a terrible twist of fate, the very day that the Centers for Medicare & Medicaid Services (CMS) Hospice Compare website went live, I found myself in a pulmonologist’s office with my parents, taking in the news of my mother’s advanced cancer and malignant pleural effusion. The shock of it, and the uncanny timing are beyond comprehension. You see, I’ve been leading research at RTI International and ...

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