I was called at 4:30 a.m. for a patient with tachycardia in the hospital, and as I logged into my EMR from home, I saw this on Twitter: https://twitter.com/EM_Educator/status/759297946160656384?ref_src=twsrc%5Etfw In under two hours, there were 15 retweets, 44 "likes," and 19 comments that appeared on Twitter (so far), most wishing the patient the best, looking forward to pictures of the angiogram, etc. This is the lovely world of social media, but it also demonstrates his ...

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She fit into the palm of his hand. That long nine months. Waiting desperately for that baby they thought they could never have. Jeff, football player from his high school days, met the love of his life, Bridget, at the school party. She was smart and beautiful; Jeff was big and burley, but as kind and gentle as a kitten. They hung out through their college days.. And finally said their ...

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A few years ago, I missed a diagnosis.  I know that’s not earth-shattering, but the stakes are high for a cardiologist.  Ms. A was an 82-year-old woman with chest pain. She underwent a transcatheter aortic valve replacement (TAVR) for severe aortic stenosis.  The pre-procedure coronary angiogram showed no coronary artery disease and the echocardiogram post TAVR was perfect. However, a few months after the procedure, she reported arm pain.  It was ...

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We are assembling too many panels of people in the name of health these days. Too many. They usually seem like a good idea. I’ve been supportive before. I assumed we needed them. More of them. I might have been wrong. There was a day when I believed my food would be toxic, my medicine harmful, and my safety gone without them. But, I’ve come to believe I was mistaken. I was wrong because ...

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A recent publication in a fine peer-reviewed medical journal of the SPRINT study proved that lowering our blood pressure to the old target of 120/80 or less led to fewer heart attacks, strokes, and kidney failure.  There was no question on what to do with younger people but to lower their blood pressure more aggressively to these levels. Debates arose in the medical community about the ability to lower it ...

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The time has come. The time has come for patients to know how dangerous the state of health care has become and to finally do something about it. I’m ticked off. So ticked off that I’m writing this in between office patients, and I really try very hard to prevent my patients from waiting. Apparently insurance companies feel practicing medicine is as easy as checking off boxes, like hanging chads ...

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Most primary care physicians (PCPs) who admit patients to a hospital are family practitioners or internists. Since medicine becomes more complex each day, PCPs must remain up-to-date on the latest treatment related to drugs, surgery, procedures, risks, complications, and costs. This might require your PCP to be a quarterback bringing together a team of consulting specialists to guide you through your hospital stay. The economics of hospitalization are changing, and since ...

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I’m pulling on my last elbow’s displaced wrist when a nurse pops in, and tells us a critical patient is two minutes away. “Mind staying?” my colleague asks. “Sure.” Paramedics are hunched over the patient as she is wheeled quickly into the resuscitation bay. At the top of the bed, a mask is secured over her mouth and oxygen is pumped with loosely gloved hands. It isn't helping -- her skin is grey -- like ...

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Since beginning my medical education, I had been on one side of the curtain; the side where the doctors confer and discuss before telling the patient his or her fate, going from room to room giving updates and prognoses. I interacted with patients for the purpose of getting their histories and physical examinations, collecting all the data so that I could present the case to my attending. I was engrossed ...

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I very distinctly remember March 16, 2015. I was the chief surgical resident on call for trauma at my busy urban training program. Like any other springtime trauma call I was steadily busy, running back and forth from penetrating and blunt trauma victims in the trauma bay to inpatients, OR cases, and attending rounds. The characteristically hectic flow of the day was interrupted when I got a call from my ...

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