“He’d feel okay about not replacing the pacemaker’s battery when it ran down, he said. But turning it off, he said, would be 'too active.' Later he would tell me that it would have been “like putting a pillow over your father’s head.” These are the words of Katy Butler in her book Knocking on Heaven’s Door – The Path to a Better Way of Death in which she writes about her ...

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Top stories in health and medicine, September 17, 2014From MedPage Today:

  1. Exercise Keeps BP Steady Despite Age. A progressively rising blood pressure trajectory is not an inevitable part of aging in men who remain active and maintain high levels of cardiorespiratory fitness.
  2. AAFP Wants GME $$ Decoupled From Hospitals. Graduate medical education (GME) should mostly take place in the community ...

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“Doctor, what do you think of alternative medicine?” a patient with chronic fatigue syndrome asked me the other day. She was interested in doing something more for her severe fatigue. “Would acupuncture help me?” I paused and, as I have done many times before, answered that my training and most of my clinical experience has been in Western, allopathic medicine. (Ironically, the word “allopathic” was first used as a derogatory term ...

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Top stories in health and medicine, September 16, 2014From MedPage Today:

  1. GLP-1 Plus Insulin Betters Glycemic Control. The combination of GLP-1 agonists and basal insulin beat other type 2 diabetes treatments at lowering HbA1c and improving glycemic control.
  2. Obamacare Does Little to Cut Kids' Uninsured Rate. The uninsured rate for kids under age 18 hasn't budged under the health law, ...

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If a doctor doesn’t do excess testing, he isn’t going to be able to live An excerpt from Doctored: The Disillusionment of an American Physician. After the blowup with Rajiv, I committed myself to changing my standoffish ways. Rajiv had been urging me for some time to meet socially with his physician friends in a relaxed atmosphere away from the hospital, and so there I was a few weeks later at a doctors’ party in Manhasset, a tony ...

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Top stories in health and medicine, September 8, 2014From MedPage Today:

  1. Dialysis Drug OK'd for Marketing. A new phosphate binder has been cleared to treat hyperphosphatemia in chronic kidney disease (CKD) patients on dialysis.
  2. Medicare ACOs See Benefits Despite Issues. Participants in Medicare's accountable care organization (ACO) programs have had their share of frustrations, but their enthusiasm for the ACO ...

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Top stories in health and medicine, September 5, 2014From MedPage Today:

  1. Potent Statin Offers No Help After Cardiac Surgery. The powerful lipid-lowering drug rosuvastatin (Crestor) -- also purported to be an effective anti-inflammatory agent -- was powerless to prevent postoperative cardiac surgery complications such as atrial fibrillation.
  2. Questioning Medicine: The Pain Management Fiasco. I spent my intern year at a ...

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Top stories in health and medicine, September 4, 2014From MedPage Today:

  1. Battle Over Abortion Clinic Restrictions Heats Up. The nation's fight over abortion continues unabated, but the battleground has shifted -- instead of seeking to limit who can obtain abortions, the latest legal attacks on abortion now focus on who can perform them.
  2. CDC Head: Ebola Likely to Worsen. The ...

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Top stories in health and medicine, September 3, 2014From MedPage Today:

  1. Low Carb Beats Low Fat for Weight Loss, CV Risk. For weight loss and for reducing cardiovascular risk, cutting down on carbs was a more effective strategy than limiting fat intake in a randomized trial.
  2. States To Help Pay Obamacare Tax on Insurers. When Congress passed the Affordable Care ...

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As I begin another year teaching EKGs to our new residents, I find I am increasingly asking myself, "Where to teach?" I do not mean to imply a geographic sense to the word "where" (although this is difficult, too, as residents move from hospital to hospital in large health care systems like ours as they change rotations), but rather as more of a "level." What level do I teach our residents ...

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