A few weeks ago Bill Maher made a number of critical remarks about medicine and physicians. I sent Mr. Maher the following response in an effort to address his comments. I am sharing this with you in hopes that other physicians will also speak out in defense of our profession. Dear Mr. Maher, Let me start by saying that I have been a fan for many years. While I do not always ...

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Three years ago I received some of the best news of my life -- that I have dopa-responsive dystonia. (Yes, a neuromuscular disorder was welcome news.) Painful, life-interrupting muscle contractions had made the dystonia diagnosis likely several years before, despite poor response to standard treatments, and I was fighting through graduate school: trying to compensate for medication-induced memory problems, increasing need to work from bed, and a disappearing social life. ...

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Cholesterol pills are one of the great medical advances I’ve witnessed during my professional career. I am talking specifically about a category of medications called statins, drugs like Lipitor and Pravachol. These drugs have prevented probably hundreds of thousands of heart attacks and strokes. Only one problem with these drugs, however: statins won’t help people who don’t take them. And according to a study in the Annals of Internal Medicine, when ...

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Many of my patients are taking herbal supplements, or so they think.  This herbal and health supplements industry likely is envied by traditional pharmaceutical companies.  The latter has to spend zillions of dollars proving safety and efficacy to the Food and Drug Administration (FDA).  Many of these drugs are cast aside during the approval process or afterwards when serious side effects become known, or a new medicine is proved safer ...

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The letters are usually four pages long and begin by saying that my patient has received a temporary supply of the medication I prescribed. Next, there are general paragraphs about how the drug either isn’t on their formulary or the quantity exceeds the plan limits. None of these letters contains a reference to an online formulary physicians can access to compare covered alternatives. Then there are several cumbersome explanations about the appeal ...

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As the Centers for Disease Control and Prevention (CDC) reported that people who received this season's influenza vaccine were only 23 percent less likely to be diagnosed with influenza than unvaccinated persons, CDC director Tom Frieden was publicly urging high-risk patients and their physicians to use antiviral medications to prevent complications and disease transmission:

People who are sick with flu, if they're very sick in the hospital or if they have ...

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Parents are appropriately expressing concern about the safety of Miralax®, a commonly used stool softener in kids, after a recent New York Times article exposed a potential association with long-term use of the drug and undesired behavioral side effects. As the article explains, the FDA has awarded a research grant to a team at the Children’s Hospital of Philadelphia (CHOP) to directly address these concerns. Miralax® has been used ...

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Spend less.  Live better.  Except, she didn’t have that long to live.  Maybe ten days ... probably not. Thirty-three years old, an illegal Mexican migrant worker, she was diagnosed in an emergency room with an aggressive stomach cancer two years ago, and she had been fighting for her life ever since.  Multiple rounds of chemo administered through our community medical clinic had not worked. And now, here she was in my ICU, ...

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The really incredible advances in the treatment of hepatitis C bring to life several relevant questions as we move forward into 2015. First, who should be treating hepatitis C patients (primary care providers, gastroenterologists, infectious disease specialists)? Second, can we really afford to use these new treatments? I recently discussed this topic with my GI and hepatology colleagues in AGA Perspectives, the bi-monthly opinion magazine of the
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If I could drop our health insurance altogether, I would. With a high deductible of $4,000 for in-network providers, my family of three has yet to reach our collective deductible over the last three years. This means we have to pay out of pocket for medical care until we reach that amount. To make matters worse, our health insurance premiums increased by 10 percent, forcing us to find a less ...

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