As we head into health insurance enrollment season, which opens in November, consumers/patients will face yet another challenge in selecting the best health plan. Sorting through policies was tough already, but now insurers are making it even harder by changing the way they will cover generic drugs. It used to be that opting for generics was a snap. Health plans usually offered three or four tiers of drugs -- one for ...

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shutterstock_32552761 Recently in the emergency room, I saw a 35-year-old patient -- we’ll call her Jane -- who was vomiting blood. The source of the vomiting turned out to be a bleeding ulcer caused by unintentionally overdosing on ibuprofen. Jane was in pain -- she was taking prescription ibuprofen for her chronic knee pain -- but she was also taking over-the-counter (OTC) ...

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I received my new thinner bigger iPhone.  Within a few days, news reports highlighted how new iPhone 6 owners accidentally bent the latest Apple iteration of the modern smartphone. A blogger bent an iPhone 6 Plus with his bare hands. This story, the subsequent fallout, and response has learnings for doctors and health care on the challenges facing the vaccination “debate.” The best launch in iPhone history with roughly 10 million smartphones shipped ...

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There he sat, hunched over with rugged, muscular arms stretched across his abdomen, his weary eyes stealing hopeful glances from behind an otherwise steely facade. Mr. J was a 53-year-old Latino agricultural laborer with a history of H. pylori who presented at our student-run free clinic with persistent abdominal pain, unchanged from his multiple previous visits. As I learned more about Mr. J and his story, I realized that treating ...

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Since 1996, 21 states have approved the legalization of marijuana for medical use. More recently, Washington and Colorado have legalized the use of recreational marijuana, with California and Oregon not far behind. The health risks associated with marijuana have been well documented in a number of studies, but these are secondary to the much greater mortality risk associated with an increased prevalence of the drug: driving under the influence. As is ...

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Twenty-five years ago, the New England Journal of Medicine issued a report on a stunning new medical discovery: Aspirin helps prevent heart attacks. Yes, good ol’ aspirin. Known since the time of Hippocrates for its magical abilities to quell fever and pain, it took only 2,000 years for us to understand the science of it well enough to design a ‘sufficiently powered’ double-blind, placebo-controlled randomized trial on aspirin’s efficacy in preventing heart attacks. The Physicians’ ...

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Respiratory syncytial virus infection, aka RSV, is a common infection in children. A key aspect of RSV is how poor a job our immune systems do in fighting it off. Virtually all children are infected with RSV during the first few years of life. Not only that, all of us are reinfected multiple times during our lives. Attempts at devising a vaccine for RSV have all been unsuccessful. In fact, ...

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Few medical interventions have been as successful as vaccines in improving public health. Whether they are childhood vaccinations, vaccines to prevent healthy adults from contracting influenza or the more recent HPV vaccine for adolescents, these preventive methods have resulted in dramatic benefits for individuals and the public. We have only to think of the eradication of smallpox and the virtual eradication of poliomyelitis to see the enormous benefits vaccines can bring. ...

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I recently treated a patient who was hospitalized with paraplegia. During some routine lab testing I noticed that his liver function tests were elevated, and so I began looking for a cause. I discussed the patient’s drinking habits (he rarely drank alcohol), risks for viral hepatitis (no IV drug use or exposure to those with known hepatitis), and general medical history (nothing relevant to liver disease). I reviewed his current ...

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shutterstock_184787189 Fran Barker called today. She was in a panic because the cost of her monthly prescription of 150 mg amitriptyline tablets had gone up to $130 from $13 the month before. Amitriptyline has been available in this country since 1961, and the 100 mg strength was on Walmart’s list of $4/month drugs the last time I looked at it a few months ...

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