As I get near the completion of an intense 5-year orthopedic surgery residency program, I had an interesting interaction with our hospitals sub-committee specifically tasked to address duty hour and resident fatigue issues. As they gave examples from other departments about changes made to their programs regarding duty hours, a clear-as-mud connection was continually made. They spoke of “improvements” made as the result of residents stepping up to serve as whistleblowers ...

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As far as follow-up appointments go, this one was routine. My 65-year-old patient had undergone hip replacement surgery two weeks prior, and we discussed her pain level, progress with physical therapy, and eagerness to return to everyday activities. But as she stood up to leave the exam room, I could tell there was something left unsaid. She stepped out the door then stopped, turned around, and leaned in close to ...

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"I have always depended on the kindness of strangers." - Blanche DuBois, A Streetcar Named Desire, Tennessee Williams It was near the end of 2008 that I developed symptoms that I recognized as sciatica.  The Internet is a wonderful source of information (and some misinformation).  I decided to educate myself.  In my reading, I encountered one study that indicated that patients who underwent surgery were better at one year, but about the ...

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Robert was the picture of health. He had run eight marathons and finished countless 5K and 10K races. He tracked everything from sleep to food intake, logging his exercise parameters religiously. A seven-minute mile was a routine workout for Robert. But over the course of a few days, he noticed that he felt more winded during his run. One morning, when he awoke and checked his heart rate variability (HRV), it ...

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I  have lately been discussing the state of health care with a lot of doctors. I’m a doctor, and I’m also a consumer of health care services. Imagine my surprise when I visited a local ER on a three day weekend, hoping to get some advice from someone who might be able to use the panoply of diagnostic tools available in the ED to help me mitigate the pain of a ...

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Dear personal trainers, I’ll admit it: I was skeptical. In the past, I doubted that personal trainers -- at least for me -- could offer real value. It’s not that I gave it much thought, or had anything against personal training, but if the idea were brought up, I’d laugh it off and say, “No personal trainer can push me harder than I push myself.” But I’m writing this to say that I was ...

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shutterstock_52832917 Daytime TV advertising is dominated by two players. Pharmaceutical companies with direct to consumer pitches and the so-called "toxic tort." How confusing it must be to the average person to see a new drug pushed by one commercial, to be immediately followed by another commercial from a lawyer trying to sue for the known side effects of the exact same drug. It ...

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shutterstock_95651341 There can be little doubt that these days that political correctness has run rampant. Terms like "racist," "sexist," or "homophobic" are thrown around so frequently and early now that one has to wonder what is actually being accomplished. If you were to ask a physician what PC label they most fear, it would be "disruptive." Let's face it. We are no longer ...

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While there are worse times to sprain an ankle and chip a bone than just one week before a long­awaited trip to Venice, I couldn’t think of one as I sat in the emergency room for eight hours last fall. Venice, the place of canals and not cars; ancient bridges sans escalators. How ironic that just a few days before I was crowing to my husband over my hotel coup. A ...

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shutterstock_110078714 In Bill’s room were his doctor, a medical scribe, a physician assistant, and a medical student. Not an imposing group, but in that moment each of them knew more about what was happening to Bill than he did. They were strangers who held keys to his fate. The doctor first instructed the scribe to generate an electronic note. Then, he turned his ...

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