There’s one question I get asked a lot: “I research my health problems on the Internet. Am I a hypochondriac?” First, we should ban that word when talking about ourselves. No one wants to be called that, and doctors who use that word are committing malpractice. Everyone has some range of complaints and worries in life, often physical and mental together, and this is our job as doctors: to hear them ...

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glass-faces Remember the figure-ground drawing from psychology 101 that demonstrates (ahem) "how edge assignment designates perceptual groupings?" I always just thought it was cool how you could look at the picture of a vase and blink and -- whoa, Nellie -- now you saw two people face-to-face. I'm concerned that the frantic drive toward evidence-based medicine as a strategy for quality improvement and ...

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There’s an elephant in the room, one that’s preventing patients from getting the most out of their visits to the doctor -- and the name of that elephant is embarrassment. It’s not unusual to feel uncomfortable about some of the more intimate aspects of your health, but too often this discomfort turns into outright embarrassment.  This embarrassment can lead to omissions, which in turn make it impossible for your doctor to ...

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An excerpt from Second Firsts: Live, Laugh, and Love Again. I spent nearly 4 years in the waiting areas and patient rooms of cancer hospitals. I was not the one with cancer but my husband was. He was diagnosed with stage IV colon cancer. He was only 31-years-old. I remember the day ...

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The roll out of Healthcare.gov has given plenty of ammunition to opponents of health care reform, who style themselves as crusaders against incompetence. While many who oppose the program do so in good faith, some critics carry an ugly prejudice against sick and disabled people. That prejudice is "just deserts" -- the idea that people get what they deserve. Rich people deserve their luxury. Poor people deserve their poverty. Sick and ...

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Imagine your spouse, parent, or best friend gets a left ventricular assist device (LVAD). This is a mechanical device put into their chest. A wire sticks out of their body and connects to a bunch of different electronic pieces you’ve never seen before. You’re in charge of making sure this wire stays clean. If it doesn’t, it could mean infection and possible death. So, you know. It’s kind of a big responsibility. Of ...

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Outsourcing work to cheaper workers is a common strategy of corporations. It has largely escaped the public's notice, however, that much of this new labor force isn't located in Southeast Asia, but is rather found here in the U.S. and is virtually free. It is we, using our laptops and smartphones to perform tasks once carried out by knowledgeable salespeople and service representatives. This was particularly salient to me this week: ...

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asco-logoEvery once in a while, something unexpected occurs that shakes me to my core -- where I question the point of life, ask why we even bother; when in the end, it all just ends. This time, it happened on a Sunday morning. I woke up in a good enough mood -- the sun was shining through my windows, and my cat, ...

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At the International Conference on Communication in Healthcare, which I just returned from, there was a discussion continuously coursing beneath the surface and bubbling up every once in a while. If we, acolytes of shared decision making, whether patients or providers, want to encourage decision making that has the person involved at the center, recognizing their preferences and values, does the kind of decision in question have anything to do ...

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My daughter loves her career as a probation officer. She is very good at what she does, and finds the work both challenging and rewarding. Yet her client case load includes some of the most unsavory of individuals, found guilty by the courts of child abuse, domestic violence, sexual assault or worse, many of them  living with added complexities like addictions or mental health issues. She’s been insulted and screamed at by ...

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