“Liver Transplant Surgeon Addicted to Alcohol” -- reads like a headline from a tabloid paper selling sensationalism. How could it be? How could a liver transplant surgeon, someone who sees up close and personal the devastating effects of alcohol on the body, be addicted to alcohol? Surely the diseased, fibrosed, hard, shrunken cirrhotic livers with dilated and engorged veins that can rupture and bleed catastrophically; the yellow eyes and skin of the ...

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Orthopedic surgeon Thomas Guastavino often alludes to his "rules of medicine" in the comments.  Here they are in their entirety. Efficacy, safety, and cost are of chief concern. If two treatments are of equal efficacy, choose the safer. If of equal efficacy and safety, choose the cheaper. Cost never trumps efficacy or safety. If you want the fastest, most efficient and cost-effective care, go to the physician with the most experience in dealing ...

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I find myself standing in front of six first-year medical students. They’re waiting for me to tell them something about how to become a physician entrepreneur. These students are now elite amongst their peers. They’re the ones who’ve had the courage to sign up for my course. And, perhaps unbeknownst to themselves, they’re also among the 1 percent of early adopters to lead the way for health care change. How do I ...

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All hopes were abandoned.  In theory, it was supposed to jump start medical care and provide access to the uninsured.  It was the promise of a new day. Every American would have access to good, quality (I really have learned to hate that word), affordable medical care. I’ll never forget that day.  It was raining hard, and my clothes were soaked through. The air felt particularly raw against my skin. The ...

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Women physicians are a testament to evolution; they’ve spent years, decades even, navigating through systems that do anything but cater to their unique needs, and actually find a way to thrive within these systems. My question is this: Why haven’t these systems really evolved with them? It’s now been 167 years since Elizabeth Blackwell became the first woman to graduate with a medical degree in the United States. Nowadays, just shy of ...

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In my practice of facilitating cancer support groups, all I do is listen to patients and their families. Consequently, I hear much about the nature of their care. They generally speak favorably about its technical aspects, and indeed these are often awesome. But when they complain, it's uniformly -- and I mean one hundred percent -- about communication. One man has been trying to get an appointment with a pulmonologist for ...

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Closing a medical practice to new patients is like cutting off the very top of a tree. It’s the beginning of the end. The top of the tree, the crown, is where the newest leaves are. It’s also the part that continues growing ever upward, at least until it reaches it’s maximal genetic height, depending on environmental factors like the availability of water and sunlight (both of which also depend on ...

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It’s amazing what you can learn from the stranger sitting next to you on a flight. As I wait for my neighbor to grab her seat next to me, I secretly hope she embodies the qualities I hope for in a fellow passenger -- keeping to herself and not requiring in-flight medical assistance. I make eye contact with a young woman who gives me the nod that she has the middle ...

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Today I met a man who wanted to interview me before transferring his records. He was about my age and seemed polite and pleasant enough. He told me his doctor of a dozen years had started to taper him off his long-term narcotics after he reported some of them missing because of theft. He used to take the equivalent of about 1,200 mg of morphine per day for his back pain. ...

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Within the last several weeks, I’ve had two plumbing issues that have caused me to reflect on the honorability of various professions and the way in which people go about earning an honest day’s crust. Let me take you back to the beginning of the story. I was actually working nights a couple of months ago when I noticed, just before I was about to leave for the hospital, that my ...

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