When I started my internal medicine residency, I was pretty sure I was going to rock this primary care thing. I knew the drugs for hypertension, the guidelines for diabetes management, and depression management seemed like nothing more than an algorithm. I felt buoyed by familiarity as I looked at the problem list for my first primary care patient: basically diabetes, hypertension, and depression. As I opened the exam room door that early July day, I ...

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I have to thank my colleague @SusannahFox for alerting me to this on my Twitter stream. It was a link to a Washington Post article about about a campaign to get people in Belgium to stop Googling their symptoms.

 
Wake up health care: Patients Google it
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Top stories in health and medicine, November 21, 2014From MedPage Today:

  1. Clinical Focus in MS: Novel Approaches to Progressive Disease. Although the drug development pipeline still contains numerous products intended for patients with relapsing-remitting multiple sclerosis (RRMS), the consensus among clinicians is that relapses can be effectively squelched in nearly all RRMS patients with the dozen or so currently approved therapies.

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I’m getting to the point where I think it might be time to stop or at least decelerate the pace of my writing on medicine. When I retired from medical practice almost a year ago there were a lot of pent up experiences that I felt a need write about. But now I have already written about almost everything that I wanted to and, as I am no longer a practicing physician, ...

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Just north of Denver, Jefferson County has become a battleground in the fight over performance-based pay for teachers.  The recently elected school board plans on implementing “[a] compensation system that recognizes and rewards our great teachers,” according to school board president Ken Witt.  The response of the local teachers’ union was for teachers to call in sick and enlist students in protesting what they describe as a proposed “patriotic curriculum.” The protests are ...

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What chaos theory has to do with family medicine Open a new browser tab and check your favorite weather forecast website or app. Right now. How many days in the future does it go? Seven? Maybe even 10? Look at the current forecast for the 7th day out from today. Do you trust it to accurately predict the weather for that day? Why? Or why not? Have you ever wondered why they can’t ...

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Primary care fits some medical students. Heres one. One of the top students at one of the nation’s largest medical schools, Ishan Gohil has made an unusual -- and to many of his colleagues -- inexplicable decision.  Instead of seeking to train in one of medicine’s most highly specialized and competitive fields, he says, “I elected to pursue a career in family medicine.”  Many view his choice of primary ...

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It seems like every few days we get a message in the in-basket of our electronic health record (EHR) about a new type of message that we will be receiving in our in-basket. They call these messages "system notices." OK, maybe that's an exaggeration, maybe not every few days, but the different types of in-baskets and all the information we are bombarded with is getting out of control. As users of electronic ...

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Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place. - Susan Sontag, Illness as a Metaphor Words are important. ...

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Need better care coordination? There’s a toolkit for that.A guest column by the American College of Physicians, exclusive to KevinMD.com. Care coordination seems to be the rage these days. It is mentioned in most discussions of new delivery and payment models such as the patient-centered medical home (PCMH) and accountable care organizations. The concept is not a new one; primary care physicians have been coordinating care ...

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