When he turned 45, Mitch Alsup bought a red Corvette. Mitch is a quick-talking guy with dirty blonde hair and a short, trim physique. He has a ready smile and is willing to share his story. “As a kid, I use to go down to the Chevrolet dealership and sit in a Corvette,” he recalls. “I wanted one when I turned 18, but I came from a poor family. I had to ...

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When was the last time you used heroin?  In the past have you injected heroin or any other drugs?  Are you currently using drugs besides opiates like methamphetamines, cocaine, benzodiazepines or alcohol? After two years of family medicine residency, I ask these questions like they are questions that everyone asks in a casual conversation with a patient.  Although these types of interviews are customary for me, I recognize that it takes ...

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For decades and decades we have been counting the number of doctors in America. For decades and decades we have been coming up short compared to other developed nations, and some less developed ones as well. A poorly educated person may be tempted to suggest that we should “make” more doctors. After all, there is hardly a shortage of young people willing and able to undergo the rigors ...

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I thought about the rather corny starfish story when I was driving home after clinic today. You know the one. It goes something like this:

A man was walking along a deserted beach at sunset. As he walked, he could see a young boy in the distance. As he drew nearer, he noticed that the boy kept bending down, picking something up and throwing it into the water. Time and again ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. If the old adage “the pen is mightier than the sword” is true, then the doctor’s note is the most powerful weapon around. When I entered practice over 25 years ago, I wrote notes when people were too sick or injured to work, or to verify ...

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As a registered nurse and health care writer and editor for more than 25 years, I routinely wrote or assigned stories to other writers about the health of LGBT individuals.  I valued these stories not only because I was a nurse, but also because I thought the subject was worthy of coverage. I believed our nurse readers should be aware of the specific health needs of their LGBT patients. I followed ...

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When I think back about what I learned about drug addiction in medical school in the 1980s, I can’t think of much. Sure, I talked to plenty of patients who had been snorting coke and injecting heroine. One man with AIDS promised to teach me how to draw blood, if I’d sit by his side and keep him company. He didn’t have any other visitors. Maximum security prison where he was ...

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Physicians have one of the highest rates of suicide of any profession: nearly twice the rate of the general population. 400 physicians commit suicide each year in the United States. The stress of being a doctor is constant and unrelenting. The majority of us are perfectionists with a strong work ethic: your classic Type A personality. Maybe we set ourselves up for failure and then cannot accept when it inevitably ...

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1. Quit taking care of yourself. There is no upper limit to the needs of patients. There is always more medicine to learn and do. Add to this the needs of children, aging parents and a partner -- your time for yourself quickly becomes zero. Want to get burned out quickly? Quit exercising. Eat on the run. Have disrupted sleep. Don’t set professional boundaries. Miss enough first steps, parent’s medical ...

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Evidence-based medicine is at the heart of what we physicians do. It is the basis for professional decision-making, and a focus of most journal articles we read. Using solid evidence to practice good medicine has been a foundation of clinical practice for decades. There are consequences for failing to follow evidence-based guidelines. If patient harm results from straying from a more loosely defined “standard of care,” which tends to be evidence-based, ...

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