EpiPens have gotten crazy expensive, yes: $600 for a two-pack. Here are some alternatives that might help you save a few bucks. 1. Wait a few weeks, and see what Mylan does. Mylan, the company that makes the “EpiPen” brand of epinephrine auto-injector, has been under a lot of pressure lately to back off their unseemly price gouging. They’ve introduced a savings card that claims to lower your ...

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You are currently on inpatient wards and notice your chief medical resident has been demonstrating erratic behavior, frequently muttering about MEN syndromes and antibodies associated with rheumatologic diseases and has been reciting gene translocations. What is the most likely cause of her symptoms? A. Hospital-associated delirium B. Conversion disorder C. Symptoms related to completing an excess number of multiple choice questions in preparation for taking internal medicine boards If you guessed C, you understand what I have been going ...

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Think keeping your life organized is hard? Try keeping your doctors organized. In this era of fragmented health care, patients find themselves in the impossible position of having to coordinate their care themselves -- a task that many can’t meet. Having multiple chronic medical conditions often means being subjected to a dizzying assortment of specialists, medical terminology, and tests that can quickly overwhelm patients. How many times have you found yourself in ...

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In a recent interview, Dr. Farzad Mostashari (former national coordinator for health IT and current CEO, Aledade ACO) gave some advice to physicians on how to avoid burnout and “restore their role as caregivers”:

The key is two things. One, if you're in a kayak in the rapids, you have to lean in and dig your paddle in and push ahead. If you lean back, you're done. You're going ...

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This spring, the California Board of Optometry shut down the only optometrist providing services to homebound patients in the San Francisco Bay Area. I learned about this because affected patients included several referred from our UC San Francisco Housecalls program, one of a few non-profit, non-concierge home-based practices in the state providing geriatrics care to homebound adults. With over 1 million adults homebound in California, why would any board deliberately limit ...

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The Washington Post featured an article by Dr. Michael Stein, "We all want doctors to be kind. But does kindness actually help us get better?" He presented intriguing but inconclusive data regarding the benefits of a "kind" doctor on control of diabetes or on perceived duration of colds for instances. In the end, Dr. Stein concludes, "At the moment, the best answer to the kindness contrarian is: Even ...

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Pharmaceutical companies are brilliant. They make profit off of chemicals that can be potentially life-saving. The list is quite impressive: antibiotics for somebody who would otherwise succumb to sepsis, insulin for someone whose pancreas loses the ability to function, antivirals for chronic viral suppression, antineoplastic agents for somebody whose cells have lost their regulatory mechanisms, just to name a few. The recipe seems to be quite simple: Charge as much money ...

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Sometimes the business plan completely falls apart. I look at my clock; it’s 11 a.m., and I only have two patients remaining for the morning? Something must be wrong. Every fail safe measure to keep the assembly line going must have failed. The initial card with the appointment time to carry in the wallet? Failed. The reminder phone call the day before? Failed. Even the insurance company gift card to ...

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By the end of my first year of residency, I knew I was in trouble. I was overwhelmed by the 15-hour days, the unbearable sadness of the tragedies I witnessed, my feelings of impotence and my fears of making a mistake. My life was my work, and everything else seemed to be falling apart: my physical health, my relationships, my ability to sleep after months of night shifts. Yet, I came to work ...

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She smiled fetchingly and threw her arms around me. She was so happy to have someone to hug. She was large, obese, kyphotic and almost bent double while edging slowly with her walker toward the examining room. She had sent a Christmas card and a birthday card, and I thanked her for them, while secretly praising myself for remembering she had sent them. She was diabetic and hypertensive and 88 years ...

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