Scalability is the end goal of nearly every tech start-up, systems innovation, and teenager you-tubing their cat -- it’s going viral, business-style. And traditionally, it’s been seen as a marker of relevance and success. Growth is good, right? But in health care systems transformation, do we lose something meaningful when we measure the value of our work by its national impact? Take Iora Health, a new health ...

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One night while on call, I was sitting in a loud downtown restaurant when I received a phone call from the hospital. I didn’t think I would be able to hear the call, and so I scurried around to find a place to speak. The bathroom appeared straight ahead, so I rushed into the first empty stall, locked the door and took the phone call. After wrapping up with the ...

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In this age of Internet-everything, online reviews have become the par for the course for business, and this includes medicine. Indeed, one recent survey found that 88 percent of consumers trust online reviews as much as personal recommendations. So online reviews count. And overall, this is a good thing. Data shows that more reviews translate into significantly more appointments, and this holds true even if ...

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Going into my final few months of residency, I am somewhat puzzled knowing that so many of my colleagues are signing contracts with hospital-owned outpatient practices or are going into subspecialist fellowship training or have plans to work as a hospitalist. As someone who plans to go into solo private practice, I feel like an outlier. Yes, I know what you might be thinking. Who goes into solo practice these days ...

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shutterstock_210431020 Here are ten ways that Internet diagnosing interferes with your health care. 1. Dr. Google doesn’t know you. Can’t see you, can’t hear your story, can’t smell you, and can’t touch you. It doesn’t have intuition or gut feelings about you. 2. The Internet breeds cyberchondria in some and false reassurance in others. The more complex the problem, the more likely your self-diagnosis ...

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Medical student Benjamin Romney created this video for a senior project.  It highlights the diverse aspects of a career in family medicine.  An inspiration to anyone considering the field.  

I see some odd things in my clinic. One recent diagnostic dilemma was a man in his late fifties with shortness of breath. He had been born with a ventricular septal defect and had undergone surgery for this in his infancy. During his lifetime, he had seldom gone to doctors and always thought he was in fairly good health, maybe just of a weak constitution. A smoker since age 13, he ...

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The recent killing of Walter Scott was another brutal reminder of the home African-Americans wake to daily. Their America, is one where your father might not come home at night, because his brake light went out, and that cost him his life. It's a place where petty crimes are penalized by life sentences, doled out on the streets by the very men and women charged with their ...

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shutterstock_122181037 JAMA published an opinion piece about the controversial issue of patients secretly recording their physicians during encounters.  We live  in the era of the smartphone.  Everyone has one -- soccer moms, teenagers, young kids who can't even read yet, elderly nursing home patients who can't safely feed themselves.  Everyone.  And these devices have amazing powers of audiovisual capability.  We all know this.  ...

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It has been known for a long time that “health care” -- all the stuff that we do, prescribe and provide -- is a minor determinant of how “healthy” any of us is. Overall health, or more technically, the variability in health outcomes, is much more dependent on the combination of genetics, personal behavior (think smoking and seat belts), environmental factors and socioeconomic status than it is on health care. I ...

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