Last week a physician friend recommended watching the movie the Big Short. The description given to me was that it was a great movie that was all about a bunch of guys who saw the 2008 financial crisis coming. Sure enough, that very weekend, I planned a night in to get take out and watch it on Netflix. And it sure didn’t disappoint. Starring Ryan Gosling, Steve Carrell, Christian Bale, and ...

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Next month when our youngest child leaves for college, the biggest change may not be in his life but in ours. We are done with dropping them off at school, or giving them driving lessons, or helping them with difficult homework assignments: We will officially become “empty nesters.” My wife and I ponder sitting at the dinner table and standing by the kitchen counter, where exuberant political dialogue takes place, and common ...

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I missed a drug interaction warning the other day when I prescribed a sulfa antibiotic to Barton, a COPD patient who is also taking dofetilide, an uncommon antiarrhythmic. The pharmacy called me to question the prescription, and I quickly changed it to a cephalosporin. The big red warning had popped up on my computer screen, but I x-ed it away with my right thumb on the trackball without reading the warning. Quite ...

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The age-old saying is that knowledge is power. But what happens when you are overwhelmed with the information you need to make a decision without the understanding of how that information fits together to answer your question? It’s like trying to put together a large, complex puzzle without a finished picture for comparison. Oh, and by the way, you also aren’t sure you have all the pieces. This situation can ...

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In days of yore, people in distress usually turned to family, friends and occasionally the clergy for help but for many years now, much of the burden of dealing with human misery has been transferred to medical professionals. Going forward and given that the iPhone and social media are ubiquitous in the daily lives of most of us, it is probably no surprise that the latest psychological support system comes ...

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It was an ordinary day in clinic — I had gotten very behind schedule when a 90-year-old gentleman, who was in for his third visit in a month related to falls, came in with his equally frail wife. We had to spend extra time discussing his placement in a nursing home for safety concerns. I hastily entered the room of a 46-year-old attractive female, who was here to meet me as ...

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I work in a male-dominated field. As a cardiac anesthesiologist, I work with mostly male cardiac surgeons in a department where the majority of my fellow anesthesiologists are male. I work with some fantastic male colleagues. They are caring, skilled doctors, and I consider many of them to be friends. While most of them know how to handle emergencies, trauma and difficult work situations, many times they clam up when we ...

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In Houston, all of my colleague's offices are closed, and there is limited access to the Texas Medical Center due to Hurricane Harvey. As a virtual medical doctor, there was only one thought on my mind this entire weekend, “How can I help?” As a Floridian, I have certainly faced my share of natural disasters beginning with Hurricane Andrew, a category 5 hurricane in 1992. Living through Hurricane Andrew gave me ...

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1. Lack of confidentiality. May have to turn over medical records to others who control your career. 2. State medical boards demand to know. May be excluded from practicing medicine in that state. 3. Hospitals demand to know. May be excluded from hospital staff privileges. 4. Insurance plans demand to know. May be excluded from insurance contracts. 5. Forced into costly, ineffective, and punitive physician health programs. May have to ...

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Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear that the skewed incentives in Medicare’s pricing system will get built into any new system, whether it is “accountable,” “affordable,” or “value-based.” This fear is well-founded. If special interests buy ...

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