This is often proposed, but I have trouble understanding it. Real outcomes are not blood pressure or blood sugar numbers; they are deaths, strokes, heart attacks, amputations, hospital-acquired infections and the like. In today’s medicine-as-manufacturing paradigm, such events are seen as preventable and punishable. Ironically, the U.S. insurance industry has no trouble recognizing “Acts of God” or “force majeure” as events beyond human control in spheres other than health care. There is ...

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He was rather tall.  Or at least he appeared so with his long erect back jutting from the bicycle seat. The cringe worthiness of his helmet-less head was assuaged by the gigantic headphones covering his ears.  I figured they would provide minimal protection during a crash, but at least he would be listening to groovy tunes. He weaved in an out of traffic on a busy two lane road.  He peddled ...

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Next in a series. The art of healing is very important in medicine. There is a difference between being a modern day physician and being a healer. All societies have healers -- wise men and women, shamans, medicine men and people of other names. The “old time practitioner” was almost always a healer but many physicians today are not. It is an issue of interest, training, time and prioritization. Most ...

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House call on a hundred foot cliff Johnny’s disabled. He can’t get to my office anymore. So I drive 100 miles up the Oregon coast to check in on him. I get lost, but finally discover his little white house on the edge of a cliff overlooking the Pacific Ocean. House call on a hundred foot cliff House call on a hundred foot cliff “Last ...

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In his book The Art of Loving, Eric Fromm wrote that “the deepest need of man is to overcome his separateness, to leave the prison of his aloneness.” In the Bible, after forming Adam from the dust of the ground and breathing into his nostrils the breath of life, God declares that something is missing: “It is not good for the man to be alone.” A number of scientific studies verify that a ...

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"Here you go, doctor." My patient with incredibly well-controlled type 2 diabetes hands me his fingerstick log at his regularly scheduled office visit. Despite his multiple medical problems (congestive heart failure, coronary artery disease, chronic renal insufficiency, and gout, among others) his sugars have been incredibly well-controlled over the past several years. Page after page of scrawled numbers, tiny smears of his blood on the pages, his fingersticks range from 90 to ...

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Health care is but one element of what makes the biggest difference in health outcomes: Social factors play a far more significant role. Income and its distribution, education, employment, social supports, housing, nutrition, and the wider environment -- what we have come to know as the social determinants of health -- are the most powerful predictors of wellness and longevity. This has been understood for centuries, and empirically validated in ...

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Thousands of health care providers now utilize Twitter and other social media as a means of communicating and staying in touch. We follow conference hashtags from afar to keep up-to-date, and to e-meet new and interesting people who share a common goal. In this way, we are able to grow our networks, foster our relevance, improve our knowledge base, and reach out to assist others. Whether we are physicians, nurses, or physical ...

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Top stories in health and medicine, June 5, 2014From MedPage Today:

  1. Higher Breast Ca Risk for Childhood Cancer Survivors. Women who survived a childhood cancer were at elevated risk for breast cancer even if they were never exposed to chest radiation during their initial therapy.
  2. Off-Pump CABG: No Lasting Renal Benefit. Performing coronary artery bypass grafting (CABG) without cardiopulmonary bypass ...

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It's not that I was stressed out about being alone with the kids.  My wife had gone out of town before. It was the darn mornings.  I'm used to racing out of the house at the crack of dawn, when the rest of my family is still asleep.  My most productive hours of the day are before most people even wake up.  With my wife gone, the mornings with the ...

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