The secret lives of doctors Recently, when my parents came for a visit, our conversations led me to realize something important: I have been a doctor for more than 20 years, and yet my parents have no idea what my daily life is like. It then occurred to me that if they have no idea, then surely my patients have no idea either. So, if you're a ...

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Dear patient: Your 5 minute appointment is awaiting you. Dear patient: I am writing to inform you of some recent changes to my practice. These changes have been implemented to improve the quality of your care. I will no longer be able to see you for a 20-minute or 40-minute appointment. These will instead be shortened to a 10-minute or 20 minute-appointment based on your stated needs. For example, if you just ...

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When Uncle Will needed a hip replacement, he chose an orthopedic surgeon, Jason Brockman, and Mountain Memorial Hospital because of their excellent reputations for low complication rates and satisfied patients. The process reminded him of when he bought his first brand new truck. Norm and Clara Anderson chose Dr. Wheeler as their family doctor once they had made the decision to relocate to Maine and raise their family away from the ...

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Before losing my health insurance in 2009, it never occurred to me to be concerned about a little thing like a blood test.  Since 1986 I’d been having three vials of blood drawn each year during my physical.  My doctor would authorize it, the nurse would draw the blood in the office and send it to the lab for processing. A few days later she would call me with the results ...

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Moving annual visits into the 21st centuryA guest column by the American College of Physicians, exclusive to KevinMD.com. The recent uproar over the American College of Physicians’ recommendation against routine pelvic examinations made me think about the status of the annual visit (a.k.a. yearly physical, annual exam) on average risk, asymptomatic adults that most internal medicine specialists perform. Some would say that ...

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Who knew questioning medical tests could be so much fun? Watch Pharrell Williams' "Happy" with lyrics that advocate more sensible medical testing. James McCormick, co-host of the Best Science Medicine Podcast, wrote this pitch perfect parody.  The ABIM Foundation's Choosing Wisely campaign educates both physicians and the public to question medical tests and treatments.

As a doctor, I’m trained to do many things: I listen. I ask. I examine, order, and test. And then I assess. I certainly try to treat. All too often, this includes prescribing. What frequently gets obscured in this paradigm is that, on many occasions, the listening part is enough. Take Gene, for instance. He’s a retired biochemist. When I met him for the first time as a patient, I took a ...

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We believe in data. We are scientists after all. And yet in this new era of big data is it possible we are measuring the wrong things? Most measures of physician performance are process or intermediate outcome measures aimed at a production line model of care. Was an A1c done, did the physician use a computer to send an order to the laboratory, were antibiotics given within two hours of presentation. Yet ...

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When I was a boy, my dream was to become an airline pilot. The job seemed glamorous and exciting, and appeared to be held in high regard by all the people around me. I actually used to have a bit of an obsession with airplanes, and living so close to Heathrow Airport, had plenty of opportunities to see planes and visit the airport: both as a passenger and whenever we ...

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There is an old gag about an intensely optimistic child whose bright outlook on life is so irrepressible that when he is presented with a room full of manure for Christmas, he screams with delight, convinced that there “must be pony in there someplace.” I was reminded of that when I read the recent research report and the accompanying editorial in the Annals ...

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