As clinicians, we often forget or become desensitized to the image that society has of medicine and doctors. Alongside teachers and scientists, we are seen to be among the most trustworthy of professionals, yet our morale is low, with almost 50 percent describing it as “low” or “very low.” You can imagine, then, why I often describe medicine as a forest: beautiful, scenic and picturesque from afar but ...

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Doctors prescribe way too many medicines for patients who don't really need them. A lot of the pressure comes from intense drug company marketing. Some comes from patients who aren't happy leaving the office without a pill. And doctors have too little time with each patient to explain non-pill solutions to problems. Wild prescribing is not new. For thousands of years, doctors have given patients useless (and often quite harmful) ...

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This past week I spoke with a patient who noted that since his wife’s death six months ago, he had lost 40 pounds, slept a maximum of four hours nightly, and stopped enjoying activities he used to take pleasure in. He found it difficult to concentrate at work, and getting out of bed each morning was described as his greatest struggle. While relaying this story, the man was on the ...

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There’s a great song by Don McLean called "American Pie.” The chorus talks about “the day the music died.” I thought about that song in my hospital a couple years ago, when the music died there, too. I’ve noticed that our physician burnout and nurse frustration have increased in the years since the music died. Could it be a coincidence? McLean’s song was about a plane crash in 1959 that claimed ...

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DeathByDespair-640x385 A friend just got back from a big medical conference at a fancy hotel. The cleaning ladies actually pulled her aside to ask, “What’s with all the grim faces and sad eyes?” Do doctors realize medical conferences look like funerals? That’s what the cleaning ladies think. I bet they’re not the only ones. Why do medical conferences feel like funerals? Maybe because doctors ...

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It has been fourteen years since I graduated from the University of Michigan Medical School. I have journeyed far from the field of medicine, and yet my heart keeps hearing the call to return to my physician communities and share what I have learned. I simply cannot ignore my sense that the pain within our health care system - now felt at every level, including patients, physicians, and payors -- ...

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January marked the start of what promises to be a four-month public reckoning: the trial of alleged Boston Marathon bomber Dzhokhar Tsarnaev. If the press reports about the evidence against him are accurate, most of the trial will not be about guilt or innocence; it will be about sentencing. Not a who-done-it, but a why-done-it. If Tsarnaev is found guilty, the death penalty will be on the table, and the proceedings will ...

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medpagetodayFrom MedPage Today:

  1. CDC: Most Nosocomial Infections Fall. Rates of most major types of healthcare-associated infections have declined markedly in recent years.
  2. RA Patients More Likely to Abandon Remicade. Rheumatoid arthritis (RA) patients were more likely to discontinue infliximab (Remicade) than adalimumab (Humira) and etanercept (Enbrel) in the first year of biologic ...

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What defines a competent psychiatrist?  To staunch critics of the field, perhaps nothing.  Some believe psychiatry has done far more harm than good, or has never helped anyone, rendering moot the question of competency.  What defines a competent buffoon?  A skillful brute?  An adroit half-wit?  Having just finished Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, a reader might easily conclude that psychiatric competency is ...

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On my voice mail is a message from Donald Wyatt. He doesn't often call, but every Monday morning he comes to see me at the Louisville, Kentucky, mental health clinic where I'm a social worker. His message is brief: "I'm not feeling well, and I am planning a trip to either St. Louis or Elizabethtown." I smile, wondering at the odd pairing. Elizabethtown is a small city of 50,000 people. And, well, ...

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