Mass murders are becoming a depressingly familiar routine in the United States -- we can now expect to experience a media grabbing shooting about once a month. And the frequency can only increase as future cohorts of copycat killers are spawned by the seductive opportunity to temporarily gain the spotlight. Amidst the anguish and heartbreak felt by the victims' families, there are always two haunting questions. What motivates someone to kill ...

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I have been blogging and tweeting about ADHD a lot lately because I believe that change is in the air. This is the worst of times for ADHD diagnosis because statistics show it is wildly overdiagnosed and overtreated. This is possibly the best of times for ADHD diagnosis because I think we have reached the tipping point and feel hopeful that the ADHD fad will soon begin to fade. We humans are ...

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The headline reads, "Study: Mental illness rate higher in soldiers." The article goes on to offer alarming statistics:

The rate of major depression is five times as high among soldiers as civilians; intermittent explosive disorder, which results in episodes of extreme anger, is six times as high; and post-traumatic stress disorder was nearly 15 times higher than among civilians, the study found.
This would be pretty scary if true -- but ...

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From MedPage Today:

  1. Temporary Fee on Big Business Funds Obamacare. The world of healthcare, like any, is full of haves and have nots.
  2. Grassroots Group Aims to Renew Primary Care. "Change is HERE. The future of primary care has arrived." The motto of Primary Care Progress, a 4-year-old grassroots organization advocating for interprofessional teamwork and a brighter landscape for primary care in the U.S., ...

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Pamela Wible, MD, a family physician who is an expert in physician suicide prevention, recently asked other physicians why so many in the profession kill themselves. The answers were plentiful, tragic and not at all surprising. One physician confessed to having post-traumatic stress disorder after medical school. Another cited constant sleep deprivation. Yet another mentioned the combination of a crushing workload, a difficult boss and payers who are more worried about ...

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I received a panic call from Jim, who had been a patient for over ten years.  His 5-year-old daughter had passed out.  Amanda was rushed to the ICU for new onset diabetes.  After stabilization, she was transferred by helicopter to a university hospital for an insulin pump insertion.  He knew that her life, his life, would never be the same. Two weeks later, I received another call from Jim.  This time, ...

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Imagine you go to work one day and your boss says all employees will be evaluated based on the performance of a new set of job skills that require additional training and, perhaps, new computer hardware and software. The boss also announces that some employees will be reimbursed for the cost of acquiring these skills and tools. You aren’t among this privileged group. In government, this is called an unfunded ...

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She looked like a whipped puppy that had had a garden hose turned on it and slunk off to a far corner of the yard to dry out in the sun. She sat there, wizened but hard, thin and wiry, dressed in standard issue blue emergency room scrubs, thin tanned face, long stringy, wet prematurely gray hair falling limply around her shoulders. She looked down at the floor, but when her ...

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Lucia Sommers of the department of family and community medicine at the University of California, San Francisco commented on my last post, noting that clinical uncertainty among primary care physicians (PCPs) is usually regarded as tolerable at best.  She was delighted that I called such uncertainty intellectually attractive, and something to embrace in psychiatry.  Sommers and her co-author John Launer recently published a book that argues for managing clinical uncertainty in primary care using ...

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Hitting rock bottom can change lives for the betterHitting rock bottom can change lives for the better An excerpt from Hope For Addiction: Help and Hope for Families of Those Struggling with Addiction. The law states that no one can be forced into treatment against their will unless they are at risk of harming themselves or others (this varies by state, but the laws are very similar ...

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