“Life is just a short walk from the cradle to the grave, and it sure behooves us to be kind to one another along the way.” - Alice Childress, American playwright, actor, author (1912-1994) I am awakened in the wee hours by the sound of rain.  Ordinarily I would return to bed in hope of stealing more sleep from night, but this particular day I know I have to rise at 4:30 ...

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It was 1989. While alternating between NCAA basketball tournament games on broadcast television, reruns of an older version of the game show Wipeout on cable, and the 8-bit Nintendo game Top Gun, a child sat in a hospital bed in the middle of rural America wondering why he was there. All he knew was that he had a sharp pain in the left side of his chest and that couldn't ...

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evolution-of-radiology-775 James Chang is a radiologist and author of Oh Doctor, The Places You Will Go… He blogs at Poor MD and can be reached on Facebook.

In 2014, a jury in Massachusetts awarded $16.7 million in damages to the daughter of a Bostonian lady who died from lung cancer at 47 for a missed cancer on a chest X-ray. The verdict reminds me of the words of John Bradford, a heretic who was burned at the stake: “There, but for the grace of God, go I.” Many radiologists will sympathize with both the patient ...

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radiological-compass Use this compass to navigate the seas of morning portables and follow up radiographs. James Chang is a radiologist and author of Oh Doctor, The Places You Will Go… He blogs at Poor MD and can be reached on Facebook.

Most of us are skeptical that insurance companies are devoted to our health. Answer the following question: Do you think your insurance company is more interested in your health or in controlling costs? Pretty tough, huh? There is a tension between medical quality and medical costs. If we had a system that offered perfect quality, it would be unaffordable. If we imposed rigid cost controls, then medical quality would be compromised. Where ...

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You will probably never meet me in person. Your name will be on the bill my insurance receives from the hospital. Your signature will be on the line after the end of the report as you mumble report after report into the system. You will never know my story. I am my organs to you; organs will anomalies that you have to squint and sometimes lean back to look for.  You ...

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A popular meme is that the U.S. spends more on health care than other developed nations but has nothing to show for that spending. This is different from saying that the U.S. spends more, but achieves something, but the something it achieves is so little that it isn’t worth the public purse. The latter is difficult to assert because the asserter must then say how little is too little in ...

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After five years of doing bedside ultrasound, I'm still excited about it. Bedside, or point-of-care ultrasound is using an ultrasound machine during the physical examination of a patient in order to make a diagnosis. I use a pretty tiny machine that fits in my pocket. As an internist who works in the hospital and in rural clinic outpatient settings, I get to use my ultrasound all the time, and it's ...

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To paraphrase Tolstoy, all competence is alike, but every incompetence is incompetence in its own way. Every time I think I’ve seen the horizon of incompetence, I’m dealt a surprise. The sun never sets on incompetence. In health care, incompetence can be found in odd places, such as three recent examples I encountered with third-party payers. Case 1: Downgrading caviar to boiled salmon A patient was referred for a CT angiogram run ...

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