Once upon a time a doctor first attended 3 or 4 years of college, then finished 3 or 4 years of medical school, trudged through 1 to 8 years of residency training to hang out “a shingle,” and finally begin to practice medicine, usually in solo practice.  Those days are long gone.  Time has expanded—schooling and training are longer. Breaks are taken between and during this once but no longer traditional ...

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Don’t be surprised if patients start asking more questions than usual about awareness under anesthesia.  We can all thank a recent article in The Atlantic magazine, with a large-print headline on the cover:  “Awake Under the Knife”.  Written by a UCSF medical student in preclinical training, the article not only assures everyone that awareness can happen, but takes pains to point out that anesthesiologists can’t always prevent it. The ...

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How we spend our days is, of course, how we spend our lives. -Annie Dillard I wish I could add up all of the moments I spend waiting for things to happen. I wait for computers to boot up. I wait for computer screens to load. I wait for programs to ask for and accept my user name and password for the umpteenth time so I can view a CT scan and then re-enter a different ...

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Here are the sad the financial facts. You have heard them before:

  • Women physicians earn $0.62 on the dollar as compared to men (US Census Bureau, 2010).
  • Women physicians start out their careers with a $17,000 pay gap, after all other factors are accounted for (LoSasso, Health Affairs 2011).
  • Mid-career women physician researchers are paid $12,000 than their male counterparts (Jagsi, JAMA 2012).
Anyone who discounts that fact that we women physicians are discounted ...

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Medical journals aren't what they used to be. Just ten short years ago, medical journals were places to report scientific study, interesting cases or clinical updates and reviews. They were, for the most part, about science and discovery. Now, there is a dramatic shift of scientific content in our journals to politics and policy. No where is this more evident than the much-heralded and widely read New England Journal of ...

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Some physicians will make over 7 times what the average college dropout will earn over a lifetime. Even within medicine there are significant differences in lifetime earnings between primary care, surgery, and specialty care. With the recent Powerball lottery jackpot at a record high, there was a lot of daydreaming going on recently for many Americans, maybe even some doctors: What would you do if you actually won it all? ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. All of us know the unpleasant feeling of pain. Often we know what caused it: a burn, a sprain or a surgical procedure. Most pain stops when the cause is removed and healing takes place. That is acute pain. When pain arises and persists for three months or more without ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 65-year-old man is evaluated for a 1-month history of headaches and blurred vision, early satiety, and itching that occurs after showering. He has a 90-pack-year smoking history. He has no history of cardiopulmonary or sleep disorders, no other medical problems, and he takes no medications. On physical examination, temperature is normal, blood pressure is ...

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Outrage #1: Wasting time of skilled caregivers. Everyday skilled nurses and physicians’ assistants waste hours of time on the telephone either getting approval for medications that we prescribe for our patients or trying to fight a rejection for a medication we requested. Outrage #2: Choosing a medication for cost, not effectiveness. A child cannot breathe because the acid and other nasty stomach ...

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Waking before dawn, I scurry into the study.  Sitting in front of the computer, I wiggle the mouse, bringing the screen to life.  Hesitantly, I call up the site for the major local newspaper.  Since being notified by my attorneys one week prior that a reporter was hunting me down for comment, I am on heightened alert.  Every day spent awaiting a story that could potentially decimate my life. The home ...

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