Each year, Medical Economics surveys physician readers to find out what irks them most. Topping the latest list: insurance paperwork, followed closely by electronic health records (EHRs). The reason is the same for both. Insurers and EHRs get between doctors and their patients. When it comes to medicine’s computer problem, the obstacle is literal. Doctors sit behind a screen, focused on the EHR and not the patient. ...

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Asthma is a common childhood condition. Estimates are that around 8 percent of all children have it. The incidence had been steadily increasing for many years, but some recent data suggest the burden of the disease in children may have leveled off over the past couple of years. That’s encouraging, but the number of children with asthma is still huge. The peak age group is 5 to 14. The ...

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Have you ever wondered why your personal health information essentially belongs to your health care provider or institution? I mean: why do they keep your information under lock and key, and you have to sign a release to get it? After all, it’s your blood that they just pulled out and tested, it’s your body they just shot up with X-rays or operated on — and you paid for these ...

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Whenever someone asks me what year of medical school I am currently in, I answer that I am a "four-out-of-five." To those outside the milieu of Stanford Medicine, this is an odd response -- four-out-of-five of what? But at Stanford, this is common parlance to refer to students taking a gap year after our third year of medical school. Some would reasonably bemoan my choice to take a research year as ...

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Health care providers may have one of the most dangerous jobs out there — and it is only getting worse. Nearly 74 percent of workplace assaults occur in the health care setting, and health care accounts for almost as many serious violent injuries as all other industries combined. The statistics are alarming. Seventy-eight percent of emergency physicians report being targets of workplace violence in the ...

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Locum tenens is a great way to make a living or earn some extra income. But frankly, there are some groups of physicians who should not even consider doing locums work. When you pair the right person with the right job, you can get employment bliss. But when the wrong person takes a job, both the employer and the employee are often unhappy. I believe everyone should enjoy the work they ...

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Here is some news about cancer that isn’t widely known and is hiding in plain sight: Deaths from melanoma -- a skin cancer that has lethal potential -- have declined dramatically over the past several years. And while that fact alone is surprising, so is the reason behind the drop. Let’s make something clear at the outset: too many people die from melanoma. It is not the ...

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I excel at intellectualization. It is a fickle defense mechanism, allowing the observer to fully comprehend the situation in front of them without fully engaging in the emotional context. Throughout my medical training, intellectualization has aided me at many patient bedsides and through emotionally charged family conferences. I am reminded of many moments on neurology wards when a patient’s emotionally charged question was reinterpreted and deflected through a purely intellectual ...

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Reflexively, I often feel my breath catch, and my eyeballs roll ever-so-slightly when a patient leads with, “I saw on the internet ...” The precious minutes available to connect, inspect, and direct the management of their Google search are suddenly squandered by backtracking to reassure the bug bite will not turn into the bubonic plague! Our medical training has been outsourced to Wikipedia and WebMD. Today we all stand guilty believing we are ...

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Here is a standard emergency department situation, played out all across America today. Patient X has schizophrenia.  He takes medication, but only until he feels better.  He is calm when he takes it, but sometimes aggressive and assaultive when out of treatment and off medications. Patient X decides to leave town and drive somewhere else because he is angry at 1) family 2) significant other 3) health care system 4) situation. He is ...

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I'm a physician married to a physician. Initially, I did not think I would face obstacles because of our dual career paths. I would soon learn; however, professional and personal sacrifices would be necessary for us to achieve our goals. This is my story as a training physician and a "single" mom, including some of the challenges I experienced being married to a physician. I met my husband in the first ...

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Exercising good judgment can mean the difference between life or death. Life can be unforgiving of the choices we make. As we all know, many life events are beyond our control and understanding. But, there is much we can do to shape our paths to a brighter destination. Consider some of the choices listed below that many folks make every day. Are any of them familiar to you?

I worked with someone (not a physician, but that doesn’t really matter here) whose title was “assistant director.” He and I quickly recognized that we worked well together: His head brimmed with big visions and ideas, whereas my head brimmed with plans as to how to make those ideas manifest in the actual world. “He’s like a bunch of balloons,” I quipped to a colleague. “He’s got a ton of ideas ...

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I had the distinct pleasure working with family physician colleagues in Sweden recently. It was a similar experience to a trip I made to Britain about five years ago that I also wrote about. I got to spend some time watching one of my colleagues care for her patients in her surgery (they use the same description of a clinic as the British). I got to spend some time watching ...

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What About Recovery” is a provocative essay by Yale professor Lenore Buckley, MD, in JAMA. She writes in detail about the death of her 68-year-old brother in a hospital. She felt his doctors did not do enough to help him recover because his nutritional and physical therapy needs were not met. However, there’s more to it. She calls out the system existing in every hospital I’m aware of writing, ...

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“Someday Syndrome” is prevalent in many walks of life, but it is particularly bad in medicine.  You know what I am talking about.  “Someday, when I have graduated medical school …” or perhaps the more common phrase is, “Someday, when I am an attending …” Phrases that start with this sort of expression imply that today is not good enough.  And I am here to tell you that if ...

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A large number of pediatric practices these days use after-hours call centers for parents who have questions about a sick child. I’ve been looking around to find some data about how common this is, but my sense is that the majority of pediatricians use them. There is no question these call centers make life easier for the doctor; having somebody screen the calls, answer easy questions, and only call you ...

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Health care is a tough job to work in -- whether you are a doctor, nurse or any other professional. We are dealing with matters of life and death, our patients expect (and deserve) the best from us, and we always have a hundred-and-one things to do at the frontlines of medicine. I remember reading somewhere when I was a teenager that a career in medicine would be a “mentally, ...

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If my medical training taught me one thing, it was how to recognize the destructive nature of fads. They pervade our health care system. Most center around medicine, vitamins, and herbals. Though there also is no shortage of treatments and procedures that become popular very quickly and flame out over decades. Although one would think these spurious “advancements” would be pushed by a fringe agenda, it is actually commonplace for ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 23-year-old woman is evaluated for 2 weeks of painful lumps on her legs. The lumps persist for several days and make it difficult for her to go to work as a waitress. She is a college student in Ohio where she has lived her whole life. She has ...

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