Late last year the New York Times reported that Dr. José Baselga, the chief medical officer of Memorial Sloan Kettering Cancer Center, had resigned for failing to disclose his conflicts of interest at professional meetings and in scientific and medical journals. The Times report says that Dr. Baselga -- who also served as physician-in-chief at the center -- “had failed to disclose millions of dollars in payments from health care companies in ...

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My friend and practice advisor showed me two very negative anonymous reviews of my practice this week. Both were posted within a one-month winter period and were written about family members. They were not written by patients. My staff and I tried diligently to identify the stated situations as they did not resonate with any of us. Unfortunately, we were unsuccessful. That frustrates each of us. Combined, these reviews were aggressive and ...

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One thing that gastroenterologists know about is stool. But, I’m not referring to that kind of stool in this post. Follow along. When we do a colonoscopy, for example, we are relying upon stool, or more accurately a stool, as in a three-legged stool. This metaphor illustrates that the three legs must be equally strong or the stool will not stand. The three pillars of support that a colonoscopist needs include:

In the 1960s, Lew Goldberg showed that a physician’s intuition and judgment can be fatally flawed.  Interestingly, the same fatal flaw that was exposed by Goldberg is the same fatal flaw that causes some of the biggest financial mistakes that doctors make with money.  Why aren’t doctors rich?  Psychology has an interesting explanation that everyone should understand. Tag along as we dive into the mind of physicians ...

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As first reported by The Wall Street Journal late last month, the war against anti-vaccination propaganda now has a new battlefront. Pinterest, the social-media platform where users discover images and information, has begun blocking vaccine-related search terms on its site. Anti-vaccine content contradicts evidence-based science and established research, the company told WSJ, while cautioning that the search ban is only 
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Thanks to the internet, collaboration has never been so easy.  If you need to learn about how to install a new irrigation system in your lawn, the resources are a few clicks away.  You just need the time and motivation to make happen.  On the medicine front, there has never been a time in the recent past (aside from a failed managed care push in the 1990s) that doctors have ...

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Forgive the autobiographical nature of this post, but here’s a recap on how I started down the path to becoming an infectious disease (ID) doctor. To begin, understand that my first year of medical school was rough going. In hindsight, this wasn’t surprising. After majoring in English during college (with a minor in the Harvard Lampoon to develop good study habits, ha ha ha), then spending a year abroad teaching, I found medical school’s unrelenting ...

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There is a lot of talk about team-based care nowadays, and I had seen some shining examples of that, most recently when a patient at my clinic had a suicide in the family. But at the same time, there are so many decisions – judgment calls, really – that we make every single day where there isn’t anywhere near enough time to involve team members. I talk to patients all the time ...

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Recently, I wrote about some key findings from a 2018 survey of U.S. physicians by The Physicians Foundation. It’s no surprise to anyone working in health care today that the survey found alarming levels of professional dissatisfaction, burnout, and pessimism about the future of medicine among respondent physicians. Sadly, it appears that much of that pessimism is directed toward hospitals and their leaders: 46 percent of survey respondents viewed the ...

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“She is meant for more than just primary care,” mused an attending on my internal medicine rotation in medical school. He was referring to a particularly adept resident with whom we were working. This resident was planning on practicing clinic-based general internal medicine. I wasn’t sure why this attending disclosed his thoughts regarding this resident to me, but the implication was clear: “primary care” — whatever is meant by the ...

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In general, physical activity is important in maintaining your health. Many people falsely believe that running can cause arthritis but research show that this isn't necessarily true. In reality, walking, running or strenuous exercise can significantly decrease risk of any knee osteoarthritis. Doctors are still trying to understand how running can improve knee arthritis, with continual research studies. Osteoarthritis (OA) is the most common form of arthritis caused by trauma or overuse ...

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Telehealth, using video to have an acute medical care visit, puts some of the power of choice back into our patient’s hands. To best frame telehealth and its use cases, the National Quality Forum published a report in 2017, outlining the following four buckets which I find especially useful with evaluating programs and interventions:

  • access
  • cost savings
  • effectiveness
  • experience
This post is specifically about access and telehealth. I’m an emergency physician ...

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When I completed my residency training in 2017 I never imagined so much of my clinical efforts would be directed towards educating patients about controlled substances. As I stepped into clinical practice and took over patients who had long-term relationships with providers that had retired or moved to other positions I began to notice a preponderance of patients, some elderly, taking benzodiazepines daily, frequently at high doses. Often conditions other ...

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“Triage” is French for “to sort.” It developed as a concept on the battlefield as a way to address injured soldiers and ensure that care was provided to those most in need. In the emergency department, triage is usually the responsibility of a trained, experienced nurse. Patients present to the emergency department, the nurse obtains a history and may perform a cursory ...

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Since finishing my medical training recently, many of my friends have embraced their newfound freedom as attendings in traditional ways: reviving long-neglected hobbies, finally exercising regularly, enjoying more time with loved ones. Me? I joined Twitter. It may seem like a strange step, but after years of caution regarding the perils of social media as a physician (and more specifically, as a child, adolescent and adult psychiatrist), it was only once I ...

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I need to see Justin before my workday commences. I'm a social worker at the outpatient cancer center where Justin has been treated for an aggressive colon cancer. Seeing him today means visiting him in the hospital, up the road from the center. It's almost surreal. When I first met Justin, nearly two years ago, he looked every bit the linebacker — well over six feet tall, with a girth to match. A ...

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Everyone loves chocolate, and nobody likes to cough. So when headlines like these appeared, they made a big media splash: Apparently Chocolate Might Be Better for Treating Coughs than Honey and Lemon. Chocolate Fights Coughs Better Than Codeine, Says Science. Chocolate Is a Better Cough Suppressant than Medicine, Study Says. Looks good, huh? Chocolate for a cough – and the headlines say it’s better than ...

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Separating fact from fiction had once been her favorite activity. Going over research with a fine-toothed comb, she caught the inaccuracies that riddled popular culture like unruly strands of hair. It came down to this simple algorithm: there were things that could be proven and things that could not. In other words, there were things that would happen consistently given the same set of conditions, while other things were random. ...

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California is often perceived as a state where healthy habits abound — with a yoga studio on every block and kale salads on every plate. Unfortunately, I know in my daily practice as a cardiologist that this is far from the truth and that diseases due to poor diet and lifestyle are abundant here in sunny California. As a cardiologist, I’m especially concerned that California isn’t very heart healthy: Just like ...

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From the moment we begin medical school, we strive to achieve the best we can. That ranges from getting good grades to filling our CV with community work and research experience. With the increasing competitiveness of residency programs, this can be aggravating. The striving, although needed, keeps sucking our energy, our souls, and sometimes our health without us noticing. It eventually drains us so much that we can no longer ...

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