Talking to patients on the phone can be very efficient and quite rewarding, like when I called a worried patient today and told her that her chest CT showed an improving pneumonia and almost certainly no cancer, but a repeat scan some months down the road would still be a good idea. She told me she was feeling better, but still quite weak and that her sputum was still dark ...

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An excerpt from Stay Away From My ER, and other fun bits of wisdom. 1. You don’t like to be told what to do. Especially not by arrogant doctors, who act as if they know better, just because they’ve been through a few decades of training! 2. Your ...

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“Let’s take a look together,” was the start of a virtual clinical assessment that led to a primary care provider and a neurologist diagnosing a patient with Parkinson’s Disease. As the neurologist in that conversation, I had the opportunity to play a meaningful role in delivering my expertise and, most importantly, making sure the patient received the highest level of appropriate care. With telemedicine’s support, both providers - and the ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 45-year-old man is evaluated for anorexia, dizziness, and weakness. He was discharged from the hospital 5 days ago after transsphenoidal pituitary surgery for a pituitary macroadenoma abutting the optic chiasm. His postoperative course was uneventful, and his postoperative hormone evaluation was normal; he did not require ...

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Although I have never been a big fan of modeling studies, viewing their appropriate role as hypothesis-generating rather than clinical decision-supporting, a study published in the Annals of Internal Medicine deserves kudos for trying to do what neither the American College of Cardiology/American Heart Association nor the U.S. Preventive Services Task Force did in their respective guidelines on primary prevention of cardiovascular disease for adults ...

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Alexa Karsdan’s medical bill for a sore throat reached over $28,000. NPR told her story recently, but I want you to know why I am actually glad this happened. Why is it good news that her charges were so exorbitant, and that her insurance paid over twenty-five thousand dollars for one laboratory test? This story is a brilliant illustration of fundamental flaws in our health care ...

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The words of the year as 2019 ends appear to be “OK Boomer” and “woke.” To this Boomer, it appears that the younger generation is blaming us for all the evil in the world, from their perch of “woke” moral superiority. They consider us to be out of touch and over the hill. According to Merriam-Webster, “woke” means “aware of and actively attentive to important facts and issues (especially issues of racial ...

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In my recent post, "Why Gratitude Is A Superpower," I told the story about a thank you note that my daughter, Maya, left me one morning for making her coffee. I was literally overcome with warmth and appreciation. My reaction demonstrates the real impact we can have on another person's emotional state when we express gratitude — either verbally or written — for something (gift, assistance, help, ...

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"Death comes for all of us. It is our fate as living, breathing, metabolizing organisms. Dealing with the fact of death is unsettling. Yet there is no other way to live." - Paul Kalanithi, MD Recently, first-year students of the medical and physician’s assistant classes completed their seventh and final practical exam in clinical anatomy. Through fifteen weeks, 117 students learned the structures of the human body organized by region, working from ...

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Kahlil Gibran writes, "In friendship or in love, the two side by side raise hands together to find what one cannot reach alone." What types of outcomes can physicians and patients achieve in healing, living, and life when Gibran's message is incorporated into the physician-patient relationship? Can humanism in medicine become even more humanistic? "Humanism in medicine" is characterized by the Arnold P. Gold Foundation as respectful ...

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I’ve just discharged a kid with a cough, and there are no patients waiting to be seen. “I’ll be back,” I tell the nurse, as I slip away to the hospital kitchen and unlock the door. I steal two frozen grilled cheese sandwiches from the freezer and throw them into the microwave. Minutes later, I’m in the call room. I take a couple of bites and can already feel acid rising ...

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Consuming too many potato latkes and Christmas cookies has left its mark on our waistlines. Unfortunately for Americans and their medical care, the seasonal overeating seems to last all year. Indeed, the American Medical Association has declared that obesity is a disease. It may be more accurate to describe obesity as a contributor to certain diseases. Obesity raises the risk of premature death, heart disease, high blood ...

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Americans are not fans of socialized medicine. Sure, some people want socialized health care payment, including many people who are fans of Medicare for all. But even most Bernie Sanders supporters probably aren't in favor of socializing the entire U.S. health care system, thereby making hospitals and medical clinics into government property. Americans are proud of the high quality of care offered by non-government providers, from their local community ...

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Anita is 37 with blonde, wild, disheveled hair. She is overweight, has bad teeth, wears too much make-up, and is severely depressed — sometimes psychotic. She tells me she often hears voices. And she constantly complains that the medicine she gets from our clinic (and she gets a lot), does not take the edge off her feelings. She has severe anger and is in an anger-management group at our offices. Each ...

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First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The ...

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I knew Friday was not going to be a good day. A leak in the ceiling of my family room.   A pet who would need surgery.  I was already stressed well before Friday. But at work, the issues started on Thursday with an osteoporotic patient for whom I had recommended Forteo, six weeks earlier.  It was denied by her insurer who wanted Tymlos instead.   No big deal.  We simply precerted Tymlos, but ...

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One of the largest problems in our ER, it seems, is that there is a subset of patients who visit us on a routine basis. Commonly known as "the regulars," these familiar faces are sprinkled throughout our day between all our other patient visits. Whether it be for chronic pain, for chronic illness, for companionship, simply to have a place to hang out for a few hours, or to get ...

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I, along with some others, take Presidents Day as an opportunity to celebrate the lives and contributions of all U.S. presidents. Amid the praise, however, perhaps I alone feel compelled to describe their skeletal maladies. I have gleaned the following information from several websites and books that carefully detail the reported injuries, diseases, bad habits, and addictions experienced by U.S. chief executives throughout their lives, starting with George Washington’s ...

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As we embark upon this new decade, many of us are committed to improving our finances. We may have vowed to stick to a budget or have a general goal to live below our means. While these are noble goals, let’s challenge ourselves to do even more. Here’s my six step-money challenge for 2020:

1. Buy 1 or 2 finance books to read. There are many different ways to ...

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Prostate cancer is the second most common type of cancer diagnosed in men in the U.S. According to statistics gathered by the American Cancer Society, approximately 191,930 new cases of prostate cancer will be diagnosed in this country in 2020, with one in nine men at risk of being diagnosed with this cancer during his lifetime. While advanced or aggressive disease can lead to death from prostate cancer, most men ...

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