Though many are not thrilled about the April 15th deadline, death is an even more inevitable part of life than taxes. Sometimes we try to lessen the impact of death through our words:  bit the dust, bought the farm, kicked the bucket, flat-lined, passed on, checked out, gave up the ghost, met his maker, paid the piper, put out of his misery, laid to rest, six feet under, pushing up daisies, ...

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One of the most popular topics in health care is the idea of universal health care coverage. You know the soundbites: “Medicare for all.” “Single-payer system.” While universal coverage sounds desirable to many, some factors must be considered. In this post, I’m going to provide an aerial view of this complicated topic. My goal is to translate this issue into patient-friendly language that all of us can understand. This topic isn’t ...

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My husband, who's had type 2 diabetes for 20 years, had been struggling for a long while to lower his hemoglobin A1C — a number that measures how well he's managing his blood sugar over time. When he and I finally investigated the issue, it turned out that someone close to him was thwarting his efforts. This person is an addict. Her drug of choice is sugar — often candy no ...

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Rural hospitals are closing their obstetric wards and stopping all obstetric services — at least those hospitals that manage to remain open at all. The tertiary care centers don’t seem to mind.Always wary of those rural hospital disasters in the middle of the night. Accepting transfers from a place where they must not have the latest technology, clearly, your little hospital must be behind the times, only subspecialty care is ...

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“Guys, are you alright in there?” I ask casually while taking the first bite of my dinner on a 24-hour PICU shift. No answer. “What is going on? Why is she beeping so much? Is her tube blocked?” My voice gets louder. Complete human silence. Except for the deafening hypoxia monitor going to 30s. Heart rate monitor dipping to below 60s. All this beeping was coming from a six-month-old girl with a history ...

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In 2006, the Mayo Clinic asked 192 patients an important question: What makes an ideal physician? From their responses, several characteristics emerged. Among the top criteria, they wanted doctors to be “personal,” “empathetic” and “humane.” This shouldn’t come as much of a surprise. Of course, we want doctors who relate to their patients as people instead of just another “case.” We want doctors to have sympathy for ...

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There are some milestones that need to be appropriately celebrated.  For the 80% of physicians who graduated with student loan debt, paying those loans off certainly qualifies as such a moment.  Everyone has a different way of tackling their student loans.  Today, I want to outline how we paid off $200,000 in student loans in 19 months, and then discuss what our plans are to rid ourselves of the rest ...

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First, there was Bitcoin, a cryptocurrency that utilizes blockchain, a decentralized system of data collection and transactions that we are told will defy hacking. (Wasn’t the Titanic said to be unsinkable?) We read that cryptocurrency and other blockchain functions will be a societal gamechanger, much like the internet was when Al Gore invented it some years ago. My state of Ohio will now accept Bitcoin as payment for commercial taxes. And, of ...

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I haven’t counted how many times this happens every month, but I find it annoying. I send a prescription for a drug (sometimes not even expensive) to the pharmacy and soon after, I get a fax asking me (or my medical assistant) to go online and print a prior authorization form to complete and fax to the insurer, or answer numerous qualifying questions on the screen, or (worst of all) 
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Practicing medicine at the frontlines is hard. It’s damn hard. Every minute you need to be alert, ready to respond to a potential life or death situation, and be called to another important problem. The current medical practice environment -- with excessive bureaucracy, suboptimal information technology, and extreme time pressure with patients -- adds exponentially to the mix, and can make for a very stressful job. Make no mistake, even ...

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Wealth seems to be an elusive dream for many people. They desire to become wealthy, but feel they don’t earn enough money to reach that goal, as if earning more would make the difference. A study of 10,000 millionaires presented in Chris Hogan’s new book, Everyday Millionaires, showed that 69% of these millionaires reached that level of affluence on a household income of less than $100,000 a year. If all ...

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Back when I was a third-year medical student, I would sometimes bike to the hospital campus early enough to catch the groundskeepers cleaning the promenade in front of the medical school before the foot traffic arrived. Discovery Walk, as it’s called, is a beautiful promenade with stone murals commemorating the significant discoveries made at Stanford. It’s a beautiful scene, especially during sunrise or sunset, which many of my classmates have ...

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Proof of concept is important because accountability is a tenuous thing. One can pretty much say whatever they want on the internet. They can boast. Spin half-truths. Tell a tale. The most deadly of these are the ones that are just a slight variation of reality. Personal finance is no different. Net worth projections, budgets, the acumen of a business venture or ...

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A excerpt from From Reading to Healing: Teaching Medical Professionalism through Literature (Literature and Medicine). There are several traditional ways to teach about professionalism. Some training programs have didactic lectures on this issue. These typically focus on principle-based ethics and “rules” about professionalism. “Do this. Don’t do that.” Most educators ...

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People often say that they can die happy if … Well, I have no intention of dying, but one of my goals in life was achieved recently. Historically, Facebook moms groups have been the bane of existence for many physicians, particularly pediatricians. We are often rated and compared like hotel mattresses. Well, last night one of my friends texted me, “Your practice is getting a lot of love on Facebook.”  Now, ...

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Burnout is a myth. Dedicated clinicians, working under circumstances that connect their skills and compassion with opportunities to impact patients, won’t experience burnout any more often than they might by doing other jobs. The story we tell -- the one that dissatisfaction is this system’s inevitable byproduct -- perpetuates more harm than we know. This is what I’d like to believe. I’d like to write about the many opportunities to do ...

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"Hey, you're a med student. Right?" "Yes, I am. Do you need me to scrub in?" "That would be wonderful, yes! Everyone is either out on vacation or is sick. It's just me and the resident." "OK, I'll be back in a few minutes." I was on my OB/GYN rotation, and once a week I follow one of the surgeons. It was 7:20 a.m., and a patient was coming in for an unplanned, stat ...

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Very few things in the universe are 100 percent good or 100 percent bad. Cannabis is perfectly ordinary in having a mixture of good qualities (medical benefits) and bad qualities (medical risks). The people who want to make money – lots of money, by the way – from selling marijuana do a perfectly fine job of pointing out the good. But they don’t educate the public about the possible risks. They know it will ...

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This article is sponsored by Careers by KevinMD.com. "Sometimes you want to go where everybody knows your name." So go the famous lyrics from the theme song for "Cheers," the iconic sitcom of the 1980s. The name thing can get really personal in medicine — and everyone has an opinion — as evidenced by a plaintive blog posting ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 79-year-old man is evaluated for a 2-month history of progressively worsening headaches, nausea, visual disturbance, and difficulty speaking. He also has hypertension and gastroesophageal reflux disease. Medications are lisinopril and omeprazole. On physical examination, vital signs are normal. Right oculomotor nerve (cranial nerve III) and bilateral abducens nerve (cranial ...

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