Every time I call a friend, all I have for them is more work. I’ve never yet called to say: “I hope you’re having a great day. Why don’t you take a break and have some fun? You’ve worked enough.” Nope. I only call to give them extra work. Whether it’s 2 a.m. or 2 p.m., I need you to get away from your bed/lover/high horse and come take my patient. ...

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The chief complaint was belly pain. He described the pain as both dull and crampy. It came and went, but bothered him the most on the same night of each week. The notes from the primary care doctor show a thoughtful search for the underlying cause. There were comments about activity logs, blood tests, and imaging studies. Months later, it remained a mystery: He still had belly pain. The investigations did ...

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Imagine you’re a CEO in charge of a health care organization with thousands of physicians and 19 hospitals. Overall, the quality of care delivered is good. Prices and costs are low. But there is a problem: Patients rate your service below average. Making matters worse, a swarm of low-priced competitors have moved in, challenging your market share. You’re going to need to improve patient satisfaction to survive. What do you do? About ...

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We all have either experienced the fears of starting our first job or will eventually do so at some point in our careers.  It only happens once for everyone.  Those of us who are in the market for a job change will end up reliving some of the challenges in job hunting; hopefully, we all have learned from our past mistakes. As I am advising upcoming graduates during their job ...

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My friends and family used to say that I was born 30 years old.  I get it.  From the time I was young, I was controlled, risk-averse, studious, and polite.  In addition to the fact that I was naturally reserved, I learned over time to do my best not to make anyone uncomfortable.  I frequently refused to stand up for what I wanted, always deferring to the wishes of others. ...

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Just because something is legal, doesn’t make it right. Just because we enjoy a right of free speech, doesn’t mean we should be verbally insulting people. Just because the Food and Drug Administration (FDA) approves a treatment or a test, doesn’t mean we should pursue it. The FDA has given approval to 23andMe, a private company, to provide genetic testing directly to individuals. The results provide genetic risks of contracting several ...

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Attention deficit hyperactivity disorder (ADHD) is a common diagnosis in children today, and is increasingly a diagnosis assigned to adults, too. ADHD is a real thing, despite some having some skeptics and a few outright denialists; differences in brain scans between persons who have it and who don’t show there is a definite physiological basis for the disorder. But in practice, we don’t do brain scans. We base the diagnosis on ...

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Congratulations to ZDoggMD's latest, One Sikh, an ode to all the immigrant clinicians who care for our most vulnerable patients.

One of the major challenges of being on medical school rotations is the necessity of changing rotations every four weeks, and how adapting to each new specialty feels like going through the first day of school all over again. I want to share my experience on other side of the coin. About a year ago, I started participating in Stanford’s Continuity of Care program, a clerkship in which I am excused from ...

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An August 2018 paper in Academic Pediatrics found an unsettling conclusion: Breastfed newborns have about double the risk of needing to be hospitalized in their first month of life, compared to babies who were formula-fed. The numbers are solid, and they jibe with the real-life experience of many pediatricians, including me. So what should we do about it? The study itself looked at about 150,000 healthy, normal newborns born in ...

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Most don’t realize how easy it is to become debt free. Instead, they envision a horrible drop in lifestyle and great sacrifices that include turning back the clock to medical school days where they were living on peanut butter and ramen. When in fact, no sacrifice is required to become debt free. All it takes is to decide that becoming debt free is what you want and then stop borrowing ...

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There is a lot of grousing in the financial independence community. Especially from those of us above the age of thirty. We look at the young people in this community and shake our head knowingly. We grumble some version of the same slogan. If I only knew then what I know now. We repeat this refrain often but put little energy it to consider if it is true. Would I do ...

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Not only is an audit unlikely to happen — if it does, it’s rarely a huge deal. Few words inspire such fear in the hearts of Americans as “IRS audit.” But one of the biggest mistakes that taxpayers make is letting fear of the IRS stop them from taking advantage of tax savings they deserve. Especially for locums tenens docs and other 1099 income earners since the 67,000-page tax code favors ...

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Here’s what most medical experts agree on: People 50 and older should be screened for colon cancer. Here’s what is more controversial: Whether that screening should start, routinely, at age 45. Recently, the American Cancer Society (ACS) recommended that colon cancer screenings start at age 45. Their recommendation was based in large part on an uptick in the number of people 45 to 50 years old who are being diagnosed with colon cancer ...

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I could hear the scream from across the room. It was shrill and filled with panic. Any parent can identify the difference between the cries of normal toddler discomforts and a true emergency. I dropped what I was doing in the kitchen and found my three year old lying motionless on the ground, unable to move his left arm. My five year old was looking sheepishly down at the carpet, afraid ...

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Diagnostic errors (missed, delayed, incorrect diagnoses) are increasingly being recognized as a prevalent cause of harm to patients. At the same time, physicians are simultaneously under pressure to deliver high-quality, low-cost health care. How do physicians come to a balance between the competing demands of addressing underuse versus overuse, and consequently a balance between underdiagnosis from inadequate investigations versus overdiagnosis and resource waste? Can physicians learn from hearing about their ...

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The mud is deep and thick and black. The smoothness of its surface is deceiving, drawing me closer to it with promises of contentment. It lures those who dare to tread upon it into its hidden depths. Hopes are dashed as one struggles for freedom. It is tenacious: Lift one foot upward and the other sinks deeper into Mother Earth. A sense of futility in escaping its grasp erodes the ...

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The tale of two physicians There once was a physician who had no idea what personal finance was. She was living the American dream, but with lots of student loan and credit card debt. During her residency, she paid minimums on all her debts, but had neither a savings account nor a retirement account. During fellowship, there was a slight jump in her income, and she used that as an opportunity to ...

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As more patients and clinicians are searching for holistic approaches to health care, Ayurveda, or the traditional medical system of India, has been gaining popularity in the Western world.  Unfortunately, many allopathic physicians still view this system as “quackery” because of its focus on the “intangibles” of health.  However, Ayurveda has contributed immensely to the foundations of modern medicine, which many may not know.  Sushruta was an Indian scholar and ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old woman is evaluated 1 month after completing a 14-day course of Helicobacter pylori eradication therapy consisting of amoxicillin, clarithromycin, and omeprazole. Initial upper endoscopy before treatment showed patchy gastric erythema with no ulcers or erosions, and biopsies revealed H. pylori gastritis. Currently, she reports alleviated symptoms. She is otherwise healthy and ...

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