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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