I looked at my life through the lens of an outsider: It looked pretty good. Funding. Presentations. Publications. Great job, and a great family. Check, check, check. I looked at my life through my own lens, an insider: a mess. Exhaustion. Absent from my closest relationships. Chronically feeling like I was dropping the ball, because I was. Unhealthy. Not enough sleep, or exercise, or joy. Apathy. This was me, four years ago, ...

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In July, 2009, the family of Massachusetts teenager Yarushka Rivera went to their local Walgreens to pick up Topomax, an anti-seizure drug that had been keeping her epilepsy in check for years. Rivera had insurance coverage through MassHealth, the state’s Medicaid insurance program for low-income children, and never ran into obstacles obtaining this life-saving medication. But in July of 2009, she turned 19, and when, shortly after her birthday, her family ...

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A male physician -- one who sits on multiple committees at a large hospital in Dallas -- was recently quoted in the Dallas Medical Journal, that female physicians earn less, and they “choose to or they simply don’t want to be rushed.” Adding, “most of the time, their priority is something else … family, social, whatever.” I should be astounded that a colleague, in 2018, who appears to be about my ...

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How much we micromanage our lives is dependent upon our compulsivity and how many goals that we set in life.  Medicine is a profession that attracts some of the most goal-driven people I have ever met.  There are egos, obsessions, intelligence, and diligence all packaged into one unit.  This is simply overwhelming.  Fortunately, these habits tend to evolve with age.  I’ve seen some of the most incendiary personalities in medicine ...

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As I explained to my medical student this morning that I was ordering an ultrasound on a patient first because the insurance company wouldn’t authorize a CT scan without it, it occurred to me that medicine derailed from its true purpose. Shortly later, I found myself again pointing out why I was prescribing a certain medicine rather than the one I wanted because it was not on the formulary of ...

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Increasingly, we see functions executed by machines that were formerly performed by living breathing human beings. Examples range from the mundane to the preternatural.

  • Order food and drink from an iPad. No server needed.
  • Driverless auto travel. This may lead to a resurgence in prayer.
  • Pilotless air travel. Hard times ahead for the Airline Pilots Association.
  • Making precision tools from 3D printers.
  • Gourmet meals created with a voice-activated command.
  • Theater ...

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It’s been said in the world of business that people only buy two things: good feelings and solutions to problems. In medicine, the single most important factor that brings patients through our doors isn’t a “toward” kind of desire, but an “away” one -- away from feeling bad. More specifically, it is pain and fear that most often cause patients to call and ask for an appointment. They hopefully leave with ...

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No, I’m not saying that the process of investing in index funds is difficult. In fact, it’s actually quite simple to build a diversified index portfolio, whether your money is invested at Vanguard, Fidelity, Schwab, or Etrade. What makes investing in the stock market so difficult is tolerating its high volatility. Many investors are unable to stick with the stock market in the long run because of the ups and downs. But those who stay invested ...

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A doctor writes prescription, pharmacist fills prescription, insurance covers prescription. Simple, right? But that’s not the way it works anymore. Some changes are good. Gone are the cryptic abbreviations and illegible handwriting -- replaced by computer printed scripts, or better yet scripts magically transmitted via the ether. But along with fewer errors there’s even less transparency on pricing and coverage. Patients, who haven’t been to pharmacy school and couldn’t possibly decode the pages of ...

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Physicians everywhere are having to deal with ever-shrinking time slots with their patients. Every doctor (or nurse) would love to have more time if possible, and it’s probably one the biggest frontline frustrations for any clinician who wants to do a good job. Time to go over the history in more detail, examine the patient thoroughly, and then spend adequate time discussing everything afterwards. Wouldn’t that be nice? The reality though ...

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