Periodically we should reflect on what challenges face patients and physicians.  Over the past few days, I have worked on a list of the issues that concern me the most.  I welcome suggestions for expanding the list. 1. Diagnostic errors. All patient care requires that we make the proper diagnosis.  Too often we make errors.  A recent paper estimated that 30 percent of cellulitis admissions did not have cellulitis.  A similar ...

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Growing up Republican, I have long believed in personal responsibility. In junior high school, when I observed close relatives who struggled with obesity, I vowed to never let myself get out of shape. (“Junior high” is what we called middle school back in the day.) When hip surgery gone wrong dramatically reduced my level of physical activity two and a half years ago, I cut back on what I ate ...

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STAT_Logo He struggled to hear when people talked to him. He asked the same questions over and over. He fell asleep when really important conversations were going on around him. But it wasn’t until he missed an emergency call that I knew I had to act. I spoke to a higher-up about this elderly doctor out of concern for patient ...

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Many physicians have become world famous writers, and in Greek mythology, Apollo was the god of both poetry and medicine. I can personally think of many prominent physician writers I have come across in my reading over the years: There was the 12th-century rabbi Maimonides, Copernicus in the 15th century and the poet John Keats in the 1700s. In the late 1800s to early 1900s, there were Anton Chekhov, Sir Arthur Conan ...

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Mrs. Smith is an 81-year-old female. She worked a long time doing very physical work and is now on a fixed income and comes to my office with chronic pain. X-rays show she has degenerative arthritis in her hips, knees and lumbar spine. She has taken Norco twice a day for years and has been able to be very stable on this. She has always been compliant with her medications. ...

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My job as a standardized patient (SP) at several different medical schools means that I spend a lot of time being interviewed and examined by students at every stage of their education. Occasionally, the interview is of such a nature that the SPs are told to dress in a certain “costume” because it signifies to the student that there is something about our cultural representation that affects our medical care. ...

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How important is it for a doctor to want to be a doctor? At first glance, that question is ludicrous. The path to becoming a practicing physician is so long and tortuous that no one would do it if they didn't want to. Right? First, there's the four years of undergraduate education, then four years of medical school, then at least three years of residency. No one has ever suggested that ...

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October is the epitome of academic conference season. Returning home, suitcase laden, and a belt-hole wider from lost promises of exercise, and plans to “watch what I eat” while on the road, I am ready to get back into my routine. All the same, I come back refreshed by a new flavor to the mundane routine of conference experiences past. At the three conferences that I attended this fall, women ...

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My young daughter will be entering middle school in another year.  However, she still likes coloring books.  If she watches a scary movie, I have to lay with her in bed until she falls asleep. She is still just a kid.  Should I really be worried about HPV? Is this something you should consider for your daughter? As an OB/GYN doctor, I know about the HPV virus and have seen so many ...

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Measuring metrics is a common catch-phrase in health care. The goal of capturing certain data is to improve patient outcomes. But, as doctors, we were taught to treat the patient and not the numbers. While optimizing clinical outcomes is a needed goal with all the complexities in medical treatment currently, the system seems to have gone too far in its quest for targeted numbers. If, for example, a patient suffers metastatic ...

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