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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There's a common affliction that's rampant in my practice, but it's not a gastrointestinal condition. It's called polypharmacy, and it refers to patients who are receiving a pile of prescription and other medications. I see this daily in the office and in the hospital. It's common enough to see patients who are receiving 10 or more medications, usually from 3 or 4 medical specialists. Of course, every doctor feels that he ...

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A strange thing happened last year in some the nation’s most established hospitals and health systems. Hundreds of millions of dollars in income suddenly disappeared. This article, part two of a series that began with a look at primary care disruption, examines the economic struggles of inpatient facilities, the even harsher realities in front of them, and why hospitals are likely to aggravate, not address, health care’s rising cost issues. According ...

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Diana Feliz Oliva, a 45-year-old transgender woman who grew up outside Fresno, Calif., remembers being bullied when she was younger and feeling confused about her gender identity. She was depressed and fearful about being found out, and she prayed every night for God to take her while she slept. “I was living in turmoil,” said Oliva, who now works as health program manager in a clinic for transgender people at St. ...

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The presidential symposium at this year’s Annual Meeting of the Child Neurology Society of America in early October in Kansas City raised many eyebrows. The first presentation of this symposium focused on burnout rates among neurologists around the country. Many of my colleagues felt that this was an inappropriate choice, especially with so many trainees and young child neurologists in the audience. Typically, the presidential symposium at a conference of such ...

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I first noticed this phenomenon while watching the world news on a weekday after work.  It was a commercial for a new diabetes medicine that showed overweight people dancing at a barbecue, cooking and enjoying life.  How different this was from my day in the wound clinic, where I saw patient after patient with obesity, diabetes, and nonhealing wounds, as well as other dire medical complications. So I tucked this image ...

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It’s no doubt that the health care conundrum our nation is facing is fraught with high-risk hypotheses and their unpalatable consequences. Complicating this further is the business-minded nature of many lobbyists and policy-makers influencing our government’s decisions, including President Trump's. This is particularly timely given the recent executive orders Mr. Trump has unilaterally implemented that both sides of the aisle are concerned about. As a physician with a top priority ...

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