A few summers ago during a week-long vacation, I started playing a mind game. In the mornings, I would sit outside on a comfortable deck chair, surrounded by the shrill call of cicadas, and gaze across the lawn into the trees. After getting settled, I would close my eyes and bring my body to complete stillness except for the rhythmic rise and fall of my chest with each breath. Then I’d ...

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It's easy to get lost in the hospital. I'm only an intern, and already I know it like the hallways of my old high school, every doorway, and doorknob. But overnight, as I float between the floors and the units, answering pages, I quickly lose track of where I am, what time it is, what day it is. I am vaguely aware that I'm on the fifth floor, the top floor ...

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As we grow into adulthood, each of us develops a personal comfort zone located on the continuum between paranoia and gullibility.  A few of us are highly suspicious by nature, a few are unwitting dupes; most of us are in between.  Mental health professionals are no exception, and it shows in our work.  Is a request for tranquilizers or stimulants legitimate, or are we abetting a substance abuser? When told of horrific past abuse, do we believe every word, ...

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The Lown Institute advocates rational use of medical resources. This is a noble goal and worthy of the attention of radiologists. It was recently RightCare Action Week: Here are five simple things any radiologist can do that week, and the following weeks. This will improve patient care by avoiding unnecessary tests. 1. Speak to the referring clinician, at least sometimes, if not often, perhaps twice a day. The conversation need ...

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I am a board certified internist.  I am Stanford trained and have been practice for nearly 25 years.  I have a very busy practice.  I love my patients.  To help, heal and to love them every day is a daily gift. I want to help them make sense of their suffering, to help awaken and empower them and help them gain health.  I have also been a lifelong seeker.  I ...

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unknown Born to a family of scientists --  my father an engineer and my mother an oral surgeon -- I was given a clear message that I could do anything. Case in point: At age nine when I declared my career goal of being “president of the world” nobody batted an eyelash. Their unwavering confidence followed me through college at UC Berkeley and ...

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I  have lately been discussing the state of health care with a lot of doctors. I’m a doctor, and I’m also a consumer of health care services. Imagine my surprise when I visited a local ER on a three day weekend, hoping to get some advice from someone who might be able to use the panoply of diagnostic tools available in the ED to help me mitigate the pain of a ...

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Dear patients, This is a hard letter to write, but it is important that you know about a major change that is coming for both of us in 2017, just a short year away. As you recall, last year I left a large hospital group practice and opened my own office, and I want to thank you for your faithfulness in following me to my new location.  With the newfound freedom of ...

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On September 12, 2015, the California Legislature passed a controversial bill legalizing physician-assisted suicide. California would become the fifth state to allow doctors to prescribe lethal medication to terminally ill patients who request it, after Oregon, Washington, Vermont and Montana. During the debate over the passage of the bill, everybody weighed in: patient’s rights advocates, dying patients and their advocates, religious groups. The one group that I didn’t hear about ...

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The U.S. health care system is under intense pressure to change from volume to value. Primary care physicians must become the leaders our health system needs us to be: finding solutions to the problems that continue to plague this system. Costs continue to rise, access to physicians is quite limited in many locations, care often remains fragmented, and quality is uneven. To provide excellent care across the country and ensure ...

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