As he sat in the driver’s seat and started to whistle that dreaded Willie Nelson song, my heart started racing, and my world started to spin. While most kids may be annoyed hearing their father whistling that toneless noise, terror started seeping into my very bones. I knew what that sound meant and it was no Pavlovian response, but rather a foretelling of the horror coming. Simply put, it meant ...

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A few weeks ago, I saw a patient some gastro issues. So far, nothing newsworthy here since I am a gastroenterologist. I ordered a CT scan colonography, a special CT scan that is designed to view the colon in detail. It’s the CT scan version of a colonoscopy. Why didn’t I simply perform a colonoscopy, which, unlike a CT scan, would contribute to my retirement fund? That’s an easy one. ...

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We live in a pill-popping society.  The first line treatment for many of the medical problems that walk through our doors is a medication.  Have heartburn?  Forget about avoiding the foods that cause your symptoms -- just take a pill.  New diagnosis of diabetes?  We give lip service to lifestyle modifications and then start patients on Metformin.  Hypertension?  Diuretics, ACE inhibitors, ARBs, beta blockers -- take your pick, and I ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. A number of years ago I had an older patient, John, who had just been diagnosed with acute myelogenous leukemia. In discussing his diagnosis, he asked me if I thought that his exposure to radiation in the past might be responsible for his ...

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STAT_Logo I was on my honeymoon in Colombia when I first became aware of the true extent of my post-traumatic stress disorder. My husband and I were walking across a smooth, granite platform to take a closer look at a fountain in downtown Cartagena. As we neared the structure, mist from the fountain’s jets dampened the ground ...

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The other day a colleague and I were discussing a topic to be presented at an upcoming conference: “How much wellness is too much wellness?” This got us contemplating. What exactly is “wellness?” Can you ever spend too much time pursuing wellness? Or is “too much wellness” merely a surrogate for a much bigger problem with the way we’re approaching wellness in the health care setting? According to the 2018 Medscape ...

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Physician burnout rates hover around 50 percent, and the adverse consequences are serious. Burnout is associated with increased medical errors, suboptimal care, turnover and personal costs, including substance use, depression, and suicide. The financial cost to health care organizations is significant: replacing a physician is estimated to cost at least $500,000. Plus, physician turnover results in care disruption, patient access issues and lost revenue for hospitals to which the physician referred ...

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I am an assistant professor of health communication. Since 2008, as a volunteer, educator and researcher, I have been active in hospice care. As many people know, hospice teams (nurses, social workers, doctors, chaplains, volunteers) help dying patients and their families live as fully as possible during their remaining days together. In November 2016, right before the presidential election, I started a project aimed at identifying the best practices in communicating ...

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Few people can argue that health care is a business these days. Medical services are attached a price tag and patients are now customers. However, intrinsic to health care is a very high ethical code that doesn’t exist in other sectors. For example, if a patient shows up in the ER, they cannot be denied service, whether they are wearing shoes or not. While McDonald’s and other top companies are ...

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Today a physician told me she lost three colleagues to suicide in the last two months. Loma Linda Hospital just lost three young doctors to suicide in 6 months. Mount Sinai had 3 docs jump in less than 2 years -- from the same building. An anesthesiologist recently told me he lost 8 of his colleagues to suicide. Each suicide should be fully investigated, ...

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