After an exciting and challenging day of caring for patients and teaching students, a third-year medical student on his family medicine rotation says to me, "I really like what you do, but I just cannot afford to go into family practice." I realized that by “afford,” he was referring not only to finances but also to the expectations of his parents, friends, and
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My mom is sick. Because of what can only be described as my crazy family dynamics I did not find out for 24 hours that she was taken by ambulance to the hospital in septic shock from pneumonia. She was hypotensive on arrival (not good) and pancytopenic (low white cell count, low hemoglobin, and low platelets – not good either). A CT scan showed multiple large, irregular lymph nodes in her ...

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I am infinitely blessed by The Girl Effect.  As I look back through the generations of my family, I see it rolling toward me, through me like a wave. I am sure it started even before my grandmother stole her parents’ car with intent to drive by herself from Austin to Chicago to see the World’s Fair in 1924; I just don’t have much history to work with prior to that.  ...

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It was a dimly lit room, up on the sixth floor.  I am not sure why they would not fix the light in that corridor. Even during the day, I would find this area poorly lit. Maybe it was not the light but the grim atmosphere of oncology floor. Some of the patients there had terminal illnesses but they would still act like they had decades to live. You would be ...

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First do no harm. Treat every patient with respect and dignity. These are values I try to live by and incorporate into my daily work.  Treatment of chronic pain is the scenario that puts me and every practicing primary care physician in a no-win situation regularly in the office. To try to make physicians feel more comfortable treating pain most states have tried ...

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Here’s something little known outside of the small circle of industry marketers, academic docs, PR flacks, and medical journalists: pharmaceutical and device companies (or their PR agencies) regularly offer to arrange interviews with well-known academic physicians to talk about new trials, drug approvals, and other items of obvious interest to the companies involved. I receive these sort of invitations all ...

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In case you have not heard about it, there is a very gut wrenching court case St Louis Park, MN.   A doctor in the hospital system is going to court to replace a patient’s wife, Lana Barnes, with a substitute decision maker, claiming that she is making futile and reckless decisions to prolong her near-vegetative husband's  life. He has ...

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Medical guidelines are well on their way to becoming the Law of the Land.  Dr. Rich over at The Covert Rationing Blog featured a recent post that highlighted this point. When a study published in the Journal of the American Medical Association showed that nearly 23% of patients receiving implantable cardioverter-defibrillators (ICDs) received them under circumstances that did not match up with the recommended “guidelines” for doing so, this breach of ...

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It's strange being on the other side for a change. I remember bringing my son to his first doctor's appointment.  A new mom. No stethoscope around my neck. No patient schedule, replaced instead by the constant grind of breastfeeding. I knew it was just another routine newborn check for our pediatrician, but every maternal fiber in me believed that my son must be the cutest baby that ever walked through that clinic.  ...

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American Medical News published an informative essay by Kevin B. O’Reilly on December 13, 2010, about errors in diagnosis and why doctors make them. According to Gordon Schiff, MD, associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, “The problem of diagnostic errors has gotten short shrift in the broader patient safety movement.” The article focused on ...

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