She was like ... Superwoman. A strapping medical visionary probably in her forties. Gray long coat falling below the knees. She strode confidently down the hallway towards the elevator, a father hurrying beside her with his young lanky daughter cradled in his arms. The girl's head nuzzled into her father's shoulder. She was old enough to walk by herself...but clearly she was sick. Unable. Undoubtedly they were headed from the medical ...

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My colleagues at the Advisory Committee on Immunization Practices (ACIP) are examining a proposed policy for hepatitis B vaccination for diabetic patients. If accepted, this would be the next in a series of baby steps expanding hepatitis B vaccine recommendations for adults. While we are taking these baby steps, HBV incidence rates among U.S. adults remain pretty flat, and they haven’t changed much since 2006. We know the vaccine works. We ...

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When we think of infidelity as "mere cheating" we are often overlooking the many fears that go along with this. Infidelity may be due to fears and fears themselves may lead to infidelity. Why is this, and what can you do about this? 1. Fear of being trapped. One of the greatest fears of commitment is the fear of being trapped. When people feel trapped, their primitive brains start to rebel. ...

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I have made a big life-changing, evolutionary decision: I am leaving my job with public health. It was not an easy one. It isn’t because I don’t love my job greatly; because I do. In fact, I feel like the queen of the jungle, leaving her subjects. It’s not easy to let go. My reasons for leaving have nothing to do with the job itself, but have everything to do with ...

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Have you ever had a cold beer after a mountain bike ride? Oh my! But does such indulgence put one at risk for an arrhythmia? Does alcohol exacerbate an existing arrhythmia? How much, if any, alcohol is acceptable? These are questions I am asked frequently.  And for those asking, they are very important questions. I wish the answer was straightforward.  But it is not. Undoubtedly, excessive alcohol can precipitate an abnormal rhythm.  Look no farther ...

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The psychiatrist knocks on the door of the patient’s hospital room. Patient: “Come in.” Psychiatrist: “Good afternoon, Mrs. Jones. I’m Dr. Moodbetter, one of the psychiatrists here. Your doctor asked me to see you. Did he say anything about this?” Patient: “No, he didn’t! You know, I’m not nuts. I didn’t think he believed me. Great. Now he just thinks it’s all in my head.” Psychiatrist: “Well, I don’t think he meant to imply ...

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Travel is frequently required for non-clinical jobs. The big question is: how much travel? When a job description indicates 30% travel, do you know what that really means? What if you had to travel 30% each week? 30% each month? If there are 5 working days each week and 4 weeks each month, then there are approximately 20 working days each month. Are you willing to be gone 6 days each ...

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What does it cost to improve operational efficiency using technologies and outsourced services? For some physicians, the first reaction to every new service or technology is that it's going to "cost too much." And you get pitches for plenty of new services: * Your clearinghouse vendor or your billing manager wants you to push all your claims, even the claims you can file directly at no cost, through the clearinghouse for efficiencies. * Your ...

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shutterstock_162044975 Dr. Ryan Flesher was working his usual shift in the emergency department that night in July of 2006.  The hospital was short-staffed, per usual, and patients continued streaming through the revolving doors.  Neither the people at the front desk nor the nurses saw Dr. Flesher slip quietly down the hall that night. The following is a true story that occurred well before healthcare ...

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Who constitutes your market? The obvious answer is "patients". We provide services and in some instances products for patients. We receive compensation for doing this. It's instructive to ponder the source of these patients. How do they get to us? What other people and institutions play a role in this process. Existing satisfied customers? Other physicians? Hospitals? Health plans? Other institutions? Tracing the sources is a critical exercise if we are ...

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