During a recent walk at Crystal Cove, a splendid California State Park with miles of pristine coastline, I encountered two young women sitting on a bench with a magnificent view of the ocean.  Yet their only view of interest was their cell phone screens.  One of them lifted her head long enough to say, “Your dog is cute,” then returned to the rapture of her device.  I thanked her and ...

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As a physician trying to keep up with all the new information about artificial intelligence, I want to know how machine learning and deep learning are impacting medicine now and to separate the hype from reality. Here's a look at some ways AI is being used successfully in health care and some ways it is not. AI has been validated for use in interpreting medical scans, pathology slides, and reading electrocardiograms. ...

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In many countries around the world, women giving birth still face substantial risks to their own lives and that of their baby. Women travel for days to reach facilities that are understaffed, unsafe, and unequipped to provide life-saving surgical care. They are pushed into financial catastrophe as a result of paying for surgical care, if they are able to afford it all, and they return home with little support in ...

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As we go through our careers, we are given the responsibility of educating the next generation of students and residents to become proficient and competent in medicine. In telehealth, which also requires training my colleagues, is it necessary? If so, what should be part of it? Part of the equivocation with this question of creating telehealth education is at the core of the practice: since I strongly stress that telehealth ...

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Telemedicine has been available now for a number of years. Despite being widely accessible, it still struggles to maintain a foothold in the minds of many traditional practitioners. There are many reasons for this, including gaps in knowledge related to billing and reimbursement for virtual visits, as well as varying levels of coverage by insurance providers. This is particularly cumbersome when it comes to Medicare patients, although there is hope ...

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The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief. Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, ...

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Telehealth, using video to have an acute medical care visit, puts some of the power of choice back into our patient’s hands. To best frame telehealth and its use cases, the National Quality Forum published a report in 2017, outlining the following four buckets which I find especially useful with evaluating programs and interventions:

  • access
  • cost savings
  • effectiveness
  • experience
This post is specifically about access and telehealth. I’m an emergency physician ...

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One day while on shift in the emergency department, I looked out into the waiting room at the dozens of people waiting to be seen.  Many had been waiting for hours. Some looked bored. Others appeared agitated by the long wait time. One thing that nearly all of them had in common, though, was the presence of a smartphone within arms reach.  I wondered, rather than spending their time mindlessly ...

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AI, artificial intelligence, is all the rage right now in medical news media. And this has many practicing physicians, even medical students, concerned. Will AI make diagnose heavy specialties such as dermatology and radiology obsolete? Can AI give rise to new medical specialties? How many tasks traditionally done by doctors will now be handled by AI? I believe that there is a right to be worried. We do not have any ...

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Physicians and other health care professionals are uniquely suited to understand artificial intelligence. They've studied or routinely use mathematics, data analysis, and algorithms. They comprehend pattern recognition, decision trees, rules-based systems, and statistics. These are the very components of AI.  Perhaps the only thing our premed and medical training didn't teach us was how to code. But we understand how coding is done. Add to this our training in how ...

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