It's 10 p.m. Seven days before Christmas. I'm sitting at work "finishing" up some charts. I am suddenly overcome with anger. What am I doing here right now at this minute? I am helping no one. This work I'm typing away at — trying so hard not to scream — it's hoops. Fucki*g hoops ... for insurance companies. So I can beg them to pay me. Pay me pennies for the hard, good, compassionate, humanitarian ...

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Telemedicine will eventually become a more prominent part of our clinical practice, with the incorporation of artificial intelligence (AI) and social media and networks, and integration with precision medicine in electronic health records. As clinicians and scientists, we should be thinking about where and how these four innovative strategies intersect, so that we can continue to not only contribute to the conversation and direction of these strategies, but also lead ...

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Ageism in health care abounds. Older adults are often overtreated or undertreated for various conditions. The presence of things like fatigue, chronic pain, arthritis, and even cognitive impairment are often accepted as "normal" parts of aging — by physicians and patients alike — despite the fact that many are preventable. According to a recent opinion piece by NBC News, "We medicalize the natural process of ...

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It's always kind of a surprise when you read a patient's chart, and you see an examination of a body part they just don't have. Just the other day, I was reading a consult note on a patient of mine who had been seen by a subspecialist for evaluation of a serious issue, and I received back a long detailed office ...

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I was reading an article in The New York Times entitled, "The Rise of the Virtual Restaurant." More and more people, particularly in urban settings, are using apps like Uber Eats, Grubhub, and DoorDash to bring fresh, warm food directly to their doorsteps.  Mr. Lopez, the virtual restaurant owner featured in the article, had no chairs, no tables, and no menus.  His virtual restaurant was actually four restaurants in one that were ...

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Keeping tabs on the sheer volume of medical drugs and devices on the market is nearly impossible – the FDA approved a record 105 novel medical devices and 59 new drugs in 2018 alone. At the same, hospitals and physicians face ever-growing pressure to cut costs while improving quality. Many physicians make patient treatment decisions based on their own expertise and/or limited review of the readily accessible information, the processes ...

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Artificial intelligence (#AI) seems to be all the rage these days, as it should be, given its potential to revolutionize medicine in many ways. #AI is actually already an integral part of many of our lives on Google, Amazon, Facebook, and other sites. Siri and Alexa use #AI too, so we can’t easily escape it. Why would we want to? Of course, one concern about the algorithms is that they often ...

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Hippocrates didn't have a server. In 2012 our practice invested $300,000 into building computer infrastructure and the purchase of a brand-spanking-new electronic health record, commonly referred to as an EHR. The mandate for this purchase was brought forth from the federal government with the intent to improve overall health care communication. Since this expenditure, terms like image server, ethernet, firewall, hyperlink, backup server, IP address, fax queue, cache server, LAN, domain server, ...

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I have penned several posts on the pitfalls of the electronic medical record (EMR) system that we physicians must use.  Indeed, I challenge you to find a doctor who extols the EMR platform without qualification.  Sure, there are tremendous advantages, and the ease of use has improved substantially since it first came onto the scene.  But, keep in mind that these systems were not devised and implemented because physicians demanded them.  To the contrary, ...

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The EMR has become a focal point in the physician burnout discussion. Although I believe EMRs are a necessary evil, current iterations of them are just not good. Each click on a mouse is a prick on the many good souls that figuratively bleed until they are physically and mentally burned out. Scribes are not a solution either. That is just a workaround. EMRs are one of many things that ...

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