As many readers of my work know, I have a huge passion for preventive medicine, and balance my acute care hospital work with an outpatient wellness clinic. I have always been into exercise and outdoor activities since a young age but only became a regular gym-goer after I finished my medical residency training. I also became very keen on learning more about healthier nutrition habits. I don’t think I was ...

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The patient arrived in cardiac arrest. He had been brought to our emergency department in the middle of the night. Although he had a significant cardiac history, including bypass surgery, he was only in his late 40s. His transport from his house to our department had been less than 10 minutes, and the pre-hospital team had done an excellent job of intubating this patient and establishing an IV to begin ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 61-year-old woman is evaluated for a 4-month history of progressive dyspnea and fatigue without chest pain. Eighteen months ago, she was diagnosed with liver cirrhosis due to nonalcoholic steatohepatitis (NASH). Medical history is also significant for obesity. Medications are propranolol, spironolactone, and lactulose. On physical examination, temperature is 36.4 °C (97.5 ...

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On September 16, 2010, I attended Fact or Fiction: ADHD in America, a Capitol Hill Forum, along with Val Jones of Better Health and Rob Lamberts of Musings of a Distractible Mind. The event, coinciding with ADD/ADHD Awareness Week, was a panel discussion discussing the impact ADHD has on our society. It was sponsored by Shire, in partnership with the Entertainment Industries Council (EIC) and the Lab School of Washington [Disclosure: ...

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It’s been more than a decade since the seminal report “To Err is Human” by the Institute of Medicine.  The report made waves when it estimated that 1.5 million people are affected by medical errors and that nearly 100,000 die annually as a result of medical errors. Some of those numbers have been debated, but there is no doubt that medical error is a significant issue in medicine that needs ...

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Mark Perry provides an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes.

Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail clinics.  Especially ...

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Do you know that the price of a contraceptive pill in Chicago pharmacies varies from $9 (Trinessa, aka generic Tricyclen, at Target pharmacy) to $84 (Loestrin 24 at Kmart pharmacy) a month? That means, over the course of the year, depending on what pill you take and where you shop, you could drop as little as $84 or -- let me get my calculator here -- $1008! These prices are if you pay out ...

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Thank you all for your patience. The migration took longer than expected, but now the blog is running on WordPress and the acclaimed Thesis theme. Many thanks to Aaron Brazell, aka Technosailor, for doing the job and navigating the obstacles along the way.  I am aware that the "Previous entries" link on the bottom of the main page, the Archives, and the RSS feed are not working properly.  They are being worked ...

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There will be no posts over the next few days, as the blog will migrate to WordPress. Furthermore, comments will be temporarily turned off to ensure all of them make the transfer. With over 19,000+ posts, at least twice as many comments, and close to 500 MB of data, it's a major undertaking. When it re-emerges, expect an updated look, better functionality, and improved navigation. The most dramatic changes will be "under ...

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Here are some of the more interesting comments readers have left recently.

1. Carla Kakutani on the lack of primary care access in Massachusetts:
So we have a chicken and egg problem. Do we wait health care reform until we have revived US primary care, or is that even possible without health care reform to create the disruption needed to change our entrenched fee-for-service, procedure-happy payment ...

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