On January 19, the first case of the coronavirus in the United States was announced. Initially, COVID cases were detected in Washington. As time elapsed, other states did best to prepare for if and when COVID came to our area. As spring break arrived, my husband, an intensivist, debated the best course of action regarding our vacation. We decided we could not take a vacation with heavy hearts while our ...

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The good Italians star at disorganization, disobedience, and discord. They sneak past no-entry signs, light up under no-smoking signs, barrel along at 80 in 35 mph zones, fasten their seat belts under their butts. Plus, they had the worst COVID-19 epidemic in Europe. So how come they’re doing so well ...

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As the coronavirus pandemic has unfolded, the uncertainty of this crisis has stoked heightened awareness and precaution in each aspect of our lives. We have incorporated personal protective equipment into our human interactions, and we are compulsively practicing sanitation rituals. Our social connections have been tethered at a distance for months on end. As a society, we are experiencing collective grief. Grieving hundreds of thousands of lives lost and the ...

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Taking a break from technology is a fine idea, but we don’t need a pseudoscientific new name for it: dopamine fasting.  Launched with viral Silicon Valley memes, online reports, and articles in the New York Times and elsewhere, dopamine fasting is now a thing.  Basically, the idea is to temporarily deprive oneself of the usual stimulations of life — largely ...

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"As an oncologist, perhaps the hardest part I play is as witness. I am there to give a diagnosis that, more often than not, will alter someone’s life forever. For some, I see resignation—a sense that they’ve known something was wrong and that it’s what they thought they had. For others, I see an almost immediate acceptance and, with it, perseverance; ...

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An excerpt from Dying with Ease: A Compassionate Guide for Making Wiser End-of-Life Decisions. Used by permission of the publisher Rowman & Littlefield. All rights reserved. In 2017, there were 2,813,503 deaths in the United States. About a quarter of Americans die of heart disease, some 22 ...

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You are doing all the right things: washing your hands frequently, wearing a mask when out in public, getting the requisite sunlight needed to reduce stress and maintain your health. And the reward you're getting for all your diligence? Dry skin, damaged nails, acne, and sunburns. As we continue to live with the threat of COVID-19, more people find themselves wrestling with skin issues they never anticipated. Fortunately, there are easy and ...

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We were surprised by the "So you want to be a doctor? Here are 10 myths debunked.".  It did not represent our collective experiences as family physicians.  We offer an alternative perspective: 1. You'll be rich. An average family physician, at a salary of about $230K, makes more than 93 percent of other households. The average medical student debt from 2019 was just over $201,000 (AAMC).  A ...

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Despite the advances in modern health care, chronic wounds remain highly problematic.  For the critically ill and those with mobility issues, missing just one routine repositioning could send them down a protracted path of intensive wound care therapies.  Even our ambulatory patients develop non-healing ulcers from neuropathy and microvascular disease.  For purposes of this discussion, the question of how the wound formed isn’t nearly as important as why it persists ...

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Using a treatment without having any understanding of how it works is often thought of as unscientific, and suggesting that a placebo can help a sick patient has until now been viewed as unethical. The New England Journal of Medicine just published an article about placebo (making you feel better) and nocebo (making you feel worse) effects, two of the most intriguing aspects of the supposedly scientific practice of ...

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"Grocery shopping is not optional; it’s necessary. But if you go every day and to multiple stores, you are increasing the chance you will be exposed. From my informal survey, this practice is extremely common. Yet, experts advise to consolidate shopping. In fact, in my experience, there is always at least one person (shoppers AND workers) in every store I have ...

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Now that it appears certain that the Republicans will approve a new Supreme Court justice in the coming weeks, there is great concern among Obamacare supporters that this could well mean the end of Obamacare. That concern is being amplified in the hyper-partisan environment in the ramp-up to the election––it makes for good scare tactics. The Obamacare case currently before the court deals with the 2017 repeal of the law's individual mandate ...

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I hate to say this, but I fear it is over. For our entire relationship, I have looked to the CDC to guide and educate me. I have put my faith in their recommendations. I have defended their stances on everything from obesity to Lyme disease to influenza across decades. I have done so because they never let me down. Until now. I am not sure that the powers that be at ...

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Done is better than perfect. The enemy of good is better. These are phrases that have echoed throughout my training and particularly in the past year of my personal life. Credited in various iterations to multiple sources, I openly note that these two phrases are not my original words and, I’d wager based on their prevalence, not my unique experience. Attention to detail, a penchant for excellence, the desire to be ...

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Black people are dying at disproportionate rates from the pandemic.  For decades, racial disparities in health care have resulted in poor outcomes even before COVID-19. Individual risk factors for poor health are more pronounced in Black people and racial minorities. However, these individual risk factors may not account for all outcomes. There are also additional factors at the community ...

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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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"Advocacy by moms is not new, but advocacy by physicians has been less common. Moms have been fierce advocates on a variety of causes ranging from Mothers Against Drunk Driving to Moms Demand Action, the anti-gun violence mom activist group led by Shannon Watts that has now helped launch moms into public office. As physician moms navigating a global pandemic, we are invested in ...

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It is likely that schools will be struggling to keep up with this ever-evolving pandemic and fluctuating positivity rates for many months to come. From July to September, there were over 9,000 cases of COVID-19 reported in over 2,000 schools in the U.S. What is becoming very clear is that protocols may need to change from week to week in order to maintain academic ...

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As a business owner, you have one primary role: Make money. I hate to put it in such callous terms, but that's the primary aim of any business.  You have to make a profit first if you want to do anything else.  Making a profit isn't the most important thing.  Your passion, your service, and your desire to help others should be the main motivation behind the business. Money can not be ...

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A few years ago, I was leading the training workstream of a multi-million-dollar EMR implementation.  The platform included 25 applications, from scheduling to revenue collection, and we trained over 17,500 employees in 12 weeks prior to go-live.  A significant part of the training effort included 4100 clinicians (physicians, house staff, medical students, allied health) across 137 specialties in both inpatient and ambulatory workflows. Many of them needed multiple specialty apps ...

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