The spaces where we live and work can exert both strong and subtle influences on the way our brains function. They can make us anxious, distracted, inefficient or tired, affecting not only our cognitive ability but also our emotional state, mental stability, and physical well-being. Clinical medical practice, like much of life in our society, is tethered to indoor space, so physicians, staff and patients alike are particularly prone to ...

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Nearly half of Canadians aged 65 and over experience osteoarthritis in their knees. Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage on the ends of bones wears down over time leading to pain, stiffness and decreased mobility.  It frequently occurs in the hips and knees -- and can be quite painful. To help improve mobility and treat joint pain, it has been ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. I distinctly recall during residency a much older and well-respected clinical teacher periodically opining that what was needed in a particular patient case was “a dose of the tincture of time.” For those less familiar with more historic terminology, a tincture is an alcoholic ...

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The National Rifle Association ruffled a lot of feathers recently when it published a tweet that said that doctors should “stay in their lane” on the subject of gun control. As a practicing physician, you might be surprised to hear that I side with the NRA. There’s something fundamentally different between diagnosing and treating a disease in a patient and recommending a new law because you treat people ...

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I was diagnosed with sickle cell disease at three months old in Haiti. The diagnosis from the doctor was followed by more tragic news; my parents were told that I was not going to live past five months. From that point on, my parents searched high and low for medication and knowledge about this unfamiliar disease. They spent an abundant amount of money in Cuba looking for any medicine that ...

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As the holidays approach, this time of year can be filled with mixed emotions for high achieving medical professionals who find themselves in the hospital, clinics, and practices caring for patients instead of spending time with loved ones.  It can be more hectic than ever as doctors try to be all things to family and friends while still carrying a full patient load. Personally, I learned the hard way that this ...

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When I was a young child, like most children, I loved Disney. However, my fascination with Disney did not involve the exhilarating theme parks, characters or delicious foods. As a young boy, I was captivated by the Disney culture, the multifaceted business model and the life and legacy of Walt Disney. During the past two decades, I have continually studied these complex concepts. Concurrently, I was pursuing a scientific education ...

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For Meg — with sorrow. We have failed to address the scale of suicide and mental illness in the medical profession, which is a global issue. Each of us can help prevent doctor suicide with these five strategies both locally and worldwide: 1. We can destigmatize mental illness for doctors and medical students First, we can change the negative attitudes to mental illness in our profession by accepting that doctors and medical students ...

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Retirement has gotten me edgy. Three months after departing, I had begun spending too much time horizontal, which I forced myself to remedy but then finding myself with nothing to do. Moreover, things have gotten more noticeably like Bowling Alone, an often-cited book by Robert Putnam published in 2000 that describes attrition of diverse communal activities over the previous 30 years. For physicians, our daily activities prevent us from working in ...

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Health care safety efforts have long focused on improving the behavior of providers and improving the systems of care. A proven model of safety is in the airline industry. There are undoubtedly many parallels between airline safety and health care working toward common goals. This work should continue in both industries to ensure the safety of the people they serve. The airline safety model, though, can only look at health care ...

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As Christmas approaches, I have begun seeing ads for things our family "must" have this Christmas. Overspending in December is a common problem I often find when I do a financial makeover for doctors. There is a huge push to buy things during the Christmas season, whether they can afford it or not. Those who choose to overspend, end up with a big headache when their January’s Visa bill arrives. Overspending ...

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It is widely recommended in the financial world that you prioritize your retirement savings over college savings for your children. I agree with this advice. Yet, I run into people all the time who are not following it. Perhaps it is because college often arrives a decade or more earlier than retirement so it seems natural to save for college first and then turn your attention toward ...

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It’s been a little over two years since I started this journey of blogging about passive income, and I’ve learned so much along the way. The term "passive income" has come to mean something very different to me over these years. I used to think that passive income was simply earning money in a way that isn’t proportional to the time you put in. And while this is ...

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I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the ...

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I had a great case the other night. Around midnight on a Friday, the hospitalist physician called me to evaluate an incarcerated femoral hernia. I thought this elderly and medically ill patient would likely die no matter what I did. I spent a grim half-hour at bedside explaining the dilemma to the patient and her family. She needed surgery, but surgery would probably kill her. The patient chose surgery. And she ...

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First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers. These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions ...

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“The dermatology profession exists for the primary purpose of caring for the patient. The physician-patient relationship is the central focus of all ethical concerns.” - American Academy of Dermatology, Code of Medical Ethics. The doctor-patient relationship is one of profound importance and complexity. And while doctors in training often receive quality mentorship regarding their chosen specialty, many lack good mentors to guide them in the art of the doctor-patient relationship. This is ...

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To my wife, Let’s just start at the beginning. When we first met, you thought I was arrogant and prideful.  For two and a half years we would rarely talk while we walked past each other in our small college town.  At the time, we never could have imagined that one day we would get married.  In a twist of irony, two weeks before we started dating you still didn’t know as ...

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Does anyone in medicine, particularly emergency medicine, understand why we lose money? Why we have to push those metrics so hard to capture every dime? I mean, we’re constantly reminded that satisfaction scores, and time-stamps and time to door, time to needle, time to discharge, reduced "left without being seen" scores are connected to the money we make. Medicine now is far less about the wonder of the body, the ravages of ...

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The oncologist had prescribed Xgeva hoping it would strengthen her bones while also delaying the progression of Angela Kahn's breast cancer. But Kahn (a pseudonym) couldn't get over the price of the drug. Before the oncologist had a chance to ask how she was feeling, she blurted out that the medication cost "$15,000 a shot." "That's crazy," the oncologist replied, continuing by saying the price "fits right in with the ...

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