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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Prevention of heart disease has centered on smoking cessation, controlling blood pressure, achieving an appropriate weight, regular exercise, control of blood sugar, and control of your cholesterol.  Despite addressing and controlling these items, individuals still have heart attacks and strokes and vascular events. Researchers are now directing their attention to a dietary metabolite of red meat called trimethlamine N-oxide or TMAO. Recent peer-reviewed and published studies have shown ...

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Colorado’s ski resort areas in Summit County have a high cost of living, among the highest in the country. The people who visit these places — Keystone, Breckenridge and Copper Mountain ­— can afford it. Many of those who live and work there can’t, especially when they get sick. In addition to expensive rent, they pay some of the steepest health insurance premiums in the nation. Hospital costs are ...

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While my forty-year parts warranty expired some time ago, leaving me with a snapped fibular styloid process not long after, the ensuing twenty-five years have not resulted in any serious medical encounters until last week.  Following a very pleasant early evening session with our Congresswoman and a sweet snack at home, abrupt abdominal pain progressed in under two hours to a clinical acute abdomen.  As I got dizzy and dependent ...

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When looking at the way medical education and patient care is delivered, there is no question that there is a culture of “knowing.” From the moment a pre-med enters high school, they are bombarded with tests that assess knowledge. This extends throughout medical training, where the development of an assessment and plan in residency is paramount in the transition to an attending physician who must make autonomous decisions for their ...

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I meet doctors in different arenas.  I meet them in clinical settings, at conferences, and by referral. I am noticing a trend. We are keenly aware of what we do not want in medicine. We talk about physician burnout and the impact it has on doctors’ lives.  We know first hand the effect the EMR has on the doctor-patient relationship as doctors spend less and less time in direct patient ...

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On the face of it, this seems like a fairly simple business arrangement. My patients or their employers pay money to a health insurance corporation so they, in turn, have sufficient funds available to pay medical claims for services I render. That simple system seems to work for auto, home, and life insurance. First of all, a little background about me.  I am a board-certified otolaryngologist who did my residency through ...

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There are two versions of “the conversation” we have with men: One is for teenage boys, and it is about wet dreams, sexually transmitted disease, unwanted pregnancy and at one point also about testicular self-examinations. Those have now been edited out of the script, which makes sense to me since I have seen only three cases of that in forty years of practice, all but a couple of them diligently ...

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STAT_LogoDuring my training to become a primary care physician, the importance of preventive cancer screening was ingrained in me. The idea of catching cancer at an early stage so we can better treat it made intuitive sense. But as I’ve learned over the years, the simplicity of this concept can obscure its limitations and make it difficult ...

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Doctors and policy wonks hear a lot these days about “low-value care.” What exactly is that, and should you care? The term refers to tests, medications, and procedures that add little to a patient’s health or well-being but which cost them or the system more money than any benefit warranted. Some of the earliest research that looked at this was done at Dartmouth, where they found enormous variations in the cost ...

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As a trauma surgeon, it’s my job to diagnose and fix the violent destruction of the human body. One of the questions I get asked very frequently is, “How do you deal with that?” My standard answer is, “After a while, you get used to it.”

And while I recognize there is some truth to that, lately I’ve been more honest with myself about the emotional toll that violence ...

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I made my 10:20 a.m. patient wait while I told my support staff about my day off. "I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there were no serious injuries and all I did was to distract the passenger so she wouldn't panic while we waited for EMS. Her husband hit a tree with their van, and ...

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Michelangelo once said, “The sculpture is already complete within the marble block before I start my work.” The same insight applies to the scientific potential that resides inside young people. Curiosity is imbued within every human being since our birth, and before we can find the words to explain why, we experience the urge to turn over rocks. Often, efforts to promote science among young people aim to impress upon them what ...

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Some radiologists perceive teleradiology as the “dark side” of our profession. I may have counted myself among those skeptics, but I now see the light and am happy to share a place among the converts. Most of my career has been in traditional private practice, but there’s not a great deal of difference in how they operate versus a teleradiology practice. Both organizations exist to provide clinicians and patients with diagnostic ...

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Breastfeeding provides ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. Breastfeeding has numerous health benefits for both the mother and infant. Breast milk contains all the nutrients infants need in the first six months of life. Breastfeeding protects against diarrhea and common childhood illnesses such as pneumonia and may also ...

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The millennial generation is known for its desire and ability to change the status quo. As this group continues to enter and dominate the workforce, particularly as our current residents and medical students, employers are adjusting their long-held practices to reinvent their culture and ensure long-term access to young, top talent. Can you give this generation the same dress code as you did the baby boomers and expect the same result? ...

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One of the great nuisances in medicine is diagnosis coding. According to Medicare and insurance companies across the U.S., each and every disease must have a unique number. Everything must be quantified and recorded. Why? To facilitate analysis, number-crunching, regulations, reimbursements and, of course, we sometimes joke, to perpetuate the jobs of the coders. They usually know the nuances better than the doctors. Is it truly possible to describe Mrs. Brown's ...

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The one thing doctors want to avoid like the plague is a lawsuit — a medical malpractice lawsuit. To be sued means the doctor loses precious time from work, endures emotional personal and family distress and is unable to fully invest oneself in providing the very best medical care possible. It is a dark cloud that hovers over the majority of physicians at least once in their lives. Some medical specialties, ...

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People often compare internship to drinking from a fire hose. Overwhelmed by new information and workflow, interns (especially international) usually do not have a clear direction about how to optimize their working/learning experience. Here are some tips for interns to smooth their transition from a newbie into a high-functioning intern in the setting of medicine inpatient wards. Success leaves clues Don't explore yourself, specifically ask your upper-level resident about the most productive ...

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Being a medical resident is really hard. This is not only due to the infamous number of hours you work, but you are truly responsible for patient care for the first time. That is a heavy responsibility, especially when you constantly feel inadequately prepared. You never feel like you have enough time to read, and you never stop feeling like you could be doing a better job. Despite the schedule and ...

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