With the recent FDA approval, Zolgensma became the world’s most expensive medication. Priced at $2.125 million per patient, the one-dose gene therapy is a potential life-saver for children with spinal muscular atrophy (SMA). Now, the treatment is at the center of an intensifying debate over the rising price of medications.

Industry watchdogs are outraged. They say Zolgensma is merely the latest example ...

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Recently, Desperate Housewives star Marcia Cross made headlines by discussing her diagnosis of anal cancer and her husband’s diagnosis of throat cancer, revealing that both had been related to the human papillomavirus, or HPV. The move was brave, as the actress broke free from the stigma related to anal cancer and sexually transmitted diseases. More importantly, it was – I hope – inspirational. HPV is something that doesn’t get nearly the publicity ...

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“I’ll put my cell phone away when you put your computer away,” said the patient. These were the very words I heard upon opening the door and stepping into the exam room. As I stood waiting for him to look up, I was already looking at my computer for his name. Needless to say, I was aghast that a patient would say this to me.  My first instinct was to defend ...

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With the announcement of CVS Health HUBs, the synergy of data and business is rapidly coming to the health sector; health systems will become havens only for the severely acutely ill, the more complex, the expensive. In the same way that urgent care centers catered to low acuity, high financial margin problems that both financially supported and congested emergency departments, HealthHUBs will take similar problems away from primary ...

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STAT_LogoWhat if I told you that, as your doctor, I’d rather listen to your memoir than to your lungs? Or that while I find the sound of a beating heart a marvel to behold, I’m more interested in hearing the jazz song that you wrote or talking about the words tattooed on your left wrist. What if ...

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I remember the day well. The dean of my medical school called me directly. As soon as she announced herself on the other end of the line, I knew it was bad news. Deans don’t tend to make social calls, and I was right. She was calling to tell me that I had failed the USMLE Step 1, the first in a long series of standardized national exams to complete ...

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Eli Lilly and Co. recently announced with some fanfare that it was manufacturing a generic version of its own best-selling insulin brand, Humalog, which it would sell for half off — $137.35 versus about $275.

David Ricks, the chief executive of Lilly, said the company was making this seemingly beneficent gesture because “many patients are struggling to afford their insulin.”

But they’re struggling, in large part, ...

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I’m a 46-year-old OB/GYN. I’ve been on call at least as often as every fourth night for my entire career. Let that sink in for a minute. How many people get up and answer phone calls, remove ectopic pregnancies, deliver babies, and do C-sections every fourth night for an entire career?  Probably not many. It’s 4:15 a.m. I just got a call from the hospital about a patient of mine who is term, ...

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After my term as a lieutenant colonel in the United States Air Force, I could join the Air Force Reserves, go back to school or work as a pediatrician. I chose school and work. I had no specific "why," since I earned the VA educational funds, it was more like "why not?" My friends and family had mixed reactions. Never one to dwell on a thought, I jumped in before I ...

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Physicians leave training with expectations of earning a generous income and dreams of an extravagant lifestyle. They go from years as a struggling resident to a working individual with a stable income. Once they become attendings, their salaries skyrocket, in some cases from $55,000 annually to $550,000 annually. A $550,000 income requires extensive financial planning, of which the average physician has no experience or exposure. They are building a practice or ...

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Recently, I was called to task -- and probably rightly so -- for signing something I know I didn't read. This was several months ago, when one of my partners was out on family medical leave, and we divided up all of the coverage of her patients while she was away, making sure that forms for home health aides were signed so ...

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A kind resident or attending asks me, "I'm going for a coffee run. Can I get you anything?" I politely decline. "You sure?" "Yeah, I'm actually doing a caffeine-free residency." A mix of utter disbelief and disgust crosses their faces, probably yours too. With skepticism, people ask: "Why?" I actually hate the taste of coffee. (That is absurd in Seattle, where I'm doing my residency training.) Whenever I try a ...

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After nearly 40 years as an internist, Dr. Ron Naito knew what the sky-high results of his blood test meant. And it wasn’t good. But when he turned to his doctors last summer to confirm the dire diagnosis — stage 4 pancreatic cancer — he learned the news in a way no patient should. The first physician, a specialist Naito had known for 10 years, refused to acknowledge the results of the ...

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I was cleaning out the top shelf of my closet — a location where, hypothetically, treasures can be found. I came upon something that was wrapped in a nondescript brown paper bag that smelled oddly of mothballs. I cautiously reached inside and found an heirloom quilt that apparently had been passed down through generations. I had discovered it an estate sale, and now it had finally come to rest in ...

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"Let's start the powwow," a man with a brown jacket and braided ponytail said with a smile. Nineteen adults and one child filled the back conference room of the hospital. The hospital had made an industrial cylinder of coffee for the meeting, and it was almost completely drained. I hung the stethoscope around my neck, knowing I wouldn't use it as anything but a prop to signify my training and ...

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As a "dinosaur" emerita professor of pathology who still teaches medical students, I have witnessed some of the United States Medical Licensing Examination (USMLE) Step 1-induced climate changes compellingly. No, I am not a reactionary yearning for the past. Medical education has never been perfect. In the not too distant past, students were taught in an environment ruled by arrogant, dogmatic autocrats. Some things have changed for ...

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After a severe fracture or removal of a tumor, what happens if a segment of bone is missing? The bone ends will try to grow into one another just as they do after routine fractures, but the lack of immobilization and the gap may be insurmountable despite how hard the bone tries to repair itself. The void instead fills with gristle-like scar tissue, which cannot restore stability. A wobbly false ...

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In the era of the recognition of vast burnout in medicine, particularly amongst medical students, there needs to be a call to address structural problems in medical education. One particularly low-hanging fruit is the Step 2 Clinical Skills Exam (Step 2 CS). The exam has a relatively short history. The National Board of Medical Examiners (NBME) developed the exam for American medical students in ...

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I am a young physician practicing medicine in the "motherland" of God-gifted Ethiopia, which is located in eastern Africa, south of the Sahara Desert. I want to share my personal story, as well as to expose some of the serious problems facing physicians and patients in my country. I started medical school, which requires the highest academic performance of any career path when I was 18 after completing secondary school. Despite ...

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I know what kinds of things I'm supposed to tell you. I know that your other would be advisors will usually stick to the same basic messages: "Keep reaching for your dreams" or "your hard work is all worth it in the end" or "your education will lay the world at your feet." These platitudes are all well and good, but honestly, they're forgettable. And pretty words don't always translate ...

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