A common proverb teaches that, “The road to hell is paved with good intentions.”  Medicine is a world where people are well-intended. Yet they fail to change a system that is broken and continues to produce burned out, depressed, and suicidal doctors. We can see their final destination, look back, and realize that we helped pave the road that carried them to that destination. Today, I want to hammer ...

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Computed tomography, or CT scanning, is one of the most powerful diagnostic tools to emerge during my medical career. Just look at the detail in the brain images above, taken at 90-degree angles through the brain. And I was there at the beginning. I remember well when I was a medical student taking neurology, and the first CT scanner arrived at the Mayo Clinic. By today’s standards, it was incredibly ...

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Some days in medicine seem like an epic saga in which the world seems to be playing whack-the-doctor. It is easy to vilify doctors and cast much blame at them. And true, we bring some of this onto ourselves. Today was one of those days, and by the end, I was just all too ready to run out of the office and go home. And then the last patient came and ...

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A physician recently recalled to me a situation he found himself in on the last National Doctors’ Day. Those of you reading who work in health care, will already be aware that this is on March 30th every year. I have seen this day celebrated in every hospital I’ve worked in since I first came to the United States over a decade ago. I actually think it’s a nice gesture, and ...

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At some point in your investing career, you’ve likely heard of a stock that’s gone on a ridiculous run or a certain part of town that has now become the trendiest in the area, and you’ve kicked yourself for not investing. We’ve all been there. Well, the cliche is true: hindsight is indeed 20/20. In hindsight, who wouldn’t have purchased as many shares as they could of Amazon or Apple back ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated for a 12-year history of refractory constipation. Her symptoms began after a difficult childbirth. She has constipation marked by straining, bloating, and a constant sensation of incomplete emptying. She sometimes has 4 or more days between bowel movements. When she does have a bowel ...

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I love the idea of turning a negative approach to improvement in health care -- looking for problems -- on its head. Appreciative inquiry, a process of focusing on a group’s inherent strengths and fostering positive interactions among group members, is one way of fostering change with a positive approach. Positive deviance (PD) is another. Basically, PD involves identifying what’s working and usual local solutions owned by the people ...

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"Those who suffer illness learn by hearing themselves tell their stories, absorbing others’ reactions, and experiencing their stories being shared." - Arthur Frank We stand together at the clinic room door, preparing to enter. “Tongue cancer. This is a 78-year-old man with an oral cavity mass and some memory loss. He had an ulcer on the side of his tongue for a few weeks which was biopsied by an outside doctor. No imaging ...

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Who was Ryan Haight? Ryan Haight was an 18-year-old honor student from La Mesa, California who died on February 12, 2001, from an overdose of hydrocodone ordered from an online doctor he never saw — and shipped to his home from a rogue online pharmacy during the beginning of the opioid epidemic. The pharmacist, Clayton Fuchs, filled ...

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Like prep sports or prime-time television, medical meetings have seasons. In the spring and fall, my calendar fills with invitations to speak. I try to get to the venue a few hours before I’m scheduled to speak, so I can “take the pulse” of fellow doctors, asking them about their practices, patients and the future of medicine. Figuratively speaking, the industry’s pulse is racing with fear. I’ve observed that in just the past ...

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There has been a recent surge in discussion about men’s fear to work alone with female colleagues in medicine. This reluctance puts both men and women at a disadvantage. Women are being excluded from career opportunities and men are missing out on the benefits of collaboration. As a victim of sexual misconduct during my own medical training, I find the recent increase of acceptance of reporting to be a step ...

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Imagine yourself as a patient burdened with a chronic disease that necessitated daily medication adherence to function. Now imagine that medication has become so stigmatized by society that you feel judged and ashamed every time that you use it. That’s the world that individuals with opioid use disorder are forced to live in when they’re prescribed methadone or buprenorphine to get through the day. Without these medications,
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With the recent 10-year anniversary of the Mental Health Parity Act being signed into law, comes the reminder that we still have so much work to be done. Unfortunately, blatant discrimination in health insurance coverage for mental health and substance abuse has continued despite this legislation. The Parity Act required that dollar limits on mental health benefits be no lower than the dollar limits for medical and surgical benefits offered ...

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One of the most important factors on patients’ minds is affordability of care. According to a recent McKinsey study, 72 percent of consumers are concerned about at least one kind of health care expense, be it related to health insurance, routine medical procedures, end-of-life care or otherwise. As it pertains to prescriptions, patients carry these affordability concerns from their providers’ offices to the pharmacy. More often than not, ...

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An excerpt from Prescription for Bankruptcy: A doctor's perspective on America's failing health care system and how we can fix it. Many years ago, while I was involved in developing the pre-hospital emergency medical care system in Massachusetts, I went with a group to meet with the then-president of Blue ...

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An excerpt from Let Go of Emotional Overeating and Love Your Food: A Five-Point Plan for Success. Copyright © 2018 by Arlene B. Englander. Published by Rowman & Littlefield. All rights reserved.  Anyone who has ever tried to lose weight or keep weight off realizes that evening can be ...

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This article is sponsored by Careers by KevinMD.com. Employer consolidation due to the mergers and acquisitions of hospitals and health systems is becoming increasingly common within the health care industry. In fact, merger and acquisition activity doubled in the first half of this year, with the volume of value health care sector deals increasing to 
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My mom was recently diagnosed with cancer. I can’t even begin to describe the shock I felt or how my heart just sank. In an otherwise healthy person with no family history, this is not something you ever expect to happen. My mind immediately jumped to so many different conclusions, and I immediately wanted answers. Is she going to beat this? How did this happen? Why did this happen? What ...

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Healers, scientists, leaders — these are all terms that we equate with being a physician. As we spend our years if not decades in training, we strive to become all of these components. But when you miss something — the small details, the nuances of a history and these are the clues that could lead to healing it can be disheartening. When it comes to your own family member, such ...

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Over the last 20 years, physical fitness as a means to improve overall health has increased among the over-40 set. This is great, right? Yes, absolutely. Athletes who remain active as they age do a better job than non-athletes in retaining lean muscle mass. They also show improved bone density, bone structure and bone strength. However, what physicians are seeing are injuries related to the increased level of activity. One area ...

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