It was 4:00 a.m. when I made it to my parents’ home. My mother called me to say that my father was having a hard time breathing. I could hear him struggling in the background. I ran inside to see my mother cradling my father on the floor — not breathing. I performed CPR on the man that gave me life! CPR on the person who just three months earlier ...

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The purpose of clinical documentation is to efficiently communicate critical data to peers in a readable fashion while meeting compliance and billing requirements. This documentation should not represent a data dump. Physicians continually increase our dependence on technology as the digital age deluges us with data. Accessing the right information at the right time is essential to providing appropriate care. The tsunami of new evidence necessitates clinical decision support, yet we ...

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Last year, in response to a continued groundswell of criticism focused on requirements for maintenance of certification (MOC), the American Board of Medical Specialties (ABMS) formed an independent "Vision Commission" on MOC, designed to "reimagine a system of continuing certification." Although led by ABMS board members, many of the 27 commission members are not directly associated with ABMS. After ...

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I have been a neonatologist for 30-plus years. Throughout my career, nurses and neonatal nurse practitioners (NNPs) have guided me, assisted me and comforted me through difficult patient care issues that arose. Even more importantly, they allowed me to leave the neonatal intensive care unit (NICU) without worrying about how my patients were being taken care of. I am writing this because our profession (MDs and DOs) continue to devalue these ...

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How can you work for 24 hours in a row? My friends outside of medicine ask me that often. What is it like? I wondered the same thing the night before my first 24-hour shift or “24.” I lay awake worrying, ironically, that I should have gone to bed earlier to rest up for the ordeal. When I get to work, full of nervous energy, I am relieved to find out ...

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As we have moved into the 21st century, we have witnessed a deterioration in our perception of our doctors of medicine. This has been a gradual, eroding process, quite possibly by the design of those in powers of authority in our government, health insurance corporations and the plethora of health care corporations. The assumption might have been to make these changes in the mode of operation gradually so that they ...

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It was another simmering-hot Texas day, and the AC was faltering in the family-practice clinic where I worked as a family nurse practitioner. Most of our clients were poor and spoke only Spanish. My nurse, Eliza, approached, wide-eyed. "There's a new patient — a woman named Maraby. She seems really angry," she murmured. "She's the color of Dijon mustard, and she's wearing a long, heavy wool cape. She looks like she's nine ...

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A commentary in the New England Journal of Medicine titled "Beyond Evidence-Based Medicine" received much well-deserved criticism for not only mischaracterizing EBM, but advocating for a novel approach, "interpersonal medicine," that was explicitly codified in the recognition of the U.S. specialty of family practice nearly 50 years ago. Here's what the authors wrote about this practice of medicine that is, apparently, new to them but well-known to the ...

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It’s no secret that physician job dissatisfaction is soaring to unprecedented levels, with over 50 percent of practicing physicians reporting burnout. While many factors have contributed to this epidemic in America over the last 20 years -- not least of all electronic medical records that are taking a heavy (and unacceptable) toll on physicians’ time -- this is not a phenomenon unique to the United States. I went to ...

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An excerpt from The Medical Marijuana Guide: Cannabis and Your Health. Despite the fact that the U.S. Department of Health and Human Services applied for a patent on cannabinoids as neuroprotectants and antioxidants in 1999 and was granted that patent in 2003, cannabis is still Schedule I. This means it ...

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Over 80,000 new cases of bladder cancer are diagnosed every year. Of the new cases, over 62,000 are men, and over 18,000 are women. Whites have higher incidence rates than blacks, although black patients have higher mortality rates, particularly black women. The majority of cases are found with painless gross hematuria (although most patients with gross painless hematuria don’t have bladder cancer). Nearly 80 percent of patients diagnosed with bladder ...

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Part 2 of a series. My own self-appointed role as my father’s health care advocate during his prostate cancer battle was a natural consequence of my training as a medical researcher. After earning a PhD in medical science, I became the elected family health and wellness guru, offering insight into everything from hangnails to stem cells, with the ongoing disclaimer that “I’m not a doctor, I just play one ...

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I have had a complex relationship with music. As a child, I had several instances of feedback that I was “bad at music.” When my class would sing at assemblies, I would get side glances and subtle and not so subtle clues that I should be at the edges and sing quietly. I played the viola from second to ninth grade. I had fun in orchestra class. For the rehearsals, I ...

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Caregiving is often described as a sacrifice. One individual bears a burden to care for another. There's a connotation of drainage, evocations of burned-out batteries and tired limbs. I was a premedical student. I was aggressive in pursuing an MD. I wanted to be the best doctor I could be. I did not realize that required me to become a much a better person. I left school to care for my grandmother. ...

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I sat knee-to-knee with a nurse practitioner at a school-based clinic in rural Ohio. Choking back tears, she described a patient she couldn’t get out of her head: a middle-school girl, accompanied by her mother and a social worker. Just days prior, the girl was dropped off at her father’s home for the weekend. Before the promised Friday night football game, she discovered him unconscious on the bathroom floor. Within ...

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If you’ve done any research into real estate investing, you’ve likely heard the term “turnkey real estate.” Businesses calling themselves “turnkey companies” claim to take care of all the hard parts of real estate investing – helping you with all aspects of purchasing and managing a rental property – leaving you to sit back and collect passive income. That sounds great, but surely there’s a catch, right? Well, ...

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There is no doubt about it, I am my mother’s son.   What would you expect? My father died when I was eight years old.  During my formative years, I was brought up solely by my mother.  I believe this is a unique lens in which to see both life and financial independence.  As the years pass, I feel lucky.  The importance of female role models cannot be ...

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Quick quiz question: two people are diagnosed with melanoma -- Sarah Sunburn, an adamant sun-worshipper, and Paula Pale-All-The-Time, a fanatical sun-avoider. Who is more likely to die of the disease? The answer is pale-faced Paula. Surprised? Let me unpack this mystery and explain why sun exposure simultaneously kills people, while making the cancers they are diagnosed with appear to be less life-threatening. I will start with what you probably know already. Melanoma ...

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Long ago, and far away, I encountered a patient that changed the way I practice. I was with a medical student while examining a middle-aged woman who presented with a dramatic eruption that was probably DRESS syndrome (DRESS syndrome was not yet described). I prescribed prednisone and asked her to come in a few days later so I could assess her progress. She returned – I did not recognize her ...

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Exhausted. Aching. Hungry. Slightly delirious. Mile twenty-four of a marathon? Or hour twenty-four of a twenty-eight-hour shift? I am a resident. I am a runner. I am also a rather tired human since, as I type these words, I'm both post-call and post-run. However, this post-call/run state of body and mind is one I have learned to love and embrace during this residency whirlwind. I'm not myself unless I'm wearing scrubs or running clothes. ...

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