Compassion. Empathy. These are some of the words commonly thrown around in medical school and residency training. If you ask most medical students why they chose medicine, they will respond with something like this: “ I love to help people,” or “I want to save a life.” I remembered when I entered medical school, one of my professors said, “In order to be good a doctor, you must be compassionate and ...

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The bloated nature of health insurance in the United States has been a much-discussed topic in recent years. Particularly with the advent of the Affordable Health Care Act as well in response to physicians’ frustrations and increasing burnout from dealing with the constraints imposed on them by insurance companies, and at times being forced to provide suboptimal care for their patients in response to these constraints. As an example, I had ...

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As an ER doctor, I often meet people on the worst day of their lives. I’m the guy who gets to tell you your mom is dead. I’m the one who works the futile code on your four-year-old, while your screams cut right through everyone in the room. I find your cancer. I tell you your husband overdosed in the McDonald’s parking lot. When you decide you want to shoot ...

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When my father reached his mid-80s, an accelerating accumulation of physical and mental functioning issues persuaded him to switch to a primary care physician in a concierge medical practice. Although the doctor’s pedigree proclaimed his competence, he mostly excelled as the medical equivalent of a hotel concierge who can magically procure hard-to-get restaurant reservations at the last minute. The doctor would see my dad on short notice and make sure he ...

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This article is sponsored by Careers by KevinMD.com. Daily headlines in newspapers and on websites across the nation and around the Internet seem to inspire and anger, and it's only natural that politics is a topic on everyone's mind. We're all concerned about the economy. We're all eager to see our political leaders solve the problem of unemployment. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated in follow-up after recent abnormal findings on intraoperative liver biopsy. Two days ago he underwent right colon resection for a large villous adenoma with high-grade dysplasia. At the time of surgery, an abnormal-appearing liver was noted and biopsy was performed. His medical history is ...

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Recently, several high-profile institutions have called attention to the issue of inclusion and equity when artificial intelligence (AI) algorithms are applied in medicine. Leaders from the law, medicine, social sciences and computer sciences are speaking out about the challenges of using smart algorithms to solve social problems. While this topic might easily be dismissed as anti-progress by the tech community, it ...

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After countless hours of hard work and three demanding years of medical school, it’s now time to face the spotlight! If your interview invites have started rolling in and you are feeling intimidated by the thought, follow these tips to land your first choice of clinical residency. 1. Be prompt with your responses to interview invites  Be sure to set your inbox to automatically refresh every hour during the interview season so you ...

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I think you can tell a lot about how things are going in a hospital based on the amount of consumption of coffee by its employees. Visit the Starbucks, Au Bon Pain, Roasterie, Einstein Brothers, or whatever coffee shop inhabits square footage in your hospital, and I’d venture to say that you can take the pulse of the hospital. Lots of large coffees to go? It’s either just about shift change and ...

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Doctors and other caretakers are the pawns of the health care system. We provide the services that allow hospitals and medical groups to bring in big revenue.  Unless we are contracting directly with insurers, doctors will never realize the true financial firepower that we have. As the health care environment evolves, we are seeing fewer individual physician-owned groups and more conglomerates.  The larger the system that we belong in, the ...

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I don’t mean to pick on McDonald’s. Insert any other large retail business where customer satisfaction massively trumps every other consideration of the relationship between employee and customer. Telemedicine companies have exploded the past few years. I suspect a lot of my readers have already seen this, but just in case not, a recent study in JAMA Internal Medicine measured the correlation between customers with a cold who called ...

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Effective clickbait doesn’t just happen. It’s carefully crafted. Take this wildly misleading article from CNN: Not exercising worse for your health than smoking, diabetes, and heart disease, study reveals. It’s one example — among many generated daily by various news outlets — of how a mundane observational study can be transformed into viral internet gold. In the days after it was published, this story was liked and shared hundreds ...

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Figuring out what’s actually true is far harder than most people realize. Our brains are both hypothesis-generating machines and incredibly credulous. As a result, most of the things we believe to be true turn out to be false. We don’t just mistakenly believe that vaccines cause autism, that the flu shot can give us the flu, and that astrology can predict our future. We also mistakenly believe that the salad ...

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Comparing the 2018 U.S. Preventive Services Task Force (USPSTF) recommendation statement on prostate cancer screening in the October 15th issue of American Family Physician with its previous recommendation, the first question family physicians ought to ask is: What new evidence compelled the USPSTF to move from recommending against PSA screening in all men to determining that there was a small net benefit for screening in some men? ...

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I've only worked four shifts of urgent care so far, but four 12-hour shifts means I've seen a lot: a lot of patients, a lot of different ailments, a lot of different reasons that people come to urgent care centers. I have to admit that this has been a breath of fresh air for me; compared to primary care, I work less frequently, I feel like the monetary compensation is fairer, ...

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“Sondor” is a made-up internet neologism that captures the fleeting but poignant sense of “the realization that each random passerby is living a life as vivid and complex as your own — populated with their own ambitions, friends, routines, worries and inherited craziness.” I think about this word often when I see my patients. Everyone is the main character of his or her life, and during the third year of medical ...

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About one in fifty people reading this essay will be diagnosed with kidney cancer at some time in their life. In fact, one out of one people writing this essay has already been diagnosed with kidney cancer. (I had a small tumor removed from my left kidney not long after I turned 50.) But how many people diagnosed with kidney cancer have been overdiagnosed with the condition? And what does moving to Florida have ...

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I don’t know how many times a patient has told me, “I was in therapy once, and it didn’t help.” My response is always: “That’s like saying 'I saw a movie once and I didn’t like it'.” That usually breaks the ice just a little. In primary care, we certainly run into a few patients with chronic mental health problems that could use some long-term, in-depth counseling. But usually, patients in my practice ...

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Health care policy has been a hotly debated political topic for many years now. In recent years, new laws passed the halls of Congress while others failed to gain any traction. Despite the rules that have rolled out, health insurance companies have been in the driver’s seat for decades. While spokespersons for the health insurance industry will tell you that they do not make medical decisions. As a doctor, I can ...

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I am bad at taking vacations — really bad. It’s not that I don’t take days off or even travel on days off. It’s my near inability to actually unplug and not bring work with me. Despite recovering from a level of burnout a few years ago that left me considering quitting medicine altogether, I still struggle with this. There is a never-ending to-do list related to work — both the items ...

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