This summer, new resident physicians begin their training all across the United States. Today, our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (OK, not really a specialty, just a sideline) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school. Anxiety-filled and debt-ridden, they will embark on four ...

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Let’s be honest — what I don’t know about parenting is astounding.  I’m a pediatrician and have three kids, and it’s amazing what I still don’t know. Every so often I hear a parenting idea (or come up with one) that seems perfect.  Easy to implement and imparts both clear short and long-term lessons. Implementing new-age parenting techniques makes me feel good, even if in reality I spend most of my parenting ...

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My oldest girl and I love watching birds.   We usually watch the birds right outside our backdoor while they eat from our bird feeder. As we were watching one day, it amazed me how comfortable the birds were jumping from post to post on the feeder or from branch to branch on the trees.  Often times at a distance taller than the bird itself. Why would they take this risk and ...

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Dr. Lynette Charity is a practicing anesthesiologist and accomplished humorist and public speaker, having made it to the semifinals of the Toastmasters International World Championship of Public Speaking in 2014.  She's also one of my coaching clients, and I am so proud to announce that she will keynote three conferences this Fall. On Saturday, September 8, she will keynote the Ohio Dermatological Association ...

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I was recently interviewed by someone on the topic of clinician burnout. The interviewee asked me how I respond to those who say that burnout does not exist, is being overstated, or is the result of a weaker generation of practicing physicians. I find this difference in opinion interesting. Most of the time, when a physician complains to me about the focus on clinical burnout, they are 1) of an older ...

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In the recent weeks we’ve seen frequent headlines alerting people around the country to dangerous heat waves.  Physicians and nurses see these headlines and the human results of the heatwaves in the form of heat illness, people burdened with lung ailments and suffering from deteriorating air quality, and a range of individual harms brought on by wildfires and torrential downpours.   Current trends in extreme temperatures are alarming and clearly linked ...

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The headline scrolling across the bottom of an evening news show certainly grabbed my attention: a new blood test had the possibility of detecting early melanoma and saving thousands of lives. And then there were more reports elevating this early research report to a point that I became quite interested -- and frankly concerned. News flash: The research is far from being shown to have proven value in the early diagnosis of ...

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I am against all forms of bodily pain, both foreign and domestic. I wish the world were pain-free. When I am suffering from even a routine headache, I want immediate relief just like everyone else. The medical approach to pain control has changed dramatically even during my own career. When I started practicing a few decades ago, the strategy was pain reduction. We gave narcotics for very few indications such ...

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You have just gotten a job offer that includes health insurance.  You’re lucky enough that your spouse has great family insurance already, but hey that health insurance is going to cover the cracks in the deductible and co-insurance, so you feel great about that double coverage as you sign your contract. Well, you just got scammed.  That is, double coverage is a scam, and you would have been far better off ...

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My patient, a rugged sixty year old with massively muscular forearms, gray chest hair at the V of his denim shirt, and a voice that suggested years of liquor and unfiltered cigarettes, lowered his voice and leaned forward. “I’m not usually scared of anything, but for three nights now, ever since I started taking the Levaquin for this pneumonia, I have had the most horrific nightmares. I can’t even talk about ...

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It is no secret that medical school is getting very expensive. Over the past 20 years, the cost of medical school has greatly outpaced the rate of inflation, and medical school debt is rapidly rising. The average medical student now graduates with over $192,000 in student loans, but with the cost of attendance for the most expensive private medical schools approaching $100,000, there are some physicians who ...

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Urgent care centers are way ahead in prescribing unnecessary, potentially harmful antibiotics that are doing no one any good – at least no patients any good. The owners of the urgent care centers are the ones who are benefitting. And you and your family are being bilked, misled, and harmed. A recent study published in JAMA Internal Medicine looked at the proportion of antibiotic prescriptions that were made for viral respiratory ...

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As physicians, we are used to asking our patients lots and lots of questions. It’s our job to elicit information, listen, and then come up with a management plan. There’s a standard script every doctor goes through, based on the science of medicine, and we usually have this memorized to a tee. And that’s all very well and good. However, as with many things in life -- especially those that ...

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asco-logo I am a medical oncologist specializing in breast cancer. I often try to conceal what I do for a living when I meet people for the first time as it always leads down a particular road. “Is that so depressing? I don’t know how to deal with that all day, every day.” But in truth, it ...

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Yesterday, I had an eye-opening experience that made me reflect once again about relationships. During the afternoon, I had to attend a mandatory trauma simulation event. Since I am a surgeon, I am referring to physical traumas like traffic or firearms accidents, and just to be clear — psychological traumas are not included in these groups, even when I firmly believe that some of them would justify such an efficient and ...

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Both patients and providers realize that an internist is different from a surgeon, but specifically how they differ and how this affects their approaches to patient care is largely under-appreciated. Over the last four years, I have conducted over 250 interviews with physicians across specialties and institutions about what they do and why they do what they do. With each project, I continue finding remarkably distinct, specialty-specific values, perceptions, and ...

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A lot has been written about Suboxone, the buprenorphine treatment drug. For many, Suboxone acts as an effective medication to treat opioid addiction. For others, it’s a highly-valued street drug that is commonly diverted and misused. To understand and acknowledge the darker side of Suboxone we have to look back at its history over the past 16 years. History of Suboxone Suboxone was first approved by the FDA in 2002 to treat ...

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Technology can be both a blessing and a curse and nowhere is this more painfully evident than in the U.S. health care system. If technology is to be used to improve the patient-doctor relationship, its systems should be designed by physicians who understand these needs, not by regulators and health care conglomerates for whom business objectives are paramount. When it’s all about billing and meeting documentation checkboxes and hospital requirements, ...

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Medical school was a difficult adjustment for me. Coming from a blue-collar background and lacking a medical pedigree, I did not relate to most of my classmates, and I made very few friends. That changed when I met J., a second-generation physician-to-be without the competitive guile or sense of entitlement implicit in most of the medical students I had met. With a generous personality undoubtedly sculpted by the experience of motherhood, ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 24-year-old woman is evaluated for severe cramps associated with her menstrual periods. The cramps have worsened over the past year, and the discomfort is severe enough that she has periodically missed work. She reports no abnormal vaginal discharge. Menses are unchanged from her baseline pattern. She has tried ...

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