Four o’clock on a Friday afternoon is an anxiety-inducing time to be running behind in clinic as patients and staff both begin to show signs of wanting to leave. After finishing with a particularly complicated case involving chronic pain with multiple spinal and abdominal surgeries, I rushed into the room of the patient scheduled for 3 p.m. frazzled. The patient was an elderly man, seated with arms folded, looking sternly ...

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Trump recently declared a national public health emergency. In this statement he was not talking about HIV or hepatitis C nor was he referring to the increased incidence of gun violence in the country. The president’s statements focused on a very different public health problem; he was talking about America’s high incidence of opioid-related deaths mostly from overdose. This declaration has been met with various pronouncements ...

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According to Hesiod’s version of an ancient Greek legend, because Pandora has opened a jar stuffed full of evil by the Olympian gods, “countless plagues, wander amongst men … earth is full of evils … Diseases come upon men continually by day and by night, bringing mischief to mortals silently.” Curiously that jar was closed before hope was also allowed to escape. Is the legend an expression of how bleak the ...

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Whether by design or by necessity, it appears that single payer is inevitable. Economic reality demands it. Some external force needs to be applied to counter the cost of rapidly expanding medical technology coupled with the political and legal pressure to make that technology available to as many people as possible, regardless of their ability to pay. The problem is certainly not new, but we are at the point of having ...

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In an article published by the Atlantic earlier this year, Ryan Park writes that neither truck drivers nor bankers work the kind of gruelingly long hours that doctors -- particularly young doctors in their residency programs -- do. It is no secret that residency life is demanding and exhausting. Over the last decade, it has also become controversial. Almost a test in itself, as if gauging doctors’ ...

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Over the past several years there have been numerous reports on the rates of death and injury in children with firearms.  In fact, a 2-year-old child recently accidentally took his own life in Philadelphia recently.  Although the studies don’t entirely agree, two things are certain; 1 death is one too many and children don’t need to exercise their second amendment rights. The United States has by far the highest rate of ...

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Recently I had an interaction online with a physician regarding his thoughts on ADHD treatment. (Let’s call him Dr. Stigma). This post is not about doctor-bashing but more to point out the prevalence of stigma against those with a psychiatric diagnosis even from within the medical community. Stigma, unfortunately, is so indoctrinated into our culture that sometimes people don’t recognize the pure ugliness of their words. Dr. Stigma’s comments: Many patients use ...

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“I know you think your organization is patient-centered … but it really isn’t.” The statement from a rare disease foundation president to a room full of industry partners stung as we observed a candid but cordial exchange about what “patient-centered” has come to mean in today’s health industry world. Everyone knew what they were hearing was right. Rewind a few days to the CBI Independent Medical Education and Grants Breakthrough Summit, where ...

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“Does physician leadership matter?” asks cardiologist and author Dr. Sandeep Jauhar in his New York Times opinion piece “Shouldn’t Doctors Control Hospital Care?” He opens his piece with the termination of the elected leaders of the medical staff office at the Tulare Regional Medical Center due to poor performance. He answers his rhetorical question with the obvious and simple response that doctors should control hospital ...

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Politics are divisive. That should not be a shock to anyone. However, the political climate in the USA at the moment is more than just divisive.  Lately, I have noticed that there is an underlying disdain for those we disagree with in a way that even my grandparents say they have never seen in this country. The current political climate pervades nearly every aspect of our society, from pop culture ...

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In 1968, Rosenthal and Jacobsen introduced the concept that expectations in the classroom can positively or negatively affect students. This phenomenon was dubbed, “The Pygmalion Effect.” Since then, there has been controversy surrounding the topic. Other authors have argued that the data was insignificant or inconclusive. From my own personal experience, having been in school for over ten years, I believe that the concept carries validity. Furthermore, I believe that ...

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While enjoying good incomes, physicians and other health care providers chronically suffer from a lack of time. Between scheduled clinical work and being on call, it is not uncommon to have only one full day off in seven. Not surprisingly, it is far too easy to spend that entire day just trying to keep your life afloat, catching up on mundane tasks for yourself and your family that fell by ...

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An excerpt from Love in the time of medical school: Build a happy, healthy relationship with a medical student. My dad is the oldest of four boys and my grandfather was an anesthe­siologist for many years. Apparently, the women who wanted to marry into the family all had to pass ...

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I was in the midst of my family medicine clinical rotation when my world came crashing down. I had failed my Step 1 boards. I would never be a doctor. It was a nightmare that unfolded over three failed attempts, from which I awoke in a new reality where I was no longer a medical student -- and there was absolutely nothing I could do to change that. I poured everything ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old woman is evaluated for amenorrhea of 4 months' duration. She has had weight gain, facial hair, alopecia, and debilitating fatigue. Her medical history is significant for psoriasis. She seems to be gaining weight in her face, abdomen, and neck. She also bruises easily. Her only ...

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Harry understood at last that he was not supposed to survive. His job was to walk calmly into Death’s welcoming arms … All those times he had thought that it was about to happen and escaped, he had never really thought of the thing itself: His will to live had always been so much stronger than his fear of death … It was over, he knew it, and all that ...

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The last few passengers filter in and buckle themselves up before takeoff. The emergency exit row is occupied by an elderly couple, and I am seated behind them. The flight attendant asks whether they are comfortable in those seats, given that they’d have to respond in the case of an emergency. “Not that I expect anything bad to happen,” the flight attendant adds with a smile. I, too, am familiar with discussing ...

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I’m passionate about patient safety. In no small part because I was raised to be. My mom has a lot of letters behind her name (RN, BSN, MSN), and she’s dedicated her career to the field. Before I was accepted into medical school, I knew about "six sigma," the "Swiss cheese model" and root-cause analysis. I’d been taught about creating a culture of safety and the example of the airline industry. ...

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Following a relatively routine doctor appointment, I received my bill for over $1,000. I rubbed my eyes, hoping to find an overlooked decimal point. I didn’t. My experience is not unique. We have a problem in the U.S. We pay over $3 trillion annually for health care — about 18 percent of our GDP. No other developed nation spends more than Read more...

Patsy loved playing bingo every Wednesday night. Her boyfriend of three years loved watching her daughter Jenna who was a tiny and pretty six-year-old her momma called "princess." Even though they weren't related, Jenna called Patsy's boyfriend "Uncle Billy" at her mother's behest. And Uncle Billy made Jenna shyer and quieter than she usually was. He'd walk in on those Wednesday nights and demand a big hug and kiss on the cheek ...

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