It’s hard to put into words the horror we all feel about the events in Las Vegas. So I won’t try. But what I will try to do is point out an often unspoken reality. Which is that those who work in emergency care constantly face terrible things with courage and skill and keep coming back for more. And everyone needs to remember that all those folks society counts on ...

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Drug overdose deaths, once rare, are now the leading cause of accidental death in the U.S., surpassing peak annual deaths caused by motor vehicle accidents, guns and HIV infection. As a former public health official, clinician, and researcher, I’ve been engaged in efforts to control the opioid addiction epidemic for the past 15 years. The data show that the situation is dire and getting worse. Until opioids are prescribed ...

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The ability to access health information via the Internet is creating a generation of empowered, informed patients. While this is almost always beneficial to both patients and the patient-physician relationship, it does call for changes to traditional counseling methods. Widespread access to myriad health information sources has divided patients into two subsets: those who prefer traditional counseling and those who become “personal health researchers” or PHRs. While some patients will continue ...

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If we listen to the president, fixing the American health care system is too complicated.  It is not actually that complicated. The number one issue is cost. Even with many millions of people unable to access care, we already spend close to twenty percent of every dollar in the U.S. on health care. If we hope to include everyone in the health care system, then we need to lower health ...

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A couple of weeks ago I visited Canada. It was my first visit in a very long time. We were in Ontario, spending most of the time in the Toronto area, and also getting to visit the majestic Niagara Falls for the day. I’ve heard so much over the years about the differences between neighbors USA and Canada, and in even just a few days there, agreed that there are ...

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STAT_Logo One of Max’s friends taught him an easy way to buy shady drugs. What he learned almost killed him, and it opened my eyes to a hiding-in-plain-sight source of dangerous drugs that is amplifying the opioid epidemic. When Max (not his real name) developed pancreatitis a decade ago, his physicians prescribed opioids to ease his extreme ...

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Future generations will look back on the opioid epidemic as the greatest tragedy of modern medicine. The recent 60 Minutes special about drug distributors really highlights that manufacturing and prescribing opiates was never about the best interest of patients. The pharma companies saw a business opportunity that could be exploited by offering patients a little pill to take their pain away. What person, given the chance, would ...

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“A condition counts as a disease independently of whether there is safe and effective treatment.” - Journal of Medicine & Philosophy, August 2017 What is a disease anyway? Mrs. Jones is 90 years old and frequently experiences episodes of chest pain. She has numerous partially blocked coronary arteries, and her physician has told her to come to the emergency room because she might be having a “heart attack.” ...

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My wife Beth and I had a rather spirited discussion about how we in the U.S. might be able to pay for the health care of our citizens. Being ever practical, and also owning the job of writing the checks that pay for the health insurance our company offers its associates (including us), Beth in effect is arguing for a national consensus on something we might describe as a baseline ...

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I learned a good lesson in doctoring from Paul McCartney. Sir Paul, if we want to get formal about it. My wife and I went to one of his shows, and aside from re-living the soundtrack of our lives, we also were struck by how fresh and personal the concert felt. If you consider how many times he’s played those songs and that there were eighteen thousand people in the ...

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I'm really excited to announce my keynote engagements for 2018. I'll be keynoting 4 Pri-Med Conferences, with venues in Florida, Texas, Illinois, and my adopted hometown of Boston, MA. I'm also speaking at the annual conferences of the Association of Staff Physician Recruiters, the American Orthopaedic Association, and the College of American Pathologists. Sample the video above to get a ...

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Born in 1920, Henrietta Lacks lived in Virginia and Maryland, worked as a tobacco farmer, and mothered five children.  At age 31, her life was unfortunately cut short by cervical cancer.  Since her death, she has helped catalyze numerous biomedical discoveries. Upon treatment at Johns Hopkins, Henrietta’s physician obtained a tumor sample.  To his amazement, her cells survived and divided in a petri dish.  Today, her cells are still used in ...

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The emergency department is a place of unpredictability. Some days are a whirlwind, others drag, but both can be interesting. On a calmer day, I found myself, a fourth-year medical student, working with a physician I will call Dr. Smith. We discovered that we shared a common love for music, and between patients, we discussed everything from opera, to banjo, to Indian music. I am a composer and amateur classical ...

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It’s fall in the PICU, and we just saw our first severe case of respiratory syncytial virus (RSV) of the season. RSV is by far the most common cause of bronchiolitis in infants. To scientists, RSV is a fascinating virus with several unique properties. One of these is its behavior in the population. When it’s present, RSV is everywhere. Then it suddenly vanishes. There are exceptions to everything in medicine ...

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I’ve finally found my groove with our EMR. Maybe I’m even starting to like it. A few weeks ago I got a new iPad, this time a Mini, which lets me type with two thumbs the way some people text on a smartphone, and the voice transcription is good enough as long as you avoid fancy jargon and unusual generic drug names. Yesterday as I sat next to a patient and ...

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My first memory of encountering a person who appeared to have no place to live was during my first year of college at UCLA. A man was sitting outside a mini-mart, his legs crossed and his hair long. He looked tired, and his clothes had stains on them. Feeling pity for him, I went into the mini-mart and purchased a turkey sandwich on wheat. “Here,” I said as I handed him ...

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One of the most important things my mother taught me was to choose my friends intelligently. From a very young age, I remember my mother quoting Proverbs to me and telling me this, “Choose your counsel wisely.” The older I get, the more I believe who I allow to influence me plays an enormous part in the place I find myself in today. Research has shown you become like the five ...

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Flu vaccines are available, and so that means that the anti-vaccine brigade is out in force. The Daily Mail published an anti-vaccine op-ed by a former reality TV contestant named Katie Hopkins. It was followed by a shorter counter argument by a doctor, but when you are given less than half the word count and are at the bottom of the page it is hard to mount an effective response. Hopefully ...

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According to recent Ohio statistics, 1.3 million people have limited or no access to primary care physicians. Based on the 2015 Ohio Primary Care Assessment, 60 of 88 Ohio counties have medically-underserved populations. The Patient Access Expansion Act (HB 273), co-sponsored by Representative Theresa Gavarone (3rd District) and Representative Terry Johnson (90th District), specifically addresses health care access by prohibiting physicians from being required to ...

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Dear patient, I meet people several like you on a daily basis. It is always a pleasure to meet you since you come much more prepared compared to the average patient. I have seen you with several sheets of paper or even a notebook, a list of questions and an extra sheet of paper on which to write recommendations. You may even have printed research papers and articles off the Internet. I ...

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