This is a special moment of female liberation, sisterhood, and solidarity. Tens of millions of women have used the #MeToo hashtag to share long-held secrets of sexual harassment and assault. The disgust generated by one extremely slimy Hollywood mogul has triggered a spontaneous worldwide outburst of disgust, righteous anger, and determination to effect social change. The movement is worldwide and includes women from all races, religions, and social classes. It started with ...

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Polypharmacy was once the exception in psychiatry; now it seems to have become the rule. Patients frequently are taking 3, 4, even 5 psych meds at one time. And often it’s primary care doctors, not psychiatrists, who are doing the prescribing -- usually without adequate training in psychiatry. Some polypharmacy is rational -- e.g., a patient with bipolar disorder who receives the combination of antidepressant and mood stabilizer. But most polypharmacy is ...

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"It's more important to know the patient who has the disease, than the disease the patient has." This was true when Hippocrates said it 2,500 years ago -- and it remains true today. Unfortunately, doctors no longer know their patients. GPs are overworked, underpaid, and must shuttle patients in and out of the office in less than ten minutes. Specialists tend to treat the test, not the patient, and earn their ...

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shutterstock_162447488 Let's get this straight. I am a penny pincher, who hates waste and wants a lean and efficient government. But, that said, we have to face the fact that our massive privatization of what once were government functions has been a failure. There are some public services that get really loused up when done privately and for profit. This is a classic mismatch ...

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Count no man happy till his end is known.  - Herodotus This was true in ancient Greece 2,500 years ago. It is even more true today -- aggressive end-of-life hospital care, the lack of sufficient palliative care, and unduly restrictive assisted suicide laws make it impossible for most people to die with dignity. There is no worse death than a hospital death. Dying well means dying at home. This requires preparation and preparation ...

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A drug company recently received FDA approval to peddle its speed-like pill for "binge eating disorder" (the very same pill that is already widely overused for ADHD). And it is sparing no expense pushing the drug -- a former world tennis champ is the shill and commercials are everywhere. Five years ago, I predicted binge eating disorder (BED) would become a new fad diagnosis and a wonderful target for pharma disease ...

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Doctors prescribe way too many medicines for patients who don't really need them. A lot of the pressure comes from intense drug company marketing. Some comes from patients who aren't happy leaving the office without a pill. And doctors have too little time with each patient to explain non-pill solutions to problems. Wild prescribing is not new. For thousands of years, doctors have given patients useless (and often quite harmful) ...

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shutterstock_163112705 You couldn't invent a worse health care system than the nightmare we have created in the U.S. Our medical costs are almost twice as high per person as they are in most other similar countries but produce only mediocre outcomes. There is massive overtreatment of people who don't need it, while many who desperately do have no coverage at all. The payment incentives ...

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Dostoevsky's Brother's Karamazov cleverly spoofs the careless inexpertness of what often passes for expert legal testimony. Three medical experts are called to testify whether Dmitri Karamazov was sane or insane when committing the alleged murder of his father. Naturally, the experts all disagree, with each completely convinced of the incontrovertible truth of his own opinion. Expert 1 finds Dmitri insane because he looked to the left as he entered the courtroom. Expert ...

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shutterstock_119657461 "If doctors do no other good, they at least prepare their patients early for death, undermining little by little and cutting off their enjoyment of life." These words from Montaigne are 350 years old, but, sadly, too often they describe the results of modern medicine, particularly when it is mindlessly applied in a needlessly heroic way to the end of life. I spend ...

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