Having worked at both community hospitals and major medical centers, the issue of ultrasound in pregnancy has revealed itself to be more complex over the years. As a resident, I worked with an obstetrics office that only scanned their own patients who had private insurance and would send uninsured or Medicaid patients (often with a high risk of inadequate prenatal care) to the hospital late in the day to be ...

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I spent considerable time after college working in academic labs being indoctrinated with the theory that publication is the currency of academic value and that researchers should always want to have their work printed in the journal most cited by other journals. You are supposed to be impressed when somebody claims that he or she is from a highly ranked university or institution, as these well-regarded institutions are synonymous with high achievement. That all changed for me during residency when I met ...

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I was talking to a physician in my hospital several years ago, and he expressed his frustration that the annual well-child exams for his four kids were expensive. Puzzled, I stated that I found it odd that a doctor’s own health insurance plan had poor coverage for routine care, and he replied that his group jointly decided on a plan with considerable upfront out-of-pocket costs. Why would doctors buy bad ...

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My nurse practitioner was pleased to see me at my annual physical this year. “So how does it feel to be 20 pounds lighter?” “It feels terrible,” I replied. Allow me to explain. Weight has been an issue my entire life. Raised on a standard Midwest diet of complex carbohydrates and the best processed delicacies that government assistance could buy, I spent most of my childhood socially segregated by my peer group due ...

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I met “Samantha” during my first rotation as an intern. She was a strong-willed and optimistic lady who weighed about 100 pounds. She was dependent on a tube in her stomach for nutrition, and she appeared 10 or 15 years older than her age of 44 years. Pictures of her children were next to her bed. I asked her how we could help her. She cried. Her husband of 20 years ...

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During breakfast with my father over the holidays, a friend of his asked me what kind of doctor I am. “I’m a radiologist,” I answered. I was met with a puzzled expression and a reply of “Oh, I thought you were a doctor doctor.” I smiled and returned to my banana. Most radiologists, especially those like me who are not physician offspring, are faced with this sort of discourse at least once. ...

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I was recently invited to speak at a conference in what is likely the nicest hotel I have ever set foot in. Partially hidden by an array of palm trees and adjacent to a golf course, I could easily see why the conference rate was $350 per night. Before making my way to the conference room, I paused in the dining area to go over my slides one last time ...

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I have only been able to make it back to my hometown once a year for many years now, but I recall my father having a very friendly dog many years back, a black Labrador mix named Abby. She was well behaved, would stay in the yard if you let her outside, didn’t cause problems, and was great with children. Then about ten years ago, another dog was added to the ...

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I was recently part of a panel aimed at helping physician trainees make the transition to becoming full-fledged independent practitioners, and a member of the panel said something that struck an important chord with the audience when he mentioned that new doctors are probably the most developmentally delayed professionals in society. When you think about the fact that for some of us, the first “real” job we have starts as ...

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Three men walk into a deli for lunch, take a number, and sit quietly until called. There are no prices on display, nor is the food visible. The first man, Ron, is called to the counter and states that he is hungry when asked what brings him in. He presents his food insurance credentials, and five minutes later, he walks out the door with a 12-inch gourmet sandwich, a side ...

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