This year Oklahoma voters made a clear choice to legalize medical marijuana, joining thirty other states that permit cannabis for medicinal use. Unsurprisingly, immediately in the vote’s aftermath, patients began asking me to "prescribe" medical marijuana licenses, as the new law stipulates users must have as a precondition for legal purchase. The new law does not, however, specify qualifying diagnoses for which medical marijuana might be clinically indicated. My answer ...

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Let’s say your loved one is at the end of life. She’s 84, with advanced cancer that is no longer treatable. A decision has been made to put her in hospice -- which is a level of care more than an actual location. (Most hospice actually occurs at home.) The patient waxes in and out of consciousness, sometimes lucid, but mostly not. While no one is ready for her to die, this end-of-life ...

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Once upon a time, a hospital was a place you went if you were sick. Doctors would (ideally) figure out what was wrong, offer treatment, and you would convalesce. The longer you stayed in a hospital, the more the hospital could charge you (your insurance, really -- if you had it). This all changed in 1983, with the advent of the DRG system (it stands for diagnosis-related group). Almost overnight, the incentives for ...

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I recently told you of my admiration for Dr. Mona Hanna-Attisha, the Michigan pediatrician and epidemiologist whose strong research and advocacy was able to finally bring a shining light to the problem of lead in the water supply of Flint. Continuing with a theme, I now bring you the story of Dr. Adriana Melo of Campina Grande, Brazil. Dr. Melo is an OB-GYN who subspecializes in maternal-fetal medicine (MFM), the branch ...

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I have a new hero. Her name is Mona Hanna-Attisha, MD, MPH. Dr. Hanna-Attisha is a pediatrician in Flint, Michigan. She grew up in a suburb of Detroit. She graduated from the University of Michigan before attending medical school at Michigan State University. During her clinical years (the 3rd and 4th years of medical school), she spent many months at Hurley Medical Center in Flint, which serves as a clinical ...

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Quick: Which U.S. state has the highest rate of unintended pregnancy? I’ll reveal below, but I learned the answer and several other surprising facts in an interview with Mark Edwards, the co-founder of Upstream USA, a non-profit advocacy organization that provides technical assistance to health enterprises (medical practices, clinics, public health departments) in the use of long-acting, reversible contraceptives (known in the trade as LARC). LARC consists of two options: ...

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The big story recently is that the American Cancer Society issued an updated guideline recommending that women undergo mammography less frequently than before. This announcement was denounced on both “sides” of the perennial debate. Those in the “mammograms save lives” camp are outraged that a scientific society dedicated to cancer prevention and treatment would issue a proclamation that seems to run counter to the notion that “early detection saves lives.” Those in ...

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Ever heard of a doula? Doula is an ancient Greek word that translates as “woman who serves.” Specifically, it’s come to mean someone who serves as a birth attendant, a person trained in childbirth who acts in support of a birthing mother. A doula provides knowledge, comfort, and an extra pair of hands -- whether it’s to provide nourishment or massage, or help a mother find a comfortable position. As you may ...

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The Affordable Care Act. Obamacare. No matter what you call it, the law has two main goals: Insure more (all?) Americans, and in doing so, lower the aggregate costs of health care in the U.S. After year one of the Act’s main rollout, there is no doubt about the first goal: Millions more Americans now have health insurance. Many have purchased it on the exchanges, whether they are state-run (best example might ...

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Twenty-five years ago, the New England Journal of Medicine issued a report on a stunning new medical discovery: Aspirin helps prevent heart attacks. Yes, good ol’ aspirin. Known since the time of Hippocrates for its magical abilities to quell fever and pain, it took only 2,000 years for us to understand the science of it well enough to design a ‘sufficiently powered’ double-blind, placebo-controlled randomized trial on aspirin’s efficacy in preventing heart attacks. The Physicians’ ...

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