“So, will this mammogram save my life?” she asked. I thought for a few seconds … "I have no idea.” “What?” she sounded perplexed. “Well, if you have a cancer that’s aggressive enough to kill you before everything else, but not aggressive enough to have already had cells metastasize, and not so aggressive that it responds appropriately to chemo but it still needs to be rapidly dividing enough to respond to chemo, and we ...

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Guess what America?  If you pay for health insurance, you’re giving billions upon billions to health insurance CEOs, hospital administrators, pharmaceutical company CEOs.  So, if you’re obeying the law, you’re contributing to their astronomical salaries. In fact, Cigna’s CEO made around $49 million this past year, if you read the various reports on the Internet.  The CEO at a non-profit hospital in New Jersey (Morristown Medical Center) made some $5 million ...

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I, much like many others, made a terrible decision on my 21st birthday.  Mine, however, didn’t involve alcohol; I adopted a dog. She was a scruffy, brindle-coated, malnourished 30-pound terrier puppy.  So in between organic chemistry, physics, Spanish, studying for the MCAT, and multiple other classes, I had to housebreak a puppy.  Those glorious visions I had of dog ownership hadn’t included several key aspects, like cleaning up accidents, cleaning up ...

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From the moment I entered medical school, I have been viewed as dollar signs by many individuals.  Every medical student is visualized this way.  Let’s start from the beginning. Most medical students come from humble beginnings.  My father is a bluegrass musician, and my parents couldn’t pay for my medical school.  So I had to take out loans.  This was the same situation for the vast majority of my friends.  In ...

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Pharmaceutical companies are brilliant. They make profit off of chemicals that can be potentially life-saving. The list is quite impressive: antibiotics for somebody who would otherwise succumb to sepsis, insulin for someone whose pancreas loses the ability to function, antivirals for chronic viral suppression, antineoplastic agents for somebody whose cells have lost their regulatory mechanisms, just to name a few. The recipe seems to be quite simple: Charge as much money ...

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Sometimes the business plan completely falls apart. I look at my clock; it’s 11 a.m., and I only have two patients remaining for the morning? Something must be wrong. Every fail safe measure to keep the assembly line going must have failed. The initial card with the appointment time to carry in the wallet? Failed. The reminder phone call the day before? Failed. Even the insurance company gift card to ...

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“You’re nothing but a punk ass kid.  And you’ll die a punk ass kid!” With that, she stormed out of the exam room, leaving me sitting on a stool, slamming the door behind her.  Apparently she walked straight up to the front desk and asked to file a complaint about me, but left prior to receiving the paperwork. Most all physicians will immediately know what the interaction involved.  I hadn’t been mean ...

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"She's ready to push, doc." It's 2 a.m. I've been up for the better part of the evening, doing my part in the process of labor. I groan; I have a full day of clinic patients six hours from now. But these are the wonderful times. These are the times, in the rural hospital that I work, where it's completely and totally about that laboring soon-to-be mom and her soon-to-be child. There are ...

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“Don’t forget to bring that stool card back in, OK?” As he walked out of the room, carrying his portable oxygen, he turned back, with the nasal cannula in his nose, and replied, “I’ll get it back to you soon.  I’d hate to have colon cancer.” At this point, I’d hate for him to have a positive occult blood card.  I could really care less about colon cancer.  Colon cancer isn’t going ...

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I thoroughly enjoy my 65-year-old male with his horrendous diabetic foot ulcer.  But there’s not enough insulin in the state of Tennessee to cover the two bacon, egg, and cheese biscuits he eats every morning. And I adore my 57-year-old female with COPD.  But the inhalers won’t work until she stops smoking two packs of cigarettes per day.  I laugh every time I see that hilarious 32-year-old with hypertension.  But the ...

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shutterstock_242366215 The physician community lost a member on November 18th, 2013.  His name was Ben Bullington.  And I’m sure that the vast majority of physicians don’t have a clue who he was.  I had no idea who he was until about a month ago. Dr. Bullington was a rural family doc.  He practiced for years in Montana, in a town of less than a ...

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I just finished my first call weekend as an attending. It was a 96-hour bender. I had 4 vaginal deliveries, 1 cesarean, rounded on 20 patients on Saturday (mostly new), 14 on Sunday. I admitted 5, transferred 2 out --one for persistent ventricular tachycardia and one for a possible liver abscess, all while juggling full days of clinic on Friday and Monday. After the call, I felt tired, but still felt ...

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shutterstock_261498554 “We all want to live longer, my friend. I’m not doing the surgery. Take care.” And with that, the surgeon walked out of the room and crushed the hopes of my patient. Yet it was one of the most compassionate events I witnessed during my residency. The patient was discharged to hospice later that day. That patient was an early 60 something frail female ...

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shutterstock_144659519 “Your wife has gestational diabetes.” My heart stopped when my wife’s physician called to tell me this. “I want you to tell her because it’ll be easier to give it some time and let it sink in. Tell her to call me if she has any questions.” But I had questions -- about a million. Let me give some background information. I’m ...

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