A friend recently asked me, “Where do we go from here?” The friend was referring to our impasse with health care in America. The Democrats have failed to repair the Affordable Care Act, and the Republicans have failed to repeal or replace it. With the status quo, I can understand our health care system providing lower quality care compared to its counterpart industrialized nations. I can even tolerate lack of access to ...

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Next month when our youngest child leaves for college, the biggest change may not be in his life but in ours. We are done with dropping them off at school, or giving them driving lessons, or helping them with difficult homework assignments: We will officially become “empty nesters.” My wife and I ponder sitting at the dinner table and standing by the kitchen counter, where exuberant political dialogue takes place, and common ...

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At this time in history, it may serve us well to reflect on the tortuous past, the harrowing present and the unpredictable future of health care in America. First and foremost we must recognize we do not have “a health care system” -- rather our health care is delivered in an uncoordinated, misaligned and exorbitantly expensive fashion. For example, 1 in 5 Medicare patients are readmitted to the hospital within 30 days of discharge, ...

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Recently, a new mother of twins in Columbus, Ohio, sent a text message to her doctor: “Adam and I would like to introduce you to Ava Jain Cullum and Piper Jain Cullum. Their middle name was a no-brainer since we are so thankful for the huge role you had in getting them into this world … Both girls are doing fantastic. We are over the moon excited to have them in ...

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Eight years ago when the tumultuous health care reform journey began, we couldn't have imagined the roller-coaster ride it would take. The Affordable Care Act passing without a single Republican vote, surviving the Supreme Court ruling by the vote of a Republican-appointed judge, a disastrous roll-out of HealthCare.gov, thriving for four years with Obama's re-election, and now its inevitable repeal with Donald Trump’s win. So it may help to look back ...

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For me, the saddest part of the 2016 presidential election is not that we have two of the most disliked presidential candidates in history but that so little attention is being paid to health care. You may have noticed that health care rarely comes up in campaign speeches or in debates, and when it does it’s often scripted empty promises. Donald Trump has a plan entitled “Healthcare Reform to Make America ...

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When you are 70 years old, you are bound to have some medical problems, so I am not sure why the media and the public are making a hoopla about the medical histories of Hillary Clinton and Donald Trump. For an elderly patient, my usual medical dictation reads “Mr. A is a 70-year-old former truck driver who has hypertension, diabetes, bypass surgery, and who now comes in with a cough and ...

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Last week, when I stubbed my toe on our family room coffee table, a throbbing pain ensued. Over the next two to three days, as the bruise turned pink and then purple, the pain persisted. During the same time, I had a case of the blues. I am overstressed at work with several staff on vacation, my college-age children had come home and then left to start their internships, and my ...

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When he turned 45, Mitch Alsup bought a red Corvette. Mitch is a quick-talking guy with dirty blonde hair and a short, trim physique. He has a ready smile and is willing to share his story. “As a kid, I use to go down to the Chevrolet dealership and sit in a Corvette,” he recalls. “I wanted one when I turned 18, but I came from a poor family. I had to ...

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I am about to place my plate in the sink, until I see a single pea left on my plate. I recall a recent article in National Geographic that stated that one-third of all the food we produce is wasted. I have a Zen moment, and think of the journey the pea made to reach my plate. A farmer in California sowed the seeds six months earlier. A farm worker harvested ...

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A grandmother develops a boil that turns out to be a difficult-to-treat staph infection (MRSA). She needs high-powered antibiotics. A middle-aged man who received a blood transfusion decades ago now has hepatitis C and needs anti-viral medicine. A young woman with HIV develops golf-ball-size lesions in her brain, has toxoplasmosis and needs anti-parasite medicine. The marvel of medicine today is that we can treat all three infections, and save the lives ...

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A few summers ago during a week-long vacation, I started playing a mind game. In the mornings, I would sit outside on a comfortable deck chair, surrounded by the shrill call of cicadas, and gaze across the lawn into the trees. After getting settled, I would close my eyes and bring my body to complete stillness except for the rhythmic rise and fall of my chest with each breath. Then I’d ...

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It was a week into my elderly patient's hospital admission when he began to have fever and profuse diarrhea, some 10 to 12 bowel movement a day. The diagnosis was not hard to make: a stool test showed he had C. difficile. Another patient, a thin women in her late 40s who had become paraplegic after a gunshot wound decades ago, came in from a nursing home when her urinary catheter ...

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INSIDE-OUT-8-1940x1092 This summer's Disney-Pixar movie Inside Out makes us think about our thinking. But, I wonder, first of all, "Can we even think about our thoughts?" In fact, over the summer with campers at Lausanne Collegiate School, beginning with junior kindergarten to grade 7, I was teaching them how to observe their thoughts: a course in mindfulness and meditation for children. We begin by sitting ...

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Recently, health insurance companies across the nation have petitioned to increase premium rates for customers covered under the Affordable Care Act (ACA). In North Carolina, Blue Cross Blue Shield (BCBS) has proposed a 25.7 percent raise in premiums; in New Mexico, BCBS requested a 56.1 percent raise; and, in Georgia, Alliant Health Plans has submitted a proposal for a hike as high as 85 ...

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shutterstock_274763711 The morning after his brother's bachelor party, standing on the fourth floor of his family home, Dr. Arvind Goel, felt the ground move under his feet. "First it was minor vibrations and then it built up in a crescendo and then the couch where my four-month-old son was lying began to shake." "It was creepy," Goel, 32, continued. "The furniture began to ...

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shutterstock_141622243 Some years ago when my father underwent bypass surgery, he was anxious, depressed and in pain as he lay in the hospital bed tied to IV catheters and tubes. Each day, his surgeon, his hospitalist, and other consultant doctors whisked in and out, asking how he was feeling and then ordering a treatment plan. A few years after his full recovery, ...

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shutterstock_108354956 This year, we celebrated our 25th wedding anniversary. So, last week, one evening, I told my wife about a news story I heard on National Public Radio (NPR) about the microbiology of a kiss. My wife smiled. A group of researchers, I said, looked at the oral bacterial flora of 21 couples to determine how many bacteria were transferred by a kiss. ...

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A few weeks ago an emergency room doctor called our infectious disease physician group concerning a patient who had returned from Liberia and was having nausea and vomiting. Several of the patient’s family members had died of Ebola. As panic struck us, our decisive question was: When did he return from Liberia? The Centers for Disease Control and Prevention guidelines for screening and isolating patients for possible Ebola infection are clear: ...

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Recently at our community hospital, after we concluded a nearly two-hour standing room only Ebola preparedness meeting, I practiced donning and doffing the personal protective equipment (PPE) for Ebola cases. PPE is the protective wardrobe health workers wear when examining a patient with a contagious infectious disease. Each disease has a different level of transmission and requires an appropriate level of protection. I wear gloves 25 times a day to examine ...

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