The computerized era has introduced all of us to a genre of errors that never existed during the archaic pen and paper era.   The paper medical chart I used during most of my career never "crashed."  Now, when our electronic medical records (EMR) freezes, malfunctions, or simply goes on strike, our office is paralyzed.  Although I appear to the patients as a breathing and willing medical practitioner, I might as ...

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There's a common affliction that's rampant in my practice, but it's not a gastrointestinal condition. It's called polypharmacy, and it refers to patients who are receiving a pile of prescription and other medications. I see this daily in the office and in the hospital. It's common enough to see patients who are receiving 10 or more medications, usually from 3 or 4 medical specialists. Of course, every doctor feels that he ...

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To accomplish certain tasks, we need a little help from our friends. No one can do it all, although many of us are more resourceful than others. Some folks are adventurous and dive into a new arena with excitement. They may be tinkerers who aren’t afraid to play with new gadgets. Sure, they might break some china, but they are apt to widen their skill set and enrich their lives. ...

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Let me post a question that neither I nor readers can answer: How much of what I do during the course of a day directly benefits patients? Perhaps, I don’t want to really know as I would be dismayed at how much of my effort benefits no one. Ask a nurse who works on a hospital ward, how much of his or her effort is directly applied to patient care. I would ...

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If any reader has heard of C. difficile, affectionately known as C. diff, then I presume you have had closer contact with this germ than you would have liked.  It’s an infection of the colon that can be serious, or even fatal.  There isn’t a hospital in the country that isn’t battling against the infection. We are not winning the war against this crafty and cunning adversary. While the infection is not ...

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Gastroenterologists, as specialists, are called upon by other doctors to address digestive issues in their patients. For example, our daily office schedule is filled with patients sent by primary care physicians who want our advice or our technical testing skills to evaluate individuals with abdominal pain, bowel issues, heartburn, rectal bleeding and various other symptoms. The same process occurs when we are called to see hospital patients. If a hospital ...

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Most of us do not know the basics of economics, although we should. It impacts every one of us every day that we are alive. Yet, for most of us, once we get beyond the law of supply and demand, our knowledge of the subject starts to vaporize. I can't explain fiscal or monetary policy. While I regard economics as a science, it seems that experts routinely interpret data differently, ...

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I have written about talcum powder previously.  Indeed, I have not only opined on the slippery substance, but I am also a regular consumer of the product.  Talcum powder has become magic legal dust that brings forth zillions of dollars to those who have been attacked by the poisonous toxin. Just last year, I informed readers of $55 million and $72 million judgments to cancer victims who used powder against ...

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We cannot let the anecdote rule over us.   We don’t make sound policy if we are swayed by isolated emotional vignettes.  Of course, a vignette describes a living, breathing human being, but we must consider the greater good, the overall context and the risk of letting our hearts triumph over our heads when making general policy.  Consider these examples. If an expensive drug treatment program keeps five addicts clean for six ...

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Today's patients must adjust to seeing many physicians, many of whom are strangers. If you need a doctor on the weekend, at night or just need a same day appointment, you may very well not be seen by your physician. This is not your father’s medical practice. The days of the physician house call have vanished. There are many reasons responsible for this evolution (or devolution) in medical care. Patients ...

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