There are times when it is necessary to step up to the plate and go the extra mile on behalf of your patients.  There is no job description for doing this and there is no manual that gives you instructions on what action you need to take on behalf of your patients.  However, when you have the opportunity to do the right thing, at the right time and for the ...

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Janus is the Roman god of doors and gateways but also the god of beginnings.  Interestingly, good beginnings and required for good endings.  The Temple of Janus had doors facing east and west, which allowed illumination of the temple at the beginning and the end of the day.  Most statues of Janus show him with two faces facing opposite directions. The Janus principle in your medical practice is the idea of ...

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Many doctors are now getting into movie production and making videos that are loaded onto YouTube.  These videos are effective in attracting new patients and educating your existing patients.  There are a few guidelines that you can use to create an effective script for each of your videos.  These scripts can be loaded onto your computer in a PowerPoint format and will serve as poor man’s teleprompter to assist in ...

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If you have been in practice for more than 10 years, you are probably familiar with the concept of professional courtesy where doctors treat their colleagues without charging them.  With reimbursement decreasing and overhead expenses rising, many physicians have started charging their colleagues when they provide their fellow colleagues with medical services. What is the position of the AMA?  The AMA advises that physicians should be aware that forgiveness or waiver ...

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Many physicians, including myself, have the misconception that the indigent patient is more likely to be litigious than those patients with greater financial resources.  A well-organized study that was reported in Clinical Orthopeaedics and Related Research reported that socioeconomically disadvantaged patients tend to sue physicians less often than their more affluent patients. Dr. Ramon Jimenez and his colleagues at the Monterey Orthopaedic and Sports Medicine Institute and his team demonstrated that patients ...

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All of us would like, whenever possible, to have a bilateral referral arrangement with our colleagues. Have you ever experienced a situation in which you are sending patients to another physician and receiving no reverse referrals? Of course, you can change your referral source, hoping that the other physician will notice that there is a decrease in referrals and will call you to ask what happened, but do not hold ...

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Several years ago I was hired by a plaintiff's attorney as an expert witness on a personal injury case.  He paid the fee in advance but the night before the trial, his co-counsel called me to review the case.  It was clear that she did not have a thorough understanding of the case and I spent two hours with her on the phone trying to bring her up to speed.  ...

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It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas.  I was assigned to a rotation in pathology where my job was to process specimens taken at surgery, dictate a gross description of the specimen and then place the specimens into the cassettes that would be used to make the permanent sections.  I was transferring a prostate biopsy, approximately 0.5mm x ...

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It was January 12, 2007 during rush hour traffic in the metro station in Washington, DC. A nondescript man wearing a baseball cap and khakis began to play the violin. He played six Bach pieces for about 45 minutes. During that time, since it was rush hour, it was calculated that at least a thousand people went through the station, most of them on their way to work. Nearly everyone ...

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"U.S. Panel Says No to Prostate Screening for Healthy Men" was the title of an article on the front page of the New York Times on October 6, 2011.  The article goes on to suggest that healthy men should no longer receive a PSA blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence ...

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