Dear Class of 2020, You’ve worked hard to earn the privilege of becoming a physician. I hope you took some time before starting medical school to enjoy yourself and embrace your passions, be they travel, music or art, or simply spending time with family and friends. Becoming a doctor is a long, bumpy and often lonely road. Resiliency is essential. My first and most important piece of advice is to be ...

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My last column told the stories of two patients from whom I learned important lessons about gratitude and compassion.  In this column, I share stories about patients who taught me critically important lessons about truly listening and the power of acceptance. Samantha -- or Sam, as she preferred to be called -- was a young surfer recovering from a serious car accident, and Paul a young father with cancer. ...

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When I first met Mary, already in her forties, she had suffered throughout her life from an arteriovenous malformation of the face. As a result, from early childhood, she had endured the discomfort and humiliation that accompanies the stares of strangers. She came to me hoping I could improve her appearance. The abnormal connection between the arterial and venous halves of her circulatory system caused her cheek, jaw, and neck to ...

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Most industrialized nations have long supported the idea that access to health care is a fundamental right, and have built centrally planned systems to accomplish that goal. The result has been universal coverage that delivers excellent-quality outcomes at lower costs than the United States. In some countries, such as England and Canada, the government controls both financing and certain aspects of health care delivery, while in others, including Australia, Sweden, and ...

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Opioids, also known as opiates, serve as important prescription medications in medical practice. But within the last decade or so, because of their overuse, misuse and abuse, they’ve also emerged as a leading cause of addiction and death. Sadly and surprisingly, those most instrumental in creating this epidemic -- however unwittingly -- are physicians and the pharmaceutical industry. The question is, how could this crisis have happened? What responsibility should physicians take, ...

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Most physicians are smart and very talented. They’re skilled clinicians and technically superb. But despite such abilities, they fail to get others to follow them, once they take on the role of leader. As a consequence, they’re unable to get physicians to change or improve performance. Jay Conger, a professor of business at Claremont McKenna College who has devoted his career to the study of leadership, has helped me understand why ...

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Consumers spend 16 times as long choosing a computer as they do selecting a health plan for themselves and their family. And it should not be a big surprise. For decades, nearly all insurance companies offered similar choices of in-network physicians and hospitals. And as a result, plans differed only minimally in clinical quality, access and service. And even when clinical outcomes varied, consumers had no easy way to access comparative data. So ...

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With fewer than 100 days until the first primaries, the leading candidates have received ample airtime to address the important issues our nation faces. But even though health care accounts for around 18 percent of our nation’s GDP and consumes close to half of the total tax revenue collected by the federal government, their silence on providing solutions to the most pressing health care challenges our nation faces continues with ...

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What should we call the people who get medical care? Are they “patients,” the traditional term for anyone receiving medical attention from physicians, nurses, pharmacists, therapists, dentists and other providers? Or are they “consumers,” people who purchase goods and services for personal use? The debate about nomenclature is growing, and it’s more than a matter of hair-splitting semantics. Among passionate advocates on both sides of the argument, emotions run high. Sometimes we ...

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Resurge In the arms of every parent who waited on the long line outside the clinic in Mexico was a child born with a facial deformity, usually a cleft lip or palate. Many of these mothers and fathers had walked long distances, carrying their child. Some families included grandparents, aunts and uncles, and others, just a mother, and her baby. Most of these ...

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Ask physicians across the country what problems they want solved, and they won’t hesitate to tell you. They worry about the growing health risks they observe in patients based on lifestyle choices, obesity and a variety of social factors that they feel powerless to change. Ask what they would modify if they had a magic wand, and they’ll point to the illogical, problematic and increasingly complex reimbursement schemes still favored ...

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Patients want to receive health care that is of the highest quality. Physicians want to provide it. But what is “high-quality health care?” On that, few agree. Ask most Americans and they’re unsure where to find it. They know they want to be kept healthy, have rapid access to personalized care whenever they need it and be charged only what they can afford. Ask the leaders of the national medical and surgical ...

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shutterstock_114520012 In the late 19th century, Dr. William Halsted, a pioneer of modern surgical techniques, performed ultra-radical mastectomies for women with breast cancer. The procedure, soon named after him, involved the surgeon removing not only the breast itself but also surrounding musculature and the associated lymphatic system. Halsted believed, and taught generations of medical students, that the more radical the procedure, the higher the ...

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shutterstock_182066816 Imagine an institution where the occupants are routinely left immobile, deprived of sleep and fed a diet that is tasteless and nutritionally marginal. Imagine further that they experience the indignity of losing any semblance of privacy and get stuck multiple times a day with needles. Sounds like a brutal prison, right? Yet the same description could apply to a typical U.S. hospital. As ...

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The Affordable Care Act (ACA) has changed Medicare for the better, and produced higher quality of care for patients. But whether the new shifts in Medicare policy will lower the total cost of health care, remains unclear. And that could present the program with a major problem in the future. For the first 40 years of Medicare, most enrollees opted for the traditional fee-for-service Medicare program. The main reason for doing so was ...

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In October, 2013, at the launch of the Affordable Care Act, I predicted that the health insurance exchanges about to go into effect would grow in popularity and improve the health insurance marketplace, then so imperfect. Twenty months later, the exchanges are proving effective in reducing the number of uninsured and are beginning to provide the information people need to make an informed selection about which plan is best ...

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The country is in a state of health care denial. Politicians, pundits, and executives proudly declare America’s medical care is the best in the world. But it isn’t. The U.S. lags behind other industrialized nations in many important health measures -- partly because citizens of certain races, ethnicities and incomes experience poorer versions of U.S. health care than others. The disparities are glaring. The solutions aren’t nearly as obvious -- but we’ll explore some ...

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My father’s sister Mary died from measles when she was six years old. Her death haunted my grandparents for the rest of their lives. She was one of the thousands who died each year from measles before there was a vaccine to prevent this life-threatening disease. Her story has always stayed with me -- from my days as a child to my years in medical school. And once again I’m reminded of ...

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Rural hospitals are fighting for their lives. Over the past five years, more than 40 rural facilities have closed their doors due to lack of funding. And because the majority of their funds come fromMedicare and Medicaid -- two government programs facing potential cutbacks in 2015 -- many rural hospitals may be fighting a losing battle.   Understandably, small-town residents fear hospital closures or downsizing may leave them vulnerable when serious illness strikes. ...

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Part of the fun of ringing in the New Year is looking back on the achievements of the previous one. And in 2014, there were plenty of health care success stories to celebrate: major medical advances, new technologies and the Affordable Care Act’s unexpectedly good first year. At the same time, many of the health care changes in 2014 yield potential risks for patients, employers and the nation as a whole. ...

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