When I was in medical school, I didn’t realize the potential data would have in health care. Back then I learned from 1000+ page hardcover textbooks and handwrote notes in paper medical records. Fast forward twenty years -- data and analytics are at the forefront of health care. Other doctors and I now have electronic medical records in the majority of hospitals and medical offices; there are claims data warehouses, and ...

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When I was a new attending, an older man came to see me as a new patient.  He had not seen a doctor in over thirty years and was experiencing worsening chest pain that first occurred when he walked upstairs but had progressed to pain at rest.  An electrocardiogram in the office showed signs of ischemia, and I advised him that I wanted to call an ambulance to take him ...

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I was recently discussing all the changes going on in healthcare at a summer cookout with a few doctors in private practice.  The topic of accountable care organizations (ACOs) came up, and the group started debating the pros and cons of them.  At one point in the conversation, I brought up Medicare’s Innovation Center (the organization leading efforts like ACOs) and asked the group what they thought of it. No ...

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In the past few years there has been tremendous criticism of the American Board of Internal Medicine’s (ABIM’s) maintenance of certification (MOC) program.  The MOC program was significantly expanded in 2014 and required doctors to get 100 MOC points every 5 years and do at least one MOC activity every 2 years. These requirements also came with increased fees for the MOC program and increased failure rates for the recertification ...

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In his State of the Union address, President Obama announced a precision medicine initiative “to bring us closer to curing diseases like cancer and diabetes.” The goal of precision medicine is to more accurately identify diagnoses and treatments based on a patient’s genetic information. This information will hopefully lead to better screening, earlier diagnosis, and more personalized treatment. But it’s hard to imagine that patients will get this kind of medical ...

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Almost every practicing doctor remembers the grueling hours and intense workload of residency.  I recall overnight calls when I ran around from floor to floor, my beeper never stopping. I would collapse at home the next morning exhausted, drained and a little depressed.  I would never want to relive residency, but I do look back at it with a sense of accomplishment.  In some ways, it is a badge of ...

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