Alexa Karsdan’s medical bill for a sore throat reached over $28,000. NPR told her story recently, but I want you to know why I am actually glad this happened. Why is it good news that her charges were so exorbitant, and that her insurance paid over twenty-five thousand dollars for one laboratory test? This story is a brilliant illustration of fundamental flaws in our health care ...

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In my urban primary care clinic, creativity and advocacy are some of our most basic tools. Recently, one of our residents brought up a homeless patient’s social barriers to colorectal cancer screening: no companion to escort her home from a colonoscopy, no address to send a mail-in test, no reliable commode location to collect a stool sample. This resident created a new workflow to have mail-in screening tests shipped to ...

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Goodbyes were confusing during my third and fourth years of medical school. Even on my way to a 28-hour labor and delivery call, I tended to say, “I’m leaving for school.” Rather quickly, my wife trained me to say, “I’m leaving for work.” I was never quite reconciled to this, as I couldn’t forget the upcoming exams and tuition costs around $30,000 per year. For the uninitiated, “work” as a medical ...

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