The United States is a nation of laws, not of men's dictates.  The rule of law is what keeps (most) drivers from routinely running red lights, police officers from demanding bribes, and our civil servants and elected officials largely honest.  There, of course, will be violators of this code, as there are in any society, but nonetheless compared to many other nations in the US most citizens and state officials ...

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Pharmacists play an essential role in today’s ever-expanding health care system today. They check for drug interactions, watch for signs of opioid overprescribing and try to determine whether a drug for one condition prescribed by one doctor will negatively impact the patient because of another diagnosis the patient has. In hospital units, their roles have become yet more complex — often serving on various quality committees, managing daily dosages of ...

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The tragic case of Alfie Evans has roiled Great Britain and the world. Alfie was a two-year-old child in the United Kingdom with an unknown degenerative brain disease who eventually deteriorated to the point that he required life support. His brain had become mostly liquid, and he could not see, speak, or hear. Alder Hey Hospital decided his condition was terminal and irreversible and wanted to stop ...

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Recently, the Los Angeles Times broke a story that Dr. Puliafito, former Dean of the Keck School of Medicine of USC, had been abusing drugs and keeping company with a group of younger individuals who engaged in drug use and illicit activity.  Much of this activity occurred while he was dean, and it is a shocking story: A 66 year-old titan of the field of ophthalmology, renowned for inventing ...

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The ACGME recently formally increased its work-hour limits for resident physicians, a change that was widely covered in the press.| This decision has also been significantly misreported.  While it may seem like all residents will now work for longer hours, in reality, only first-year interns will be allowed to work longer 24-hour shifts, where the previous maximum was 16 ...

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Dr. Pronovost is a leading figure in the patient safety movement, and is someone I greatly admire.  His work with surgical checklists is touted by Dr. Atul Gawande as having saved more lives than any researcher in the past decade.  However, I disagree with his latest initiative: to get hospitals who perform certain procedures at very low rates to stop performing them altogether. On the surface, it seems like a ...

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In the wake of the horrific Orlando shootings, there has been renewed attention given to the U.S. Food and Drug Administration's (FDA) so-called ban on blood donations from gay men.  A congressman called the ban discriminatory, and demanded it's repeal -- a call joined by the American Medical Student Association. I can understand how many gay men feel.  I often donated blood at various American ...

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This presidential campaign has been alternately amusing and terrifying, courtesy of the antics of Donald Trump.  The prospect of someone who feels the need to boast about the size of his penis during a presidential debate having his small, small hands on the button to launch our nuclear arsenal does not inspire feelings of security. He is looking increasingly likely to be nominated by the Republican Party.  Many, however, ...

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There's been a bit of kerfuffle over resident duty hours lately. For those unfamiliar with the topic, physicians in training in the United States have traditionally lived in the hospital -- hence why they were called residents -- and available to patients 24/7.  Over time, concerns about patient safety led to limits on how many hours could be worked consecutively in the hospital.  In 2003, the maximum number of ...

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Theranos is a Silicon Valley start-up dedicated to revolutionizing (some would say disrupting) the medical blood testing industry.  The claim to fame of the company was to use a single drop of blood from a finger stick to run hundreds of tests.  This premise led to a $9 billion valuation and rock-star status for it's founder, Elizabeth Holmes; and was recently threatened by a Wall Street Journal exposé, ...

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A brief article recently posted the name and picture of a neurosurgery resident accused of smoking marijuana on the job.  Dr. Gunjan Goel, MD is a neurosurgery resident at University of California, San Diego, and the list of her awards and publications alone is almost as long as my entire CV.  The article is brief, and rather uninformative.  The only facts that are known are this: ...

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A recent paper in the Annals of Internal Medicine has sparked a large media response. In it, two incidents are described: In one, a male OB/GYN is prepping a patient's vaginal area for surgery, which involves running a brush soaked in Betadine or ChloraPrep solution over the labia, mons pubis, perineum, and inner thighs when the patient is already put to sleep by anesthesia.  He makes an appalling joke, "I ...

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For two years, I served as a representative to my medical school's student affairs committee.  My job was to convey medical student concerns and problems.  As part of that role, I had a lot of time to think about how and why many medical students experience depression and stress. Two recent articles have led me to write about the issue now: "10 simple solutions to stop medical student suicide," ...

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shutterstock_282279032 In the news recently has been a complaint filed by over 60 Asian-American groups, alleging discrimination in admissions at Harvard.  They point to such statistics as this: in 2009, among accepted applicants to the Ivy League, the average SAT score on a 1600 point scale for Caucasians was 310 points higher than Hispanics ...

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As a medical student, I strongly support vaccination.  It works, it's safe, and it doesn't cause autism.  But I also understand why many parents don't believe me and the medical community when we beg them to vaccinate their kids. Medicine has come a long way from "do no harm."  Now we talk about risks and benefits: and none of our tests, medicines, or procedures are without risks.  Increasingly, pharmaceutical companies have ...

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shutterstock_112847326 I'm on my family medicine rotation right now.  One of my preceptors is about 80 years old and went through medical school in the 1960s.  He is still sharp as a tack; he used to do C-sections, hernia repairs, appendectomies, fracture repairs and get this -- emergency burr holes for subdural hematomas (a.k.a. neurosurgery).  He stopped around 1997, mostly because he ...

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shutterstock_168769238 Ebola is in the United States!  Everybody (please don't) panic!  Quarantine all Texans!  Though that might be a good idea anyway (just kidding).  More on Ebola in general in another post if I have time. First off though, we've found out more information about the sequence of events leading to the hospitalization of the patient, Thomas Duncan.  Apparently, he came ...

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This post by Paul Levy got me thinking about informed consent, and a case I saw recently got me to take a little time and write about an issue frequently ignored in medical school. A bit of background for non-medical readers. Informed consent is a term in medicine for when doctors get the agreement of the patient to do something to said patient.  For example, before a patient is cut ...

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There's a bit of buzz in the news recently over President Obama's nominee for surgeon general, Dr. Vivek Murthy. It's worth pausing here to note the last truly consequential surgeon general:  Dr. C Everett Koop single-handedly carried out the entirety of the Reagan Administration's AIDS response (to be clear -- this is true because of how little the Reagan administration did, not because of how much Koop did); fought hard ...

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The death penalty has been in the news lately, what with a "botched" execution in Ohio, using a 2 drug method that Louisiana has also recently adopted for it's administration of the death penalty. These changes come on the heels of a new tactic by death penalty opponents: getting European countries to ban their pharmaceutical manufacturers from exporting drugs that may be used to execute people.  These bans were partially responsible for nationwide ...

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