Well, they are calling it the golden age of rectums! The trends are simple and straightforward. First, Baby Boomers and beyond are aging and staying alive longer. The gut, a hidden culprit behind many ailments, requires continuous maintenance. Colonoscopies, EGDs and ERCPs. These require services of gastroenterologists (GIs) who are always in short supply (14,000 in the U.S.).4 Second, gastroenterology practices are fragmented like hotels were before the Hilton. Regulatory, technological and ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated in follow-up after recent abnormal findings on intraoperative liver biopsy. Two days ago he underwent right colon resection for a large villous adenoma with high-grade dysplasia. At the time of surgery, an abnormal-appearing liver was noted and biopsy was performed. His medical history is ...

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Facebook. Where else could I stumble on a video of a baby hippo taking a bath, or Toto’s Africa performed on solo Harp? But among the shares and silliness and talent, there’s a dark side to Facebook. It’s become a fast way for quacks to push their scams and empty your wallet. Just today in my feed I received a promoted post about a “food sensitivity test.” I’m not going to link directly ...

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This is an article about certainty, or maybe lack of certainty? It is about the need for confidence, without having overconfidence. Doctor! Don’t be arrogant -- listen to your patient -- they are telling you the answer. So believe them, but be a skeptic! Better yet, figure out the diagnosis, but then don’t believe yourself. Try to prove yourself wrong at every turn. The definition of the word hubris is important to understand. One definition of hubris is “exaggerated pride or ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia that has resulted in the loss of 2.3 kg (5.0 lb). She has had no fever or blood in ...

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Before coming to medical school, I made a promise to myself: I will not become a robot doctor. Time and again, I visited what I call robot doctors: those physicians unable to empathize with me and seemingly unable to compute moments when I said something unscripted. For example, I once made an appointment with a doctor to discuss what might have been irritable bowel syndrome (IBS). While describing my symptoms ...

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So much of life depends upon timing. Sure, we plan, but we know how much of our life’s events are unplanned and unexpected. So often, our jobs and our mates -- two of our most defining accomplishments -- are the result of a chance encounter or a random act. Life does not reliably proceed in an orderly manner. This is often true in the medical profession. Here, physicians in our quest ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated for a 12-year history of refractory constipation. Her symptoms began after a difficult childbirth. She has constipation marked by straining, bloating, and a constant sensation of incomplete emptying. She sometimes has 4 or more days between bowel movements. When she does have a bowel ...

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Human beings have grappled with obesity for thousands of years. Greek philosopher and physician Galen described “bad humors” as the cause of obesity and prescribed low-calorie foods, massages, baths, greens and garlic to his patients to help them slim down. In the 18th century, William Banting successfully lost weight following a low-carb diet and spread his mantra to the public in a pamphlet called a “Letter ...

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Increasingly, we see functions executed by machines that were formerly performed by living breathing human beings. Examples range from the mundane to the preternatural.

  • Order food and drink from an iPad. No server needed.
  • Driverless auto travel. This may lead to a resurgence in prayer.
  • Pilotless air travel. Hard times ahead for the Airline Pilots Association.
  • Making precision tools from 3D printers.
  • Gourmet meals created with a voice-activated command.
  • Theater ...

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