March 30th is National Doctors’ Day, a day set aside to recognize physicians, their work, and their contributions to society and the community. Though we are used to thinking of the profession of physician as something many parents hope their children aspire to, the reality is that fewer and fewer students are choosing that path. According to a March 2017 report by the Association of American Medical Colleges, the U.S. will ...

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You go to your doctor because you are suffering pain, fatigue, or some equally debilitating ailment. Your doctor examines you and is worried there may be a serious underlying medical reason for your symptoms and orders a test. But, before you can have that test done to determine the cause of your symptoms, the insurance company must agree that you need it in order for them to cover the cost ...

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It is wildly popular to say that the chief culprit in the U.S. health care system is the traditional fee-for-service payment system, which rewards physicians for volume but not quality, leading to high-cost, low-quality health care. It supposedly follows that the fix is a system of “value-based” payments. Despite the popularity of these arguments, both aspects have been shown to be wrong. Studies show that the rising cost of American health ...

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Our health care system in the United States is notorious for providing a lot of unnecessary medical care — something we’ve written about extensively. Doctors may provide that unnecessary care because they perceive that patients are expecting or requesting it. If health care professionals don’t provide the aggressive care that patients believe they require, the thinking goes, patients won’t be satisfied, and the doctor-patient relationship will suffer. Plus, the patient ...

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Drug costs in the U.S. are higher than in in any other industrialized country in the world. Our cost for an insulin glargine (long-acting insulin) pen is $76.80 and in Canada, so very few miles away, it costs $19.60. The latter price is reasonable. The former price can make the difference between being able to afford a life-saving drug and dying. It is illegal, however, for a U.S. citizen to ...

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I was behind schedule (again). My next patient was Helen, a non-compliant diabetic that hadn’t been into my office in over two years. Her blood sugars weren’t controlled at her last visit when I’d tried to impress on her the serious health problems that could develop if she didn’t take better care of herself. Clearly, I’d failed. Maybe I’d even chased her away? No pill I prescribed would help her diabetes ...

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Behind that computer in your doctor’s office, there is a war going on. As a patient, it affects your care. Your doctor is pushing back on the forces eroding your quality of care, but they are being torn apart by legislation, bureaucracy, and big business. Unlike, 30 years ago when doctors controlled patient care, your doctor is being outflanked by powerful people  that did not go to medical school or swear an oath to protect. Your doctor gave up a ...

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There has been a nauseating amount of discussion about physician burnout lately. An equal number of remedies, from mindfulness to exercise, to inpatient psychiatric treatment for doctors experiencing unmanageable stress and burnout. And then I read this report of a survey from the world-famous Cleveland Clinic, which describes 35 percent of nearly 1100 physicians employed the Cleveland Clinic have signs of overt burnout. More importantly, those physicians who cared ...

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I’ve got a confession to make. I own stock in a firearms maker. Seems ironic that someone like myself -- a physician has cared for countless victims of gun violence and someone who advocates for evidence-based policies to avert gun deaths -- would not only own guns himself but also be a stockholder of a company that manufactures them. Let me explain how this happened. When I first got out of residency, ...

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The NHS is robust. And part of that is due to the passion of its workforce. Since its beginning in 1948, the service has met each new challenge with vigor. But never before has it’s existence been under such threat. And with it, the safety of a nation. And there is no one more qualified to save it than those who fight on the frontline. I sat ...

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