In medical school, we learn about Broca’s area, the region of the brain that when injured prevents a person from translating their thoughts into spoken word. When this area is damaged, from a stroke or traumatic injury, the person can hear a partner declare their love or a child cry, but are unable to vocalize a response. Silenced by their injury, their voice is trapped. In a similar way, as medical ...

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Recently, a child was on a waitlist for five months to get into my practice. For this article, I will call him Tiny Tim. Tiny Tim, now five years old, has a skin condition known as eczema or atopic dermatitis. When we first met, virtuously every area of his body was covered with wounds from constant scratching. Skin that breaks easily and heals poorly can give bacteria access to other parts ...

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I recently met an old friend of mine for the evening in New York City. He’s a talented young orthopedic surgeon, who has already, in the short amount of time since finishing residency, experienced so many of the problems our health care system faces. The topic of conversation quickly turned to the current state of medical practice, the dramatic swing to corporate medicine, and the consequential loss of autonomy suffered by ...

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Last year, in response to a continued groundswell of criticism focused on requirements for maintenance of certification (MOC), the American Board of Medical Specialties (ABMS) formed an independent "Vision Commission" on MOC, designed to "reimagine a system of continuing certification." Although led by ABMS board members, many of the 27 commission members are not directly associated with ABMS. After ...

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As we have moved into the 21st century, we have witnessed a deterioration in our perception of our doctors of medicine. This has been a gradual, eroding process, quite possibly by the design of those in powers of authority in our government, health insurance corporations and the plethora of health care corporations. The assumption might have been to make these changes in the mode of operation gradually so that they ...

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It’s no secret that physician job dissatisfaction is soaring to unprecedented levels, with over 50 percent of practicing physicians reporting burnout. While many factors have contributed to this epidemic in America over the last 20 years -- not least of all electronic medical records that are taking a heavy (and unacceptable) toll on physicians’ time -- this is not a phenomenon unique to the United States. I went to ...

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I sat knee-to-knee with a nurse practitioner at a school-based clinic in rural Ohio. Choking back tears, she described a patient she couldn’t get out of her head: a middle-school girl, accompanied by her mother and a social worker. Just days prior, the girl was dropped off at her father’s home for the weekend. Before the promised Friday night football game, she discovered him unconscious on the bathroom floor. Within ...

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As a physician who has spent his career taking care of people with HIV/AIDS, cancer and various blood disorders, this is an amazing time to be working in these overlapping fields of medicine. I began my training when roughly half the people diagnosed with HIV were destined to develop cancer, and nearly everyone died shortly after they progressed to AIDS. In resource-rich countries today, HIV care is often as simple as ...

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Patient access to care is a high priority for all neurosurgeons. Unfortunately, many of our practices are thwarted in these efforts from unwarranted insurance denials. Know, you are not alone. Take this common scenario:

When Ms. Mary Smith (not the patient’s real name) started her new job several years ago, she purchased the premium insurance policy that her company provided. Recently, she developed severe neck and left arm pain. Imaging of ...

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There was a point in my life when the words “climate change” would recall pictures of polar bears marooned on precarious chunks of ice, bobbing aimlessly in some foreign landscape of tundra and sea. While tragic, the environmental drama playing out at such extreme latitudes always felt like an abstraction, particularly to a kid growing up in temperate Colorado. Today, however, as I study medicine and the environmental factors that influence ...

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