As a corrections physician I frequently heard the question, “How can you take care of those people?” I understood what they were asking, after all, I was caring for people convicted of such crimes as murder, rape and child abuse. And yet I had very little difficulty providing the same care to inmates that I provided to everyone else. In fact, the corrections environment was generally easier to work in and ...

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A little ways back, I was at a gathering of friends and family and was in the kitchen setting out a dish of black bean and quinoa dip. Suddenly, I heard someone from behind me exclaim: “What is that? If that’s something healthy, I am not eating it.” Although somewhat intended as a joke, there was no doubt a truthfulness to what was said, just as exists in similar comments which ...

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We have all seen and heard the story: a patient who is overweight and has heart problems (or arthritis, diabetes, low back pain or any number of other chronic conditions) is told by their doctor that they need to exercise. The patient agrees, “Yes, I really will try to start an exercise program.” Six months later, the patient is back in the doctor’s office, and the conversation goes something like this: “Well, I ...

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In loving memory of my grandfather, my first physician mentor. Earlier this year, my 90-year-old grandfather passed away unexpectedly after undergoing transcatheter aortic valve replacement (TAVR). Similar to many elderly patients who die each year in the United States, his death was preceded by a litany of costly and time-consuming tests and treatments. Despite this extensive workup, the end of his life was shadowed by suffering left unaddressed. But, unlike the ...

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I ran a 5K last weekend. I succumbed to peer pressure. The more others talked about running it, I decided I could be a runner too. My patients describe their HIIT workouts (high-intensity interval training, for those of you not in-the-know), PiYo classes (Pilates-Yoga combination), increasing mileage for an upcoming duathlon/triathlon/marathon, and now I can proudly share my measly 5K experience with them. Of course, I will leave out the small ...

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I wonder what the best thank you any physician has ever received?  I think this one is mine.  This recent thank you was for our efforts to not save a child but for simply allowing this family to have a few more days with their infant who ultimately passed away.  This amazing thank you has deeply and positively affected me so much ...

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Here’s the typical story we come across every day: Jack was overweight and had a terrible cardio-metabolic profile. Jack changed his diet: He eliminated X, Y, Z and added more A, B, and C. He’s now lost 30 pounds, and he feels fantastic. His numbers are also perfect: His HDL is through the roof, his LDL is undetectable, and his A1c is smack in the normal range. Todd was overweight and had ...

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Empathy is a cryptic term. Those in the health care profession can certainly spout off a variety of phrases and metaphors that are typically used to describe the concept of empathy in the educational setting. Throughout my medical education thus far it has been described as “putting yourself in another’s shoes” or “sharing in another’s emotion.” We are also taught early on what empathy is not. Empathy is not feeling sorry ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated during a routine examination. He has no symptoms or significant medical history. He is active and exercises regularly. He does not take any medications. On physical examination, blood pressure is 135/70 mm Hg, pulse rate is 82/min, and respiration rate is 17/min. Cardiac ...

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“A condition counts as a disease independently of whether there is safe and effective treatment.” - Journal of Medicine & Philosophy, August 2017 What is a disease anyway? Mrs. Jones is 90 years old and frequently experiences episodes of chest pain. She has numerous partially blocked coronary arteries, and her physician has told her to come to the emergency room because she might be having a “heart attack.” ...

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