Artificial intelligence (#AI) seems to be all the rage these days, as it should be, given its potential to revolutionize medicine in many ways. #AI is actually already an integral part of many of our lives on Google, Amazon, Facebook, and other sites. Siri and Alexa use #AI too, so we can’t easily escape it. Why would we want to? Of course, one concern about the algorithms is that they often ...

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I expect my patients to develop or sense responsibility in connection to their health because I believe personal responsibility creates the basis for a constructive, therapeutic relationship and healing process. My experiences as a patient have made me understand how difficult it can be to maintain a sense of responsibility. I often yearn for clarity and a "gameplan," but instead find myself confronted with medical guideline gray-areas and conflicting treatment recommendations. ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. For years, research and common belief have supported the concept that patient education alters patient behavior and improves patient outcomes. For instance, lifestyle changes, implemented after improved physician-patient engagement and education, have demonstrated clinical benefits in a wide range of chronic illnesses, ...

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I've always felt lucky and relieved when a cardiologist told me I seemed to be fine despite my heart condition. My condition, referred to as congenital, complete AV block, is estimated to affect between 1 in 15,000 to 22,000 live-born infants. The electrical block is more commonly seen among older, adult patients where it presents an acute pacemaker indication. Researchers don't know very much about what causes the condition prenatally or ...

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Many consider the novel the House of God, written by Samuel Shem (pen name for Stephen Bergman), to be a must-read for any physician or soon-to-be physician. A fictionalized account of his internship year, the book details how the accumulated stress, fatigue, and powerlessness of being a first-year doctor inexorably accumulates during that year — with sometimes hilarious, and but also disastrous, results. The survival strategies of the interns in ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 69-year-old man is evaluated during a follow-up visit. He initially presented with a 3-month history of chest pressure and dyspnea that occurred primarily with exertion. Despite maximal medical therapy, his symptoms have not abated and adversely affect his quality of life. Medical history is significant for type 2 ...

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I recently read an article in a peer-reviewed journal citing the benefits of a few eggs per week as part of a low carbohydrate dietary intervention for Type 2 diabetes.  The information was so meaningful about a controversial food source of protein that I decided to write about it in my blog and pass it along to my patients.  Three days later the American Heart Association and American College of ...

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I received an email from our hospital accreditation coordinator/quality coordinator in a manner that wasn’t clear if it was directed to me personally or if it was sent to the entire medical staff.  It said that she was reviewing the Joint Commission's recent survey which found that the charts did a poor job of reflecting the patient’s “code status.”  The institution only received a 40 percent rating. Some patients were listed ...

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I recently had the pleasure of participating in an administrative law judge (ALJ) hearing. Novitas, the Medicare administrative contractor had denied the E/M code 99291, critical care. The case was appealed to the qualified independent contractor, who also believed that the care, in this case, did not meet the CMS and CPT definitions of critical care. Subsequently, the case was appealed to the administrative law judge. The encounter occurred in an ...

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Our 20-bed ICU finally captured 10 intensivists — all board-certified in critical care medicine. We were fortunate enough to have one of these doctors in our ICU 24-7. Of course, they all practiced professionally with expertise. But I remembered this one the most: Dr. Jason McKenzie (name changed for privacy). He easily became our friend and "go-to" person. Clocking in at night and finding out that Dr. J was our doc, would give me ...

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