acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. Of all medical specialties, perhaps the most difficult to understand is internal medicine. While the name suggests that those who practice internal medicine focus primarily on non-dermatologic diseases of “Internal” organ systems (which in many ways is true), unlike other medical fields whose names ...

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Pain and suffering together is a universal language. It is unspoken, one that a person of any age feels when they see a loved one die, or when someone sees another human being suffer when nothing more medically can be done. I once saw a Vietnam War veteran who, within a few years of returning home, suffered from a hemorrhagic stroke. He was robbed of his ability to walk, to talk, ...

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A featured article titled "Death by A Thousand Clicks" addressed some of the serious problems and challenges we still face in the "digitization" of health care. As an early adopter of EHR since 2003 and a self-avowed "techie," I can vouch for the fact that many of the government initiatives in HIT, like "meaningful use," actually made many EHRs worse. Why? Because many of the regulations were being written by ...

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Why does the most expensive health care system on the planet do such a poor job protecting the lives of pregnant women? More important, what can be done about it? The United States continues to lead the world in health care spending yet it has the highest maternal death rate among wealthy nations. Researchers have found that maternal mortality in the United States 
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Is your patient having trouble breathing? I can ask respiratory to give him a nebulizer. I'm looking at his chest X-ray now — why don't we bump up that Lasix, too? I wish the ER would have grabbed an ultrasound of that swollen leg. Does he need more oxygen? If something is missing from this picture, it isn't the clinical people who are at fault. Clinicians solve problems with the tools they're ...

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When Ashley Pintos went to the emergency room of St. Joseph Medical Center in Tacoma, Wash., in 2016, with a sharp pain in her abdomen and no insurance, a representative demanded a $500 deposit before treating her. “She said, ‘Do you have $200?’ I said no,” recalled Pintos, who then earned less than $30,000 at a company that made holsters for police. “She said, ‘Do you have $100?’ They were not ...

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Victor Frankl is an Austrian neurologist, psychiatrist, and Holocaust survivor, who survived three years in the concentration camps of Dachau and Auschwitz. He once told a story about a woman, his patient, who called him in the middle of the night saying that she wants to commit suicide. Viktor Frankl kept her on the phone, giving her many reasons to keep on living, until she promised not to take her life. ...

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It may seem odd that a gastroenterologist patronizes fast food establishments several times each week. I’m in one right now as I write this. I eschew the food items –though French fries will forever tempt me – and opt for a large-sized beverage. In truth, I am not primarily there for a thirst-quenching experience, but more to ‘rent a table’ so I can bury myself in some reading. Indeed, many ...

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I'm fascinated by the human body — the intricacies of it, the poetry of it. I am intrigued that a cell can come together with other cells to form tissues, those tissues, organs, and systems. The body is a powerful metaphor for unity: what happens when the one becomes the many, and the many, even more. It is a lesson in both individuality and community; how one sets out to create ...

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This past August, I attended the American College of Obstetricians and Gynecologists (ACOG) District VI meeting in Wisconsin. The theme of this year's meeting was "Bringing it Back Home," with a keynote presentation focused on developing the emotional habits to influence others and "embody the inner attitude of a leader." After a day of much self-reflection, I decided to stop by the poster presentations during a break between the major talks. ...

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