One of my readers, Natalie, wondered about my thoughts about the digital pill. My initial reactions were similar to several of those who were interviewed for the article. The digital pill, which provides electronic information to confirm whether someone has ingested the medication, has great potential to become a tool of coercion. Aripiprazole (Abilify) is classified as an antipsychotic medication, which is often prescribed to people who have beliefs that machines ...

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I first noticed this phenomenon while watching the world news on a weekday after work.  It was a commercial for a new diabetes medicine that showed overweight people dancing at a barbecue, cooking and enjoying life.  How different this was from my day in the wound clinic, where I saw patient after patient with obesity, diabetes, and nonhealing wounds, as well as other dire medical complications. So I tucked this image ...

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The Sunshine Act is part of the Patient Protection and Affordable Care Act passed in 2010.  This act went into effect in August of 2013 and requires the full disclosure of any payments (or transfers of value, i.e., lunches and dinners) made to physicians from pharmaceutical and medical device manufacturers. The spirit of the act is to have more transparency with regards to potential conflicts of interest created when physicians receive ...

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Future generations will look back on the opioid epidemic as the greatest tragedy of modern medicine. The recent 60 Minutes special about drug distributors really highlights that manufacturing and prescribing opiates was never about the best interest of patients. The pharma companies saw a business opportunity that could be exploited by offering patients a little pill to take their pain away. What person, given the chance, would ...

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I was surprised when I felt my body stiffen as I became aware that an iPhone had just been fiercely thrown in my direction. “I’m calling security,” shouted a distant voice in the background. “I want the 10 mg oxycodone pills! I am in 10/10 pain!” The patient shouted this to me as he abruptly got up, violently launched his phone in my direction and stomped toward the exit of the ...

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I recently asked, “Who’s to blame?” for patients not taking their medications and cited a couple of papers describing the poor state of medication adherence. I concluded nonadherence was a huge problem, and doctors failing to educate their patients was not a major cause. To support my contention that physicians are not the reason why patients do not take their medications as ordered I submit the following new information. A 
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Approximately 300-400 physicians commit suicide annually. Given that a typical doctor has about 2,300 patients under his or her care, that means more than a million Americans will lose a physician to suicide this year. In a study of six medical schools, almost seven percent of students said they had thought of ending their lives in the last two weeks. In another recent study, 29 percent ...

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I have written about talcum powder previously.  Indeed, I have not only opined on the slippery substance, but I am also a regular consumer of the product.  Talcum powder has become magic legal dust that brings forth zillions of dollars to those who have been attacked by the poisonous toxin. Just last year, I informed readers of $55 million and $72 million judgments to cancer victims who used powder against ...

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What is it like living in pain? Those of us who have ever experienced unremitting pain for months or years know that it is enveloping and all consuming. I struggled with intractable pain for several difficult years, and I am fortunate because my pain finally got better — what if your pain never did? That is a horrible reality millions of people are living in right now. The chronic pain population ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old man is evaluated for a 4-month history of intermittent, nonprogressive solid-food dysphagia. He has a long-standing history of heartburn that has been well controlled with once-daily proton-pump inhibitor (PPI) therapy for the past 5 years. Results of a screening colonoscopy 4 years ago were normal. ...

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