My experience trying to obtain the drug prescribed by my rheumatologist is a cautionary tale. This is not about whether the doctor ordered it, or how the specialty pharmacy (CVS) must wait for approval from the insurer before filling the prescription, but the fact the patient who resides and waits at the end of the line, me, is treated not as a person in need, but an expense. In my ...

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One night, a woman I’ll call Tonya got a compliment from a guy when she was out with her boyfriend. Tonya’s boyfriend cursed her because another man had complimented her. He said: “You give it to everybody, I want it too.” In anticipation of his physical abuse, she reasoned, “I could go off to Wonder World.” She then injected heroin, to be “in her own world,” she later told me. Tonya ...

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In recent years, it feels like we’ve been inundated by stories of greedy pharmaceutical companies jacking up the price of important generic medications. In 2015, “Pharma Bro” Martin Shkreli, recognized that no other generic companies were manufacturing Daraprim, a drug used to treat infections common among people with AIDS, from $13.50 a pill to $750, confident that no generic competitor was around to cut into his market 
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman is evaluated during a follow-up visit. She was discharged from the hospital 3 weeks ago following a small non–ST-elevation myocardial infarction treated with drug-eluting stent placement in the right coronary artery. An echocardiogram obtained during hospitalization showed normal left ventricular function and normal valvular function. Her ...

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What is CBD? Cannabidiol or CBD for short is made from either the marijuana plant that contains tetrahydrocannabinol (THC) or hemp which contains little to any THC. “Hemp-derived” means that the CBD generally contains less than 0.3% THC while “marijuana-derived” contains higher amounts of THC. It is THC — and not CBD — is the primary psychoactive or intoxicating component of marijuana. CBD can also be manufactured synthetically. CBD is routinely sold ...

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On a daily basis, patients of mine come in for office visits complaining of wear and tear injuries, as well as aches and pains, and their methods of dealing with chronic pain. As we all know, aging is a part of the normal life process. For instance, as we approach 70 years old, we typically lose three-quarters of our functioning kidney cells (nephrons) but do well with our limited reserve as ...

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I recently read an article -- "California Doctors Alarmed As State Links Their Opioid Prescriptions to Deaths" -- that infuriates and frightens me I'm furious that doctors are being persecuted for opioid prescriptions written years ago, and frightened that my doctor here in California may be pressured to stop prescribing them for my painful genetic disorder (Ehlers-Danlos). Twenty-six states have already implemented arbitrary restrictions on our ...

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I haven’t counted how many times this happens every month, but I find it annoying. I send a prescription for a drug (sometimes not even expensive) to the pharmacy and soon after, I get a fax asking me (or my medical assistant) to go online and print a prior authorization form to complete and fax to the insurer, or answer numerous qualifying questions on the screen, or (worst of all) 
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Very few things in the universe are 100 percent good or 100 percent bad. Cannabis is perfectly ordinary in having a mixture of good qualities (medical benefits) and bad qualities (medical risks). The people who want to make money – lots of money, by the way – from selling marijuana do a perfectly fine job of pointing out the good. But they don’t educate the public about the possible risks. They know it will ...

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“Try this,” whispers Kate Winslet as I wander past the Lancôme counter. “Your glowing skin will thank you.” The consequences of a celebrity endorsement are seemingly harmless when it comes to revamping a makeup routine, but what happens when this type of advertisement seeps into the world of health care? It has been proven many times that celebrity endorsements influence decisions about specific political candidates, issues or parties, and the positive ...

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As a pediatrician, I am asked by worried parents about what they should give their child with a fever, Motrin (ibuprofen) or Tylenol (acetaminophen) to bring down the temperature daily. This question always requires more than a one-word response to the choice between anti-fever medications. An explanation of medication even being necessary for the fever and to clarify many long-standing fever phobia misconceptions. Mainly, it is not necessary to treat the number ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. The aim of medical education is not only to transfer scientific knowledge, but also impart the wisdom accumulated over the long history of medicine that equips us to apply this knowledge for the betterment of our patients. Although much of medical wisdom transmitted in ...

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We have embarked upon a unique strategy to assess and manage pain. "Opioids Rarely Help Bodily Pain" is not a catchy phrase but a mnemonic related to educational learning which serves as the cornerstone of a new acute-pain management paradigm. As is known, the evaluation of pain is extremely difficult due to its subjective nature. However, this new evaluation not only accounts for the patients’ self-assessment but, for the first ...

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The FDA has given official approval to market eskatamine as a treatment for depression. As expected, there has been great fanfare (press releases, morning TV talk show guests, NPR segments and so on). The news leaves me salty. The esketamine story reveals so much of what is wrong about how we get useful medical science findings into clinical practice. Esketamine is not a new drug Esketamine is being promoted as a new ...

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Pharmacists play an essential role in today’s ever-expanding health care system today. They check for drug interactions, watch for signs of opioid overprescribing and try to determine whether a drug for one condition prescribed by one doctor will negatively impact the patient because of another diagnosis the patient has. In hospital units, their roles have become yet more complex — often serving on various quality committees, managing daily dosages of ...

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We are writing as a parent and a dentist to spread a message to parents and dental health care providers across Canada: there are alternatives to prescribing opioids after wisdom tooth removal. Removing wisdom teeth is considered by many as a rite of passage for teenagers. It is one of the most common surgical procedures done in young people aged 16 to 24. Amy’s 16-year-old son, Felix recently had his wisdom teeth ...

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Results of a much-anticipated trial on fish oil and vitamin D generated conflicting headlines recently. Some stories declared good news about the popular supplements. Reuters wrote that fish oil “can dramatically reduce the odds of a heart attack while vitamin D’s benefits seem to come from lowering the risk of death from cancer.” The Washington Post reported fish-oil medications were found “effective” in protecting ...

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As the health care landscape evolves, health care provider roles continue to shift. Industries recognize the power of collaboration and the strength of communication between different providers; among those, the pharmacist and the physician. Unfortunately, doctors and pharmacists have historically had strained relationships. In many cases, communication suffers, which can lead to adverse drug events (ADEs), or harm caused to a patient as a result of medication exposure. It’s worth noting, though, that ...

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It’s a common scenario: a patient shows up to my office lugging a bagful of over-the-counter supplements, defiantly informing me that they “don’t believe in prescription drugs.” In the very next breath, they present a lab slip with a list of bloodwork that their alternative medicine doctor wants me to order to help diagnose their myriad symptoms. I’ll admit, my initial natural reaction in this situation was a feeling of annoyance ...

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For those of you who have been following my story since this summer of 2018, you will remember that I quit my nine-to-five job to pursue a career in public speaking on a more semi-permanent basis. I started working essentially full-time with a national telemedicine company. I am extremely excited about the opportunity and very satisfied with the options it has given me to stay home — while I complete ...

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