Recently, the world’s largest research-based drug company, Pfizer, announced that an automated packaging error led to a recall of the birth control medication, Lo/Ovral-28 and the generic counterpart, Norgestrel/Ethinyl Estradiol. The packaging issue had to do with the placebo pill being placed in the wrong order in the 28-day cycle and an inexact number of placebo (should be 7) or active forms (should be 21) of the medication. The placebo pill ...

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As my husband and I try and make a long term financial plan for paying off my almost $200,000 in loans from medical school, I sit here wondering, why did I pay 200 grand so that I can get peed on, pooped on, bled on, screamed at and sworn at? I’ve delivered a baby without gloves on (it was an emergency).  I’ve been kicked so hard I almost fell off ...

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Labor and deliveries are slowly closing across the United States:  California, Pennsylvania, and Ohio.  In regional areas where there have been no closures, conversations in hospital boardrooms are probably questioning whether they should be.  But why?  Because of health care reform, increasing medical expenditures, hospitals are making less money due to reduced reimbursement, and because of the financial margin of obstetrics.  To explain the complex answer further, we need to ...

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There is a healthy debate over whether a lab that created an extremely infectious version of influenza ought to publish the genetic sequence. The debate speaks to a larger problem: sometimes, medical advances do the world a disservice. The medical field could use some soul-searching, just as physicists did in the wake of the Manhattan Project. A few years ago, I read a neat research finding.  In a pregnant woman, ...

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Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease is at an advanced stage. Tests to look for the disease, such as the transvaginal ultrasound or the CA-125 blood test, are not specific enough. That leads to false positive tests that necessitate more studies that may not ...

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Despite the adversarial political climate that divides so many Americans, there are some topics that most people can agree on regardless of politics. One of those is that early detection and screening for cervical cancer and breast cancer are important initiatives that should be supported because early detection leads to earlier treatment which, in turn, saves lives. While many women have such exams paid for by their health care insurance, ...

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I come back into the exam room, keeping my best poker face, sit down and turn to face her.  She’s on the edge of her seat, nervous and barely able to contain herself, maybe not even sure which answer she wants. “Congratulations,” I say. She lets out her breath and smiles, huge. “Thanks!” Once the adrenaline settles down and she can hear me again, ...

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“I laughed so hard, tears ran down my leg.” That was a quote from a sign I saw on vacation last summer. While we read it and laugh, we all know what it means. “How’s your bladder working?” is a common question that I ask patients in the office. The responses I get include, “fine, except when I ____”, or, I’m fine as long as I know where the bathrooms are. ...

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William Osler famously said (among other things):  “Listen to the patient. He is telling you the diagnosis.” I was doing my obstetrical rotation as a first year family practice resident. I had done nearly 100 deliveries and was feeling more confident in  my skills and knowledge than was justified.  Although this rotation did not involve actual care for the recently delivered newborns, I loved pediatrics and frequently stopped by the nursery ...

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Celebrity is an interesting phenomenon. On a hot summer night in 1990, my chief resident and I were on call at Harlem Hospital. We were informed that a “guest” was coming to interview us. Hot, sweaty and looking haggard rather than glamorous, we wanted to choke our director when Spike Lee walked through the door with film crew in tow. Lee was there to film the infamous movie, Mo' Better Blues. ...

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