From ACOG comes five new cautions, part of the American Board of Internal Medicine Foundation’s Choosing Wisely campaign, to eliminate wasteful and unnecessary medical interventions that can actually cause harm. All the recommendations are evidence-based and have broad consensus. 1. Don’t schedule elective, non-medically indicated inductions of labor or cesarean deliveries before 39 weeks 0 days gestational age. Delivery prior to 39 weeks 0 days has been shown to be associated with an increased risk ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old woman is evaluated during a routine examination. She is very concerned by her lack of interest in sexual intercourse. The patient feels like she "just doesn't want to be touched." She used to enjoy intercourse and does not know why she feels this way now, but she acknowledges that it is causing ...

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I was startled to learn, when interviewing medical school applicants, that tagging along with a physician, or “shadowing,” is a common practice among high school and college students these days. Yes, I did say students as young as high schoolers. Shadowing provides a way for students to observe at first hand what it is like to be a physician, and helps them decide whether the career will suit them. Medical school ...

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The first test tube baby was born July 25th, 1978 in the north of England.  Louise Brown was called the “baby of the century” by some and a “moral abomination” by others.  It wasn’t Brown who critics accused of being immoral, of course.  She was just a blameless infant.  Instead, it was her doctors who came under fire for their new fertility treatment—in vitro fertilization (or IVF).  Roman Catholic theologians ...

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downton abbey If you have not yet seen the fourth episode of the third season of Downton Abbey and wish to be surprised by it, read no further. And if you aren't watching PBS's addictive costume drama currently set in 1920--and, seriously, why aren't you?--read on anyway. This is about medicine, then vs. now. First, to recap the medically relevant aspects of the ...

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My membranes ruptured at 22 weeks during my pregnancy. It was the evening of July 5th, 2003. Two days later my first son was born and died. The task before me was bed rest and squeeze as many more days (hopefully weeks) out of the pregnancy as possible to save my other two sons. It was, to put it mildly, a very low time. To pass the hours I read, slept, ...

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shutterstock_98508239 Somewhere near where you live, a couple will discover this week that they are infertile and that if they want biological children of their own, they are going to need in vitro fertilization (or IVF).  According to treatment protocol, the woman will need to take powerful medicines to ramp up her production of fertilizable eggs.  One monthly cycle of this treatment will run ...

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The Patient Protection and Affordable Care Act cleared two major hurdles in 2012: the Supreme Court ruling on constitutionality and the reelection of President Barack Obama. However, in 2013 there is a very good chance that Courts will see much more of the health care reform law due to objections regarding the contraception mandate. Despite the bills legal successes in the past, there are (at publication) more than
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Are you or your patients sleeping well?  Mine are not, and I wasn’t either.  Do you ask them how they sleep?  I never used to ask, and no one asked me.  When I was in medical school, we had rigorous instruction in taking detailed medical histories.  Sleep quantity and quality were not included. What changed?  Is it the digital age we live ...

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There has been an explosion in health apps. Patients are using them for weight loss, calorie counting, exercise monitoring, ovulation calculation and for many other health needs. But to truly integrate the concept of health apps in the health care system healthcare providers will need to get involved. There is discussion in the health IT world lately regarding physician adoption of ...

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