In the last decade, specifically in the last five to six years, we have seen the gradual disempowerment of America’s physicians as well as their unfortunate patients. Starting with health management organizations, managed care, all the way to the insurance exchange, doctoring has been forcefully wrestled away from physicians only to be placed into the hands of large insurers, administrators and the United States government. The common denominator was never about improving ...

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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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I recently stopped by our local grocery store after work to pick up a handful of items to bring home. With only four items in hand, I luckily found a short checkout line behind this lovely elderly couple who were almost done and ready to pay. As they smiled and made small talk with the cashier, I imagined a typical geriatric medical story about them. They appeared in good health which ...

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2019 is here. I started my year by doing an urgent care shift on New Year's day.  It was not quite as busy as I expected; most of the shifts I've done around the holidays were high-volume, with lots of flu, other respiratory infections, and lacerations sustained while cooking holiday meals.  New Year's day was a little slower on the illnesses, but the acuity of the injuries was high.  That's what ...

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Does any living, breathing human believe that there is not enough paperwork in our lives? While we are all burdened, I believe that the medical profession is uniquely deluged with an absurd volume of documentation requirements, most of which should be filed under "N" for nonsense. Ask any physician or nurse about this and have antacids on hand as you will soon see some sizzling smoke emerging from the medical ...

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86 minutes. That's what I found when I added up how late patients were through a single practice session earlier in the week. Some patients arrived on time, and some a few minutes early, but the average was about 8 minutes late, ranging up to one patient who showed up an hour and 12 minutes after their scheduled appointment time. The reason I ...

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I am beginning to think that we should not see chronic care patients between Thanksgiving and New Year’s Day. It just makes us look bad. Our quality metrics make the last blood pressure and the previous diabetic lab test of the year for each of our patients our final report card. We should quit while we’re ahead, in mid-November. So here we are: The office has Christmas decorations up. There are trays ...

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The purpose of clinical documentation is to efficiently communicate critical data to peers in a readable fashion while meeting compliance and billing requirements. This documentation should not represent a data dump. Physicians continually increase our dependence on technology as the digital age deluges us with data. Accessing the right information at the right time is essential to providing appropriate care. The tsunami of new evidence necessitates clinical decision support, yet we ...

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A commentary in the New England Journal of Medicine titled "Beyond Evidence-Based Medicine" received much well-deserved criticism for not only mischaracterizing EBM, but advocating for a novel approach, "interpersonal medicine," that was explicitly codified in the recognition of the U.S. specialty of family practice nearly 50 years ago. Here's what the authors wrote about this practice of medicine that is, apparently, new to them but well-known to the ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. When reading (or writing) blog posts, it’s easy to be left with a mostly negative and often depressing view of the current state of medicine.  This is completely understandable as people usually write on topics and issues about which they feel strongly, and ...

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