It started slowly.  My former resident and present colleague, Terry Shaneyfelt first authored "Are Guidelines Following Guidelines? The Methodological Quality of Clinical Practice Guidelines in the Peer-Reviewed Medical Literature." This paper alerted us to the problem.  But guideline fever continued to rage.  Almost every specialty and subspecialty society decided that they needed to join the guideline movement.  They needed to tell us the right way to practice medicine. While ...

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Newborns born in 29 other countries of the world have life expectancies exceeding 80 years; yet, an infant born in the U.S. in 2016 is expected to live only 78.6 years according to recently released statistics. While death rates fell for 7 of the 10 biggest killers, such as cancer and heart disease, they climbed for the under-65 crowd. The irrefutable culprit is the unrelenting opioid epidemic. Last year, life expectancy ...

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Four and a half years ago I read an editorial in JAMA, the Journal of the American Medical Association, that etched a short phrase into my memory. These five words seemed so profound and poignant that I really think they almost define primary care medicine today, perhaps with the alliterative addition of the word “teach”. Dr. Abigail Zuger wrote of how the computer had changed the dynamic in the ...

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I recently collected anecdotes from women in medicine who have noticed the same thing I’ve noticed: We’re not as comfortable here as our male counterparts. Despite progress, medicine remains a patriarchy -- an “old boy’s club” -- and the women in this world are frequently reminded of this status quo. In collecting these anecdotes, I’ve noticed two main themes for the type of advice and comments women receive. The first one speaks ...

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As we continue to lead longer and healthier lives, too many Americans aren’t taking advantage of an easily accessible set of tools that could protect their well-being into old age: adult vaccines. As a nation, we’ve embraced a regular schedule of vaccines for our children. But science shows that they are proven life-savers for us grown-ups, too. The numbers are staggering: tens of thousands of Americans die each year from flu ...

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Is laughter the best medicine? Indeed it is. Brad Nieder is a physician and comedian and can be reached at the Healthy Humorist.

acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. I keenly remember the thrill of making my way to the medical bookstore as an early first-year student to buy my first stethoscope. Although receiving the short white coat at the start of medical school symbolizing the transition into the medical profession was incredibly ...

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As the health care debate drags on, prescription drug costs continue to rise by almost 10 percent annually. It is the rare patient who is spared this expense. Over the years, I have seen how these costs have affected my patients. At first, most patients had little in the way of co-pays. However, once the local economy deteriorated, co-pays skyrocketed as employers tried to curb their health ...

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There are a lot of TV commercials for structured settlement companies these days. You know, the companies that say if you are cash-strapped but have a structured settlement they will be happy to buy your settlement and give you "cash now." Some of the commercials are quite clever and catchy featuring everything from operettas to boy bands. After seeing so many of these, one has to conclude that there has ...

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“I made myself a hypodermic injection of a triple dose of morphia and sank down on the couch in my consulting room ... I told her I was all right, all I wanted was twenty-four hours’ sleep, she was not to disturb me unless the house was on fire.” – Axel Munthe, MD, The Story of San Michele (1929) When people in this country mention the opioid epidemic, most of the time it is ...

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