"Both clinical and direct-to-consumer genetic testing have become significantly less costly and more common, providing people with access to a wealth of information about everything from their ethnicity and family lineage to their risk for certain diseases and how they will respond to medications such as blood thinners and antidepressants. But before you decide to take the plunge into your gene pool, ...

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I have written, or more accurately ranted, about electronic medical records (EMR) systems throughout this blog. While the systems have clearly improved since their mandatory introduction into the medical universe, they have still not delivered on many of their promises. Of course, EMR has brought tremendous advantages to the medical profession, and we are all grateful for the technology. But this progress has exacted a cost. Many of them are clumsy ...

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My favorite patients were the older physicians who came to me as patients. I was humbled, grateful, and awed by each of them. For some reason, I had quite a few physicians as patients, and caring for this group is interesting. It was not until I got old enough and had issues needing a doctor for myself that I learned how hard it is to walk both sides of that ...

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In 2009, I started a family medicine residency. This dream had been brewing since age five when I decided that I wanted to be a doctor. I followed that dream like a mouse follows cheese. Despite some obstacles in the way, I kept my eyes on the prize. I couldn't wait to be a doctor—a PCP. I couldn't believe that someone would call me "their" doctor. The thought thrilled me. ...

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He canceled his follow-up appointment because he was feeling fine. He didn’t see the point in wasting a Saturday to come to my clinic when he had lawns to mow and chores to do. Less than two weeks before that, he was sitting on the exam table in my office, again and again nodding off, waking up surprised every time his wife prodded him. The stack of printouts from the emergency ...

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What do you picture when you think of health care? How different is that from your vision of health? Is it possible to connect these two mental images? Can they be merged directly or at by way of a bridge? When I envision health, I see images of vitality, vibrant smiles, glowing skin, and strong bodies. When I sense health, I feel peaceful spirits, connected hearts, kind actions.  When I witness health, ...

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I'm glad you're looking at a career in medicine. I hope you will be happy with your choice forever. To help you out, these are a few myths I wish somebody told me about when I was in your shoes. 1. You'll be rich. You likely won't. After two decades or so of med school and residency, you'll be paying back student loans with exorbitant interests for a few more decades ...

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We all have understood by now that life has been changed irrevocably by COVID-19. As physicians, while we navigate the rapidly changing waters of testing, prevention, and acute treatment, we are now becoming increasingly cognizant of the long-term effects of COVID-19 infection with post-COVID clinics already being established in many places. Here are some of my thoughts on what practice should look like in the coming years, with respect to COVID ...

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While there are certainly instances of malicious intent in thoughts, feelings, and actions, most people operate with the intent to do good, be good, offer good to the world – but what we do isn’t always received in the way we set out to offer it. In the words of Oscar Wilde, “No good deed goes unpunished.” It can be frustrating and even paralyzing to consider this consequence, resigning us to, “What ...

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The COVID-19 pandemic has resulted in at least 25 million cases worldwide with a continued spread in the United States, causing global disruption in every sector of society and forcing adaptation to a new normal relying increasingly on technology. Even in the medical field, where there is a pervasive and persistent traditionalist approach to technology adoption, many of the barriers have been overcome. When we reflect back on this life-changing ...

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A bird slams into the glass. A bird slams into the glass. A bird slams into the glass. Over and over again, head first, determined to defeat its own reflection. A headbutt of bravado. I watched it, time and time again. From the inside, I studied the dozens of oily streaks smeared across the window. After a few minutes, the bird would fly away – sore or distracted from its ...

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The COVID-19 pandemic and the consequent drop in patient visits have led some observers to conclude that primary care physicians would be better off financially if they were capitated than if they were paid fee for service. If they received a fixed amount of money per health plan member per month, they’d have a guaranteed income stream regardless of how many patients came to their offices. However, a growing number ...

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A free Wednesday afternoon, time to catch up on charts and paperwork, do a little online CME. "I'll see a few walk-ins if anyone comes by," I told my front office. A knock on my door sometime later: "A patient for you, Doctor." "Send him back," I said. He was a well-dressed man in his 30s, a new patient for me. His story: "I've been having a lot of headaches; sometimes, I feel pressure in my ...

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“The only end to pain is the graveyard.” Those words are etched forever in my mind. They underscore the hopelessness of so many throughout the world. She was 90 years old, crippled by arthritis, no family, and lived alone in a dirt floor hovel with no electricity or running water. She lived in a tiny village of 2000 people in the poorest country in Europe, Moldova. She lived every day without ...

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"Although technology and disruptive innovation theoretically diminish systemic barriers and geographic isolation, in practice, they frequently widen chasms in access for vulnerable populations. The reality is telemedicine disproportionately caters to younger, wealthier, and more educated patients. Hospital systems need to ensure every patient has access to remote health care services, whether through offering landline phone visits, examining pitfalls in digital skill requirements, ...

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As we navigate everyday life in the midst of battling COVID-19, our thoughts naturally migrate to what medicine might look like post viral pandemic. As the new norms of social distancing, virtual meetings, and little to no human contact continue, we cannot help but wonder will these new social norms become permanent behavior patterns? And if so, what implications do they have for the physician and patient alike? Humans are a social ...

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"Is it possible to have it all?  Can you have a job that you love, helping people and using your brain and hands all at the same time; plus, a family, with a spouse and children, that you are always there for?  Is it possible to have a balance between your work and your family live while working as a medical ...

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"Building great tech for doctors is no different from ventilator technology. In some scenarios, you will want to talk to the EMR like you talk to Siri, rather than poring over a screen littered with boxes and lists. In other cases, you will want elegant graphs intuitively laid out to show how your ICU patient is progressing. Other solutions will go ...

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Physicians are natural caregivers. We are in-tune with the needs of our patients, often to the detriment of our own health. It is a rite of passage during medical school to stand in for lengthy eight to ten-hour surgeries, as retractor holders, keeping the surgical field clear for the surgeon. The thrill of being part of surgery makes us forget our own needs; the bleary-eyed fatigue of having woken up ...

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"We all knew this pandemic was going to change how we practiced medicine, but I, personally, was not prepared for how much it would challenge the ‘work-life balance’ that I have spent years carefully maneuvering. Female physicians are often hesitant to express individual needs for fear of being viewed as “weak.” I’m finding freedom in removing the stigma of weakness and ...

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