Quality of life matters. This straightforward assertion gets complicated when we discuss the treatment of depression. Depression is common, part of a family doctor's daily schedule; it can affect anyone, although certain groups are at higher risk. There have been many hypotheses as to why we as a species are susceptible to depression (and its frequent companion, anxiety), but in the day to day practice of medicine, those proposed etiologies end ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Chronic pain is a silent epidemic Chronic pain is a significant public health burden, but one that is not talked about enough. In 2011, the Institute of Medicine estimated that approximately 100 million Americans suffer from chronic pain. But chronic pain is not just ...

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Noticing. If you think about it, that's really a lot of what we do a lot of the time. As clinicians, we are trained as observers to notice, to use our eyes, our ears, our hands. To notice. We notice that our patients seem different today. More tired. A little pale. Notice a change in their gait. Notice they are in pain. We notice swelling in their legs, a new heart murmur, a ...

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That statement from a recent patient was a summary to me of what is bad in our health care “system.”  It’s a terrible summary of what is seen all over this country with people who must make the choice between financial solvency and health. Here’s what happened:  It was a new patient I saw, who is a veteran who owns two businesses.  He went out on his own when he “kept ...

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I remember reciting a phrase during my childhood that goes something like this, "Step on a crack, break your mother's back." So as I would walk back and forth to school, I would make a conscious effort to avoid any and all cracks in the sidewalks for fear of bringing unwarranted harm to my mother. This was a pretty difficult task to accomplish since in my small hometown, cracks in ...

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Every small community has a unique but similar cast of characters. Our small Southern Utah town was no different. From a young boy’s perspective, the cops and docs were feared but cautiously idolized, the mayor was respected, the athletic coaches were immortalized, and of course, we had the homeless man in town, whom we feared. We will call ours Stu. Stu had greasy disheveled hair and a gray beard. He wore ...

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I have written previously about the raging opioid epidemic in Ohio.  Attacking and reversing this tidal wave will require many weapons, resources and time.  Opioid addiction is a crafty and elusive adversary that will be difficult to vanquish.  Our battle plan will have to be nimble and adjusted over time, much as military leaders must do in actual armed conflict.

Here in Ohio and elsewhere, physicians must abide by new ...

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There are so many theories out there about what we should or shouldn’t be doing with our complex and fragmented health care system. We are facing a perfect storm of factors: an aging population, a huge increase in chronic disease, new and expensive treatments, and rising expectations of what care we should be receiving. All of this is sending costs spiraling out of control. As a nation, we spend almost ...

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Since the two very sudden public suicide deaths of Kate Spade and Anthony Bourdain, society has again recognized that we never know what is under the surface of another’s façade. As physicians, these tragic occurrences emphasize that our caregiving requires seeing the entirety of an individual’s many parts. While we acknowledge that the façade is not fake -- it is but one true representation of an individual, well-curated, like pages on ...

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Generally speaking, patients and physicians are working towards good health. While many patient expectations can be unreasonable, others are practical; this article amalgamates them. Can you identify the absurd demands? But multiply half of the listed expectations by hundreds or thousands of patients, and we begin to understand why there is such a high rate of physician burnout. Bilateral empathy lowers expectations. Bedside manner. Don’t accept a walk-in patient and leave us waiting ...

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