I have been working in pediatric primary care for nearly 5 years post-residency and truly love my work. I currently am dealing with very painful post-herpetic neuralgia and many people with this quit working. At some personal cost, I have continued my practice because I find my work day so rewarding I simply can’t imagine not being a practicing pediatrician. On a given day I might see a newborn fresh from ...

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We are human, we are not indestructible. We have feelings and emotions that can get hurt, probably more than the average person based on the careers we have chosen. Yes, we will pass up on our well-being (such as sleep, hygiene, exercise, relationships with family and friends) to be there for our patients. To receive our critical training to be able to care for others. This is our sacrifice, and ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 49-year-old woman is evaluated during a follow-up visit. She is overweight and has hypertension and type 2 diabetes mellitus, both of which are well controlled. For several years, she has attempted to lose weight through various commercial diets; dietician-monitored, calorie-restricted diets; and physical activity. She has worked with ...

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“It kind of strips you of any pride that you have. It was very humbling.” As a care manager, Mary helps patients follow their care plans by coordinating medical visits and community resource referrals, but this was the first time Mary shadowed one of her patients out in the community. At the food bank, Mary watched her patient, who was living with diabetes, receive one box of macaroni along with other ...

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A colleague recently sent me a link to the American College of Cathopathic Physicians a new organization whose mission “is to protect the professional autonomy and advocate for a full, broad scope of practice for DNPs as a ‘cathopathic physician’ completely equal in every way to our MD and DO counterparts.” I was, I admit, so stunned by the statement that I thought the whole thing might be an elaborate joke. It was only ...

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A store cashier sees dozens of customers during a shift. A car tire shop mechanic may work on 20 cars. Workdays can be hard across professions. Medicine surely does not escape this. We just don’t deal with customers or goods, despite efforts to make it look like that. A simple runny nose visit may be the closest thing to a customer who is ...

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Why do we underestimate risk? This phenomenon isn’t unique to politics or natural disasters, and it contradicts our need to prepare for future events. It explains why it is hard to get healthy “millennial invincibles” to sign up for health insurance, why earthquake insurance policies skyrocket after an earthquake, and why people tend to underinvest for retirement. Two separate biases -- availability and recency -- explain why we make medical ...

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Since the beginning of a new academic year is fast approaching, here’s some heartfelt advice. You might need it, I hope you read it and heed it. If you’re just beginning your medical school journey, the first line is written specifically for you, but the rest of the piece is pertinent for any doctor, at any age and any stage of their careers. If this is your first day of med ...

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When Amazon, Berkshire Hathaway, and JP Morgan (AmBerGan) announced their health care partnership, Berkshire CEO Warren Buffett declared “the ballooning costs of health care act as a hungry tapeworm on the American economy.”  He is right. Our broken system is infested with tapeworms. Tapeworms are parasites; they exploit their hosts, drain resources, and suck the life out of their prey. Unfortunately, Buffet failed to call attention to the tapeworms specifically; ...

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This was the end-of-the-hallway conversation with an elderly patient after wrapping up a recent office visit, as we walked away from the exam room toward the front desk to schedule her follow-up appointment, and she realized that we were "celebrating" 20 years together. I met her when she was admitted as an inpatient when I was on service as a junior attending just starting out, and after going home she came ...

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