Countless times as a patient both at two hospitals in New York City, I have witnessed doctors arrogantly waltzing into an examination room and arriving not alone but with an entourage. Like Greeks bearing gifts, they arrived with something unwanted and threatening: medical students, interns, residents, and fellows. And not once, in all the many times that I have been subjected to this ignominious practice, was my consent ever obtained ...

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It’s 3 a.m., and I wake with a jolt. My heart is pounding out of my chest. I stumble out of bed to take a beta blocker hoping it’s enough to quiet my heart so I can doze off again. I sleep fitfully the next three hours, experiencing weird dreams and terrifying nightmares. At 6 a.m., I take my Valium. Nauseated, I lie in bed for 30 minutes, so I keep ...

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Every patient eventually asks the same question: “How can I find the best hospitals and doctors?” The solution might seem easy, since we live in a world where information is readily available on the Internet. In a few clicks we can shop for goods, review consumer products, market ourselves on social media, and complete financial transactions instantly. You would think that health care, which accounts for 17 percent of the GDP, ...

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Here’s the typical story we come across every day: Jack was overweight and had a terrible cardio-metabolic profile. Jack changed his diet: He eliminated X, Y, Z and added more A, B, and C. He’s now lost 30 pounds, and he feels fantastic. His numbers are also perfect: His HDL is through the roof, his LDL is undetectable, and his A1c is smack in the normal range. Todd was overweight and had ...

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Have you ever wondered why your computer often shows you ads that seem tailor-made for your interests? The answer is big data. By combing through extremely large datasets, analysts can reveal patterns in your behavior. A particularly sensitive type of big data is medical big data. Medical big data can consist of electronic health records, insurance claims, information entered by patients into websites such as PatientsLikeMe and more. ...

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I have written about both issues before: freestanding ERs and retail clinics. Two recent studies continue to show how useless they both are in helping create a better more efficient health care system. The freestanding ER study  examined the number of these facilities and population characteristics where they locate. They identified 360 freestanding ERs, mostly in Texas, Ohio, and Colorado. This will come as no surprise; they were located in ...

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Health care in America and the practice of medicine has undergone a sea change over the last couple of decades. It used to be about Dr. Johnson’s office around the corner that would serve you and your whole family. Nowadays, it’s about mega-specialty groups and large health care conglomerates. It’s about mergers and hostile corporate takeovers. Statistics now suggest that over 50 percent of physicians are employed rather than ...

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In about 1990 we got our first computer. I say "we" because my husband and I shared a desktop which I used infrequently. I mostly used it for word processing, and the Internet was very young. At the turn of the millennium, my children were using computers, and they were limited to 1 hour of computer time a day, which was on a shared desktop. By 2001, I was communicating ...

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It’s a tale of two health systems: the VA and Kaiser Permanente. The U.S. Department of Veterans Affairs, Veterans Health Administration (VA) is a mission-driven health organization, serving our nation’s veterans. A patient population of 8.9 million, led by David Shulkin, MD. An early leader in health technology adoption. The VA has faced serious issues; however: long patient wait times (deadly long in some cases) and high physician turnover rates. Kaiser Permanente ...

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According to a recent publication by the Robert Graham Center, the number of family physicians practicing high-volume obstetrics (more than 50 deliveries per year) dropped by over one-half from 2.3 percent of practicing family physicians in 2003 to 1.1 percent in 2016.1 In small corners of the country, though, innovative training programs continue to foster these skills among learners and build supportive communities for family ...

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