It was 5:30 a.m., and I was startled to feel the nudge of my husband’s hand on my arm while vaguely hearing the sound of my alarm going off in the background.  Although I was not prepared mentally to get up for another day, I quickly jumped out of bed so as not to allow the sound to wake my sleeping daughter in the next room. I cherished no actually, ...

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Pink ribbons are everywhere, and we all know what that means: breast cancer. While this has helped raise awareness on a horrible killer and the importance of early screening, it does not address the fact that there is still no cure for stage IV cancer or the fact that men get breast cancer as well. Yes, it is important that we all know that breast cancer is prevalent in our ...

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I am not the first physician blogger to write about the difficulties of prior authorizations, denials, and appeals, but recent occurrences in my own practice have been so convoluted that I feel they must be shared. The nonsensical denials would almost cause one to laugh, if not for the reality that each denial represents potential delay in care for the patient and redundant work for the physician. That's work that expands ...

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I love breast cancer awareness month. As a breast medical oncologist, it gives me an opportunity to spread the message of how important early detection is for improving the success of breast cancer treatment. I am surprised regularly at the number of women who either are not doing mammography at all or who do it every couple of years when they remember. We know that women who are participating in ...

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What should you do if an insurance company denies a test?  Record the name of the denying physician in the chart and take the burden of the denial off of your shoulders and onto the shoulders of a faceless, algorithm-following insurance clinician.

A study published in JAMA looking at the brains of former football players donated to a brain bank, a highly selective sample, found signs of chronic traumatic encephalopathy (CTE) — a degenerative neurological disease — in nearly all deceased players examined. The mainstream media converged towards numerical consensus.

I am a gynecologic-oncologist. I work in the high-stakes realm of cancer care. I strategize complex treatment plans involving surgery, radiation, chemotherapy and the newer biological agents to treat the myriad of disease that we call collectively “cancer.” Cure — or at least control — requires urgent and timely administration of these modalities along with various imaging or blood work to assure that the treatment prescribed is effective. I love ...

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The age-old saying is that knowledge is power. But what happens when you are overwhelmed with the information you need to make a decision without the understanding of how that information fits together to answer your question? It’s like trying to put together a large, complex puzzle without a finished picture for comparison. Oh, and by the way, you also aren’t sure you have all the pieces. This situation can ...

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I bought a pocket ultrasound in 2011, determined to learn how to perform and interpret ultrasound at the bedside and thus transform my internal medicine practice. I bought it new, and it cost over $8,000. That was a staggering amount of money to spend on something I knew very little about. In 2015 after having performed many thousand ultrasound exams with my little GE Vscan with the phased array transducer, ...

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“Can you hear it?” she asked with a smile. The thin, pleasant lady seemed as struck by her murmur as I was. She was calm, perhaps amused by the clumsy second-year medical student listening to her heart. “Yes, yes I can,” I replied, barely concealing my excitement. We had just learned about the heart sounds in class. This was my first time hearing anything abnormal on a patient, though it was ...

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