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Personal responsibility is needed to treat drug addiction

Patient

August 24, 2011

A 44-year-old man came to my office to begin Suboxone in hopes of stopping his injecting heroin. He was raised well by married parents, whose other four children have not indulged in narcotics.

He lives with a friend, unable to contribute to rent while “not working” yet somehow he affords $50 per day for narcotics through (self-admitted) hustling (comprising: working as one tentacle of the drug-dealers’ network, shoplifting, borrowing with no …

Why medicine actively and legally stifles innovation

Jay Parkinson, MD

Physician

August 23, 2011

Upon finishing my second residency at Hopkins in Baltimore in September of 2007, I moved back to Williamsburg to start a new kind of practice:

Patients would visit my website
See my Google calendar
Choose a time and input their symptoms
My iphone would alert me
I would make a house call
They’d pay me via paypal
We’d follow up by email, IM, videochat, or in person

It was simple, elegant, and affordable for me to start. But …

How Medicare undermines primary care

Kohar Jones, MD

Health Policy

August 23, 2011

When I was a family medicine intern, I met a diabetic patient in the hospital who had stopped seeing his regular doctor after he lost his job and his health insurance. His untreated diabetes made his feet go numb. He stepped on a nail and didn’t realize it until he noticed a smell that cost him his foot.

He spent thousands of dollars on the surgery and subsequent hospital stay—far …

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How Medicare undermines primary care

Why my family doctor is a superhero

Bryan D. Peach

Physician

August 23, 2011

In the interest of full disclosure, I’m not a family physician. I never aspired to be one – I wanted to be a superhero as a kid. When I got older, I realized that all the best ones (like Spider-Man and Superman) spent their non-costumed hours as newspaper reporters or photographers, so I decided to go into that line of work instead. It eventually led me to the Pennsylvania …

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Why my family doctor is a superhero

How environmental exposures can contribute to autism and ADHD

Philip J. Landrigan, MD

Conditions and Diseases

August 23, 2011

Each year, biologically based disorders of brain development – autism, attention deficit/hyperactivity disorder (ADHD), mental retardation, dyslexia, and subclinical neurodevelopmental disabilities – affect between 400,000 and 600,000 of the four million babies born in the United States. This means that between 10% and 15% of American children have some kind of learning disability.

Reported rates of autism spectrum disorder (ASD) are sharply increasing. The CDC reports that the rates of ASD increased …

Taking care of yourself sometimes means being selfish

Stewart Segal, MD

Patient

August 23, 2011

My family, my friends and my patients think being selfish is bad. I bet you do, too. I used to think so, as well. Twenty seven years in practice has taught that being selfish is good. Actually, selfishness is essential to an individual’s health.

Today, I saw a selfless young woman who was ill. She had an assortment of complaints. She had not felt well in months. If she was the …

How politics have weakened the USPSTF

Kenneth Lin, MD

Health Policy

August 23, 2011

Health reform was supposed to have been good news for the U.S. Preventive Services Task Force. Until 2009, this independent panel of federally-appointed experts in primary care and preventive health was not particularly well known, and its evaluations of the effectiveness of clinical preventive services had no binding authority on public or private insurance plans. Within the small circle of physicians and policymakers who were aware of the their …

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How politics have weakened the USPSTF

Patients need to contribute to help their doctors

Maurice Bernstein, MD

Patient

August 23, 2011

“Be a fountain not a drain,” an expression used by baseball announcer Rex Hudler, is one that has motivational content particularly in terms of an individual included as part of a team.

I would suggest that this expression would be appropriate when considering a basic team in medical practice: the doctor-patient relationship. It is critical in most clinical situations that both the doctor and the patient assume responsibility for making …

The art of medicine and the power of human touch

James Asante, MD

Physician

August 22, 2011

Though I had a less than comfortable childhood, I did not know what I missed in nurturing until I played football at around age 10. The coach, a big burly man, with a voice as huge as his girth, put his hand on my shoulder as he explained something to the team.

I have never been able to explain the feeling that went through me that day, that moment, like a …

The interests of doctors and patients sometimes conflict

George Lundberg, MD

Health Policy

August 22, 2011

Organized American medicine would like for physicians to “speak with one voice.”

If they could do so, and if that voice were in the public interest, not only in the self-interest of those physicians, it would be a very powerful voice indeed.

Arnold (Bud) Relman, the esteemed former editor of the New England Journal of Medicine, once rightly told the International Committee of Medical Journal Editors that physicians speak with many …

It’s possible to have fun during medical school

Eric Lu

Medical Education

August 22, 2011

Before I start second year of medical school, I wanted to take this time to reflect on my first year in medical school and use these lessons to ground me as I begin a new school year.

When people ask me how first year was, my first answer is that it was a lot of fun. That usually comes off as a surprise. Don’t get me wrong, there were definitely …

Beware whenever you hear a story about a simple blood test

Gary Schwitzer

Conditions and Diseases

August 22, 2011

After seeing the NBC Nightly News last night, a physician urged me to write about what he saw: a story about a “simple blood test that could save women’s lives.”

Readers – and maybe especially TV viewers – beware whenever you hear a story about “a simple blood test.”

And this is a good case in point.

Brian Williams led into the story stating: “Two of three women who die suddenly of cardiac heart …

Take the effort to reach across cultural and language barriers

Sharon Bahrych, PA-C, MPH

Patient

August 22, 2011

I was working in an urgent care clinic when I walked into the exam room to see my next patient. He was a six-year old who primarily spoke Spanish, with some broken English. Jose’s mom was with him, she only spoke Spanish.

I sat down and picked up the phone receiver to contact our translator service. With the Spanish interpreter on the line I was able to proceed. I then asked …

Regrets after patients have lost their health

Stewart Segal, MD

Patient

August 22, 2011

Regret is a harmful emotion. Regrets are best avoided. Its one thing to regret buying a stock that plummets. It’s another to regret that you ever smoked because your chest x-ray shows a large tumor.

People often don’t appreciate what they have until they’ve lost it. When you’ve lost your health, you will regret its loss for the rest of your (shortened) life. Imagine that you were supposed to take your …

How not to treat yourself when chronic illness strikes

Toni Bernhard, JD

Patient

August 21, 2011

Despite this culture’s obsession with good health, people get sick.

This piece is based on a story I tell in my book.

In 2001, I got sick with what the doctors initially thought was an acute viral infection. I have yet to recover. Diagnosis: Chronic Fatigue Syndrome—a little-understood illness that is as debilitating as its more justly named cousins that also compromise the immune and neurological systems. My case is particularly …

Why concierge and direct pay medicine is not unethical

Steven Reznick, MD

Physician

August 21, 2011

A response to Concierge Practice: Unjust for Patients and Doctors Alike.

Like the shots fired at Concord and Lexington in 1776, concierge medicine and direct pay practices are the initial shots fired by concerned primary care physicians in the revolution against health care systems which limit access to physicians and destroy the doctor / patient relationship. Concierge medicine arose as a result of government, private insurance, and employer intrusion into …

Our country fails to view physicians as humans

Rachel Loa

Patient

August 21, 2011

As a patient, and reader of KevinMD.com, I’d like to respond to a recent piece, Doctors face difficult choices to save Medicare.

The funny thing about this entire situation is that people refer to numbers. Numbers that consist of how much doctors are in debt when actually entering into the working world, how much Medicare reimburses or pays annually, how many patients are actually on Medicare, and how much …

The entire approach to food based on nutrients is wrong

Shantanu Nundy, MD

Conditions and Diseases

August 20, 2011

The science of nutrition is changing and not in the way you might expect. After years of “reductionist” thinking — where food has been viewed as the sum of its parts – a call to treat food as food has been sounded. No more poring over nutrition labels to calculate grams of fat or chasing down the latest go-to chemical – be it vitamin E, fish oil or omega-3. …

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