Allow patients to continue their opioid of choice while starting microdoses of buprenorphine

Meds
June 16, 2022

Twenty-six hours into the shakes, sweats, crawling anxiety, and gripping nausea of opioid withdrawal, Faye caves in and takes a couple of fentanyl tabs. She knows that she must tough out a couple of days without fentanyl to start Suboxone (buprenorphine/naloxone) through a medication-assisted treatment program, but the sickness gets the better of her. Those couple of tablets reset the clock on her withdrawal.

Starting buprenorphine – an evidence-based …

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Virtual care is convenient, but is it better for everyone? [PODCAST]

Podcast
June 15, 2022
YouTube video

“2022 is well underway, and we are still unclear about exactly where this virus is headed and what the lasting impact it will have had on all of us. We have self-driving cars, drones delivering food, and most of us spend our entire day on video calls, and the rest on …

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Fresh prescriptions: Looking for the twinkling lights

Physician
June 15, 2022

I always got my contacts from Costco, and it constantly felt like a chore. Like any child made to go on errands with their parents, Costco was my eye-rolling-moan-inducing trip.

I realized my eyes were inadequate in third grade while reciting the Hail Mary. I was a little distracted as my blue and green plaid skirt was all twisted and the scratchy green sweater vest a little too tight. Despite years …

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The gravity of difficult questions

Conditions
June 15, 2022

“I don’t want to be alive anymore.”

My friend Margot was despondent. Her lips quivered. Her eyes, normally the shape of almonds, folded themselves into little triangles when she cried. This kind and gentle woman of 62 years – my neighbor –  was undeniably at her lowest point. I was sharing a couch with her during my junior year of college as her composure crumpled before me.

I first met Margot when …

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How long will it take to address clinical inertia in T2DM? [PODCAST]

Podcast
June 14, 2022
YouTube video

This article is sponsored by the Academy for Continued Healthcare Learning. Visit the CME activity and Clinical Inertia Assessment Tool. This activity is supported by an educational grant from Lilly.

It’s been over …

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I married an MD

Conditions
June 14, 2022

Recognizing accomplishments and a ticket to residency: That was Match Day. But now, at the doorstep of the next challenge, you’d better take a hard look at your most important personal relationship.

That is, if you want to keep your good thing together. Because if you think residency is going to be the start of easy, no-maintenance times for you and your partner, maybe you need to go back to medical …

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Health care worker appreciation: When the thought doesn’t count

Conditions
June 14, 2022

Maybe we need to educate upper management — those multi-million-dollar hospitals with multi-million dollars per year salaried CEOs and board members with their financial perks — that health care professionals and nurses during “Health Care Worker/Nurse Week” in May of each year are no longer in the second grade.

Maybe we need to remind “them” that we are college-educated health care professionals with degrees, like ADNs, BSN, MSNs, RNs, LPNs, educators, …

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The health care system will cause its own physician shortage

Policy
June 14, 2022

A quarter of a million dollars — that’s the amount of debt the average medical student in the United States owes after completing medical school. After all the late nights studying, the endless exams and selfless sacrifice, it’s human nature to expect a historically stable career as the reward — right? I mean, weren’t we all told that “hard work pays off” at some point in our lives? For budding …

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Eating disorder myths debunked [PODCAST]

Podcast
June 13, 2022
YouTube video

“When people think of eating disorders, the image is often of an emaciated, white teenage girl in the hospital hooked up to feeding tubes. In fact, eating disorders are varied in how they present in a person, and they certainly do not ‘look’ a certain way.

Eating disorders occur in all cultures, …

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Flip the axis: primary care rotations

Physician
June 13, 2022

Primary care is foundational to the U.S. health system, but not enough students are entering the field. Whether students are interested in medicine, nursing, social work or pharmacy — it is critical that we share the exciting aspects of primary care and then adequately prepare them to work in the field. High loan burden and low pay relative to other potential jobs and specialties and training within a culture that …

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Help stop health care burnout

Conditions
June 13, 2022

The landscape of medicine and health care is constantly changing. With the integration of electronic medical records (EMR) and other technological advances, physicians and health care providers must be much more adaptable than ever before and possess unprecedented levels of technical literacy in the field.

The modernization of health care has been a driver of burnout, defined as “the constellation of symptoms that occur when your energy account …

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10 suggestions for a smoother high school experience

Conditions
June 13, 2022

I used to spend most of my day listening.

As a high school counselor, I encouraged teenagers to talk. Feeling stressed, they said, is their automatic response to demanding teachers, parents’ high expectations, and the drama of shifting friendship alliances.

Daily dilemmas and problems affect everyone: the terrified boy who just heard rumors he was going to be jumped after school, the teary-eyed girl whose teacher embarrassed her in front of the …

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Re-wounding the wounded healer

Physician
June 13, 2022

I walk onto the inpatient unit on a Monday morning. The feeling of discomfort begins to overwhelm me. Perhaps this was due to being forced back to inpatient, but I felt it had to do with changes in the process.

I started my training at a time when therapy was a central part of education. Understanding even the most psychotic patients was a key element of our field. I do not …

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Gender inequality is making burnout worse [PODCAST]

Podcast
June 12, 2022
YouTube video

“If we want to alleviate the fatigue and frustration women physicians are experiencing, we can always start by solving two old problems: (1) All doctors need fewer bureaucratic tasks forced upon them, and (2) women physicians must be able to work in environments free of harassment and discrimination.

There’s yet another solution …

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3 decades in medicine: new name(s), same me

Physician
June 12, 2022

Many women change their last names after marriage, after a divorce, or just because. During my 30-year career in medicine, I have had three last names. Yes, not a typo, three!

I got married for the first time during my internal medicine residency. I didn’t change my name and was “Mrs. Married Name” to friends and family and “Dr. Maiden Name” at work. I grew as a physician, conducted research, and …

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3 reasons practices should implement patient-initiated collaborative texting

Tech
June 12, 2022

Medical care continues to advance at a frenetic pace, with new diagnostics, treatments, and therapies arriving monthly. So why are medical communications still stuck in the 20th century?

Despite the ubiquitous presence of smartphones among consumers of all ages, medical practices still use one-to-one telephone calls as the primary communications vehicle. While some communications have moved to patient portals, responses often take hours — or days — if they are answered …

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Receiving feedback and critique is a complicated art

Physician
June 12, 2022

In the mid 16th century, surgical education was that of a true apprenticeship. The student learned through direct observership and imitation of a skilled, elder surgeon. It wasn’t until the beginning of the 20th century that surgical education evolved into a formalized and structured program. Dr. William Osler introduced the concepts of specialty clerkships and bedside rounds in the late 1800s. Graduated autonomy, introduced by Dr. William Halsted in the …

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Thoughts of a retired physician [PODCAST]

Podcast
June 11, 2022
YouTube video

“COVID-19 melted down the world at a very inopportune time in history. Just as medicine was getting a handle on previously intractable conditions, from sophisticated diabetes management to less invasive surgical procedures, a new threat that devastates our population with few good treatments overwhelms health care.

Medical workers come to the rescue, …

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