Don’t blame Big Pharma for insulin’s problems

Policy
December 4, 2022

For diabetics, insulin matters as much as H2O. Unfortunately, insulin’s a hell of a lot more expensive than bottled water. High insulin prices force approximately nine million Americans to balance their wallet and well-being.

The American Action Forum reported that a type-one diabetic’s average yearly expense for insulin was $~6000 (i.e., $500/month). It’s easy to lambast Big Pharma companies for the current state of insulin’s affairs, but history and market behavior …

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Bulletproof backpacks: There’s more we can do [PODCAST]

Podcast
December 3, 2022
YouTube video

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“As a parent of elementary school children, every mass shooting, particularly ones killing school children like in Uvalde, jolts my doing-the-mom-thing-just-keep-busy-can’t-stop denial. On the last day of school before summer vacation, when the bus doors squeaked open, …

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The unstoppable momentum of a medical “fact” with no source

Physician
December 3, 2022

When I started my company in 2009, personal experience was a driving force in identifying the problem I wanted to help solve. As a neurosurgeon, I often treated patients who were neurologically devastated by acute bleeding in the brain after years’ worth of poorly controlled high blood pressure. In many cases, when I asked the family why the patient quit taking their hypertension medication, they described the patient as “not …

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Bring the real You to your workplace

Physician
December 3, 2022

Life is short, so make yours extraordinary. Capitalize on what makes you, YOU, and be your own unapologetic self.

The Almighty designed us as unique but imperfect and flawed individuals, prone to sin and blundering error. But that’s the great part of being human; we’re expected to sin, blunder, and make mistakes. We’re made to err for the sake of learning and growth; otherwise, we’d wither into uninspiring nothingness. Keep this …

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Migrants need and deserve access to healthy lives in the U.S.

Policy
December 3, 2022

Anti-immigrant rhetoric was at an all-time high during the midterm election season, and now as the 2024 presidential election gathers momentum, it is urgent to note how it fosters violence against immigrant communities and creates a chilling effect.

Texas Gov. Greg Abbott continues busing immigrants to sanctuary cities from Texas, including new arrivals in Philadelphia, and Florida Gov. Ron DeSantis defends his practice of sending immigrants to  …

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Preventing prostate cancer with simple, proactive choices [PODCAST]

Podcast
December 2, 2022
YouTube video

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“You have the power to make healthier choices to reduce your risk for prostate cancer. While things like genetics are out of your control, there is a wealth of research showing that there are simple ways to …

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A case against real estate syndications

Finance
December 2, 2022

If you like real estate, you may have heard the term “real estate syndications.” This is a fancy term for group investment, where several people get together to acquire a big asset (like an apartment complex), they form an LLC, and there are active investors who manage the property and passive investors who help with the capital for the down payment, and they get to share the profits with the …

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From Uber driver to Harvard Medical School

Education
December 2, 2022

“What happens to a dream deferred?
Does it dry up
like a raisin in the sun?

Or fester like a sore—
And then run?
Does it stink like rotten meat?

Or crust and sugar over—
like a syrupy sweet?

Maybe it just sags
like a heavy load.

Or does it explode?”
– “Harlem” by Langston Hughes

“$23.46,” the Walmart cashier distractedly mentioned to me as I got ready for my first ride. I had signed up and passed the background check. My …

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Much more than simple white coat syndrome

Conditions
December 2, 2022

Ongoing consultations with a new-to-me internist have raised attention to my in-office blood pressure measurements. In preparation for my next appointment, I regularly record my BP, sometimes several times a day. In other office visits, for cancer talks and such, I simply explain I regularly home and grocery store measure my BP, which always seems to be in the established normal range. I am confident that these in-office rises are …

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We get what we incentivize

Physician
December 1, 2022

We get what we incentivize.

This is a basic rule. I’d love to say it’s a basic rule of humanity, but unfortunately, I have a background in psychology, so I know it goes a lot deeper than that—it’s a basic rule of every living creature. Humans are, in many ways, just very big pigeons. We reliably prioritize certain rewards. We prefer smaller sooner rewards to larger later rewards; we push the …

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The immediate impact of the transition to a pass/fail Step 1 exam

Education
December 1, 2022

Historically, students’ three-digit scores on the United States Medical Licensing Exam (USMLE) Step 1 were a main factor in determining competitiveness for residency programs. In February 2020, the world of medical education shifted drastically when it was announced that the USMLE Step 1 would transition to a pass/fail scoring system. One of the main factors driving this change was that medical students and residency programs were attributing too much …

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Why even doctors need regular doctor visits

Physician
December 1, 2022

After a great game of doubles tennis, a good friend brought up a recent visit with his primary care physician while sitting with friends, trying to cool down. He expressed appreciation for his position but complained about the need to see his doctor every three or six months, all the while acknowledging various medical problems being addressed.

This led to general comments by several non-physician friends about how they feel that …

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Effective doctors need to be challenged [PODCAST]

Podcast
November 30, 2022
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“Empathy, intelligence, and commitment are crucial traits every doctor must have to succeed. However, there is one trait that stands above the rest. One of the most important aspects of an effective doctor is the desire to …

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Prudence and promise in psychedelic-assisted therapy

Meds
November 30, 2022

Psychedelic-assisted therapy (PAT) represents one of the most promising developments in psychiatry in decades. The treatment typically involves the infusion of a compound such as LSD, psilocybin, or MDMA during an extended therapy session with licensed professionals.

Although it lacks widespread regulatory approval or clinical use, significant advances have been made in the study of PAT in the past decade, with a pronounced increase in recent years. Recently, a Read more…

A doctor’s grief

Physician
November 30, 2022

Last evening I crumbled in the arms of my patient and wept. This was unknown territory to me, an unexpected role reversal. For three weeks after my Mom’s death, I maintained a stoic distance as patients offered their condolences, as they asked about my mother, and empathized. We doctors have been trained to do this, to face death, to keep our emotions at arm’s length. But this patient, who has …

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When your letter to the editor is rejected or ignored

Physician
November 30, 2022

Dear Dr. El-Dalati,

I am sorry that we will not be able to publish your recent letter to the editor regarding the Chowdhury article of 16-Sep-2021.  The space available for correspondence is very limited, and we must use our judgment to present a representative selection of the material received.  Many worthwhile communications must be declined for lack of space.

The response from The New England Journal of Medicine (NEJM) seemed simple and …

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Let doctors in recovery be able to recover their careers [PODCAST]

Podcast
November 29, 2022
YouTube video

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“During addiction, the brain becomes ‘hijacked,’ which then ‘exaggerates the need for the drug and minimizes the dangers associated with the use of the drug.’ This is so affirming because the chemicals in my brain told me …

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What is cognitive load? How can we help clinicians manage it?

Sponsored
November 29, 2022

This article is sponsored by the Nuance Dragon Ambient eXperience. AI-driven ambient clinical intelligence (ACI) promises to help by revolutionizing patient and provider experiences with clinical documentation that writes itself.

What is cognitive load?

Cognitive load is a psychological theory that deals with how the human brain uses its working memory, how …

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5 tips for treating seasonal depression during the holidays

Conditions
November 29, 2022

Although the holidays are typically associated with feelings of joy and thankfulness, it is imperative that people should not automatically assume these emotions are commonly shared. Three percent of all individuals are impacted by seasonal affective disorder (SAD) during the holidays – a statistic many people are unaware of. The media promotes an unrealistic expectation that everybody should be happy during this time, but this is not the case …

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