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George Lundberg, MD

George Lundberg is a physician.

Physicians

Should hospital beds be kept full or empty?

Should physicians strive to keep hospital beds full or empty? Obviously, in an economically optimal situation, just like in the hotel business, the hospital beds that are "needed" and available should be kept pretty close to full, in order to…

Should physicians strive to keep hospital beds full or empty?

Obviously, in an economically optimal situation, just like in the hotel business, the hospital beds that are “needed” and available should be kept pretty close to full, in order to cover fixed costs and balance the hospital budget.

A recent discussion board on another physician website has called attention to an alleged practice of both emergency physicians and hospital administrators being paid …

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Should hospital beds be kept full or empty?

Policy

How to fix primary care in 3 steps

Primary care physicians, including pediatricians, are usually really nice people. But old baseball fans will remember that Leo Durocher famously said, "nice guys finish last." How true. And, as one result, the American healthcare system and the American people are…

Primary care physicians, including pediatricians, are usually really nice people. But old baseball fans will remember that Leo Durocher famously said, “nice guys finish last.”

How true. And, as one result, the American healthcare system and the American people are the real losers.

A deliberate radical change in the behavior of American primary care physicians and their representative organizations could go a long way toward fixing our broken healthcare system.

Primary care physicians …

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How to fix primary care in 3 steps

Patients

Every American deserves the right to have a death with dignity

My old Canadian friend toxicologist Cliff Walberg was right when he famously said, "there is absolutely no limit to how revolting things can be." Remember that. It comes in handy, in addition to strong swear words, when stuff happens. Case…

My old Canadian friend toxicologist Cliff Walberg was right when he famously said, “there is absolutely no limit to how revolting things can be.”

Remember that. It comes in handy, in addition to strong swear words, when stuff happens.

Case in point: I believe that every American deserves the right to choose to have a death with dignity and as pain-free as medical science and practice can provide.

To achieve that, patients and …

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Every American deserves the right to have a death with dignity

Education

How to check your scientific paper for plagiarism

We were taught in grammar school that plagiarism is wrong. It is stealing someone else's property. Imagine in high school asking your mother to buy you "Cliff Notes" so you can copy it word for word. Mother would not have…

We were taught in grammar school that plagiarism is wrong. It is stealing someone else’s property.

Imagine in high school asking your mother to buy you “Cliff Notes” so you can copy it word for word. Mother would not have liked that, and it wouldn’t have been right.

To write an essay today, you’ll probably start with a search engine. Instantly, Mr. Google delivers many intelligent commentaries on anything, probably better than …

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How to check your scientific paper for plagiarism

Physicians

The stent problem and the overuse of medical procedures

In 1911, George Bernard Shaw famously wrote "All professions are a conspiracy against the laity". One hundred years later, in 2011, I write "the MBA has done more to harm the public through bottom-line hospital administration than have many dread…

In 1911, George Bernard Shaw famously wrote “All professions are a conspiracy against the laity”.

One hundred years later, in 2011, I write “the MBA has done more to harm the public through bottom-line hospital administration than have many dread diseases.”

As an example, the continuing saga of this stent, that stent, the other stent placed into as many coronary and other arteries as often and as fast as possible does show …

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The stent problem and the overuse of medical procedures

Policy

Guns and why doctors should partner with the National Rifle Association

Is there anything that we physicians can and should be doing to help with the huge problem of gun violence in America? We all know it is nuts to sell guns and ammo to nuts, yet as a country we…

Is there anything that we physicians can and should be doing to help with the huge problem of gun violence in America?

We all know it is nuts to sell guns and ammo to nuts, yet as a country we do it every day.

We all know that, in contrast to rifles and shotguns, the only moving targets for hand guns are people; that the Congress and president in this century legislated …

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Guns and why doctors should partner with the National Rifle Association

Meds

Statin use and its effects on venous thromboembolism

In 2003 in the BMJ, Wald and Law and a supporting editorial by then editor Richard Smith, proposed that 80% of heart attacks and strokes could be prevented by widespread use of a six drug polypill. The six ingredients were…

In 2003 in the BMJ, Wald and Law and a supporting editorial by then editor Richard Smith, proposed that 80% of heart attacks and strokes could be prevented by widespread use of a six drug polypill. The six ingredients were a statin, three low-dose antihypertensives (a thiazide, an ACE inhibitor and a beta blocker), folic acid, and aspirin.

Although there was a lot of derision at that time and there has …

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Statin use and its effects on venous thromboembolism

Physicians

A national license to practice medicine

Why are you, Dr. Jones, licensed to practice medicine by the state of New Jersey? And, if you live in Ewing Township, right across the Delaware River from Yardley, Pa., why can't you practice medicine in Yardley? In these United…

Why are you, Dr. Jones, licensed to practice medicine by the state of New Jersey? And, if you live in Ewing Township, right across the Delaware River from Yardley, Pa., why can’t you practice medicine in Yardley?

In these United States, each of us physicians must obtain and retain a license in each state in which one practices.

Since we may have gone to a medical school in any state, or even …

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A national license to practice medicine

Physicians

Lifelong lessons from the Code of Medical Ethics

The American Medical Association was founded in 1846 for a number of reasons, including to create a Code of Medical Ethics. It did, and the Code is alive in 2010. I believe that all medical students should memorize these bedrock…

The American Medical Association was founded in 1846 for a number of reasons, including to create a Code of Medical Ethics.

It did, and the Code is alive in 2010.

I believe that all medical students should memorize these bedrock principles — a little like many did the Boy Scout Oath and Law.

And, I believe that all physicians should follow them scrupulously, lifelong.

The Principles are:

I. A physician shall be dedicated to providing …

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Lifelong lessons from the Code of Medical Ethics

Policy

How American physicians should be paid

How do you think American physicians should be paid? I think many of the current methods are insane. Case in point: In the 1980s, during a meeting of the board of trustees of the American Medical Association, I experienced sudden…

How do you think American physicians should be paid?

I think many of the current methods are insane. Case in point:

In the 1980s, during a meeting of the board of trustees of the American Medical Association, I experienced sudden unexpected unilateral loss of hearing. You might say that was lucky. But I was scared and went right to my ENT’s office.

He looked in my ear and extracted a large wad of …

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How American physicians should be paid

Physicians

Tobacco and alcohol kill large numbers of Americans every day

Ethyl alcohol kills large numbers of Americans every day (about 200), almost all legally. Tobacco kills large numbers of Americans every day (about 1,200), almost all legally. Americans also use many illegal psychoactive drugs and some of these also kill,…

Ethyl alcohol kills large numbers of Americans every day (about 200), almost all legally.

Tobacco kills large numbers of Americans every day (about 1,200), almost all legally.

Americans also use many illegal psychoactive drugs and some of these also kill, but the numbers are much smaller. We don’t know what the effect on American mortality figures would be if these illegal psychoactive drugs were legalized or decriminalized, but it is a topic …

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Tobacco and alcohol kill large numbers of Americans every day

Physicians

Should nurses become doctors to save primary care?

Do nurses want to be doctors? Of course many do. And I say, if you want to be a doctor, go to medical school. I say that as a red-blooded, licensed, board-certified, AMA card carrying, guild mentality, protectionist physician. But…

Do nurses want to be doctors? Of course many do.

And I say, if you want to be a doctor, go to medical school. I say that as a red-blooded, licensed, board-certified, AMA card carrying, guild mentality, protectionist physician.

But I am also a citizen, a patient, a taxpayer, a public health professional, and a member of the Institute of Medicine (IOM) of the National Academy of Sciences.

The IOM has recently issued …

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Should nurses become doctors to save primary care?

Physicians

Fruits and veggies for everyone, including doctors

Doctor, did you eat your fruits and veggies today? Two servings of fruit and three servings of vegetables each and every day? If you did not, how can you expect your patients, for whom you are supposed to set an…

Doctor, did you eat your fruits and veggies today?

Two servings of fruit and three servings of vegetables each and every day?

If you did not, how can you expect your patients, for whom you are supposed to set an example, to do so?

The Healthy People 2010 program of the Department of Health and Human Services set as a goal that 75% of Americans would consume two or more servings a day …

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Fruits and veggies for everyone, including doctors

Physicians

Healthcare murders as a patient safety issue

How many murders did you have in your hospital last year? Did they involve sporadic or serial killers? What? You don't know? You really haven't thought that much about it? I'm not surprised. Chances are you might have had some…

How many murders did you have in your hospital last year? Did they involve sporadic or serial killers?

What? You don’t know? You really haven’t thought that much about it?

I’m not surprised.

Chances are you might have had some murders but they were not discovered. I’m not only talking about the angry patient or family member who brings a gun to the ER or a patient room to seek revenge for a …

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Healthcare murders as a patient safety issue

Conditions

Papillary carcinoma of the thyroid in young people

Cancer is a really bad diagnosis and I hope I never get one. But I was taught a long time ago that if I had to get a cancer, a papillary carcinoma of the thyroid would be a good one…

Cancer is a really bad diagnosis and I hope I never get one. But I was taught a long time ago that if I had to get a cancer, a papillary carcinoma of the thyroid would be a good one to get.

An article in the World Journal of Surgery in June 2010, selected as highly credible by McMaster PLUS, bears that out.

Long-term follow-up really is the best way to learn …

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Papillary carcinoma of the thyroid in young people

Conditions

Benefits of mammography may not outweigh the harms

Stop pushing screening mammograms now. One by one, the big-time screening tests for dread diseases, begun with good intentions, the best science known at the time, and a mass public health campaign, bite the dust. Real science, that of statistically…

Stop pushing screening mammograms now.

One by one, the big-time screening tests for dread diseases, begun with good intentions, the best science known at the time, and a mass public health campaign, bite the dust.

Real science, that of statistically and clinically valid outcomes over time, obviously takes time to be realized. It also takes unbiased scientists and physicians with minimal conflicts of interest to study, deduce, report and then take the …

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Benefits of mammography may not outweigh the harms

Meds

Will California allow the government to regulate marijuana?

How are we going to solve the drug problem? The answer is we aren't. Psychoactive drug abuse is as old as recorded history. As long as drugs are available and humans are frail, there will be drug abuse and drug…

How are we going to solve the drug problem? The answer is we aren’t.

Psychoactive drug abuse is as old as recorded history. As long as drugs are available and humans are frail, there will be drug abuse and drug abusers.

The main point for medicine is to follow Hippocrates. First, do no harm.

So many of our drug laws, intended to do good, actually do more harm than good. Witness marijuana.

Will California …

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Will California allow the government to regulate marijuana?

Physicians

Why doctors should care about the professional behavior of physicians

Doctor, why did you behave the way you behaved last night? Frankly, I don't really care how you behaved last night as a person, although you should. I do realize that the Christian religion states that "I am my brother's…

Doctor, why did you behave the way you behaved last night?

Frankly, I don’t really care how you behaved last night as a person, although you should. I do realize that the Christian religion states that “I am my brother’s keeper.” I do care about your welfare, but I am not that strong a believer as to make your personal life my personal business.

But, if it were your professional behavior, I …

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Why doctors should care about the professional behavior of physicians

Conditions

Is the critical value reporting system truly life saving?

We at the Los Angeles County/USC Medical Center are generally credited with having created the "Panic Value" or "Critical Value" laboratory reporting system in 1969. A Panic or Critical Value is a laboratory finding at such variance with normal as…

We at the Los Angeles County/USC Medical Center are generally credited with having created the “Panic Value” or “Critical Value” laboratory reporting system in 1969.

A Panic or Critical Value is a laboratory finding at such variance with normal as to be life-threatening if something is not done quickly, and for which there is a corrective action that can be taken.

We determined that it was the laboratory’s responsibility to recognize such …

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Is the critical value reporting system truly life saving?

Conditions

Why a lab test is more than a numerical result

A couple of centuries ago, when I was a graduate student in biochemistry and later a med tech, we thought about a lab test as a CBC or a blood sugar that produces a numerical result. Period. Later, I learned…

A couple of centuries ago, when I was a graduate student in biochemistry and later a med tech, we thought about a lab test as a CBC or a blood sugar that produces a numerical result. Period.

Later, I learned and wrote that there were at least nine separate vital steps in the performance of a laboratory test and that the analysis that produces a result was important but that so …

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Why a lab test is more than a numerical result

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