Mismatched twin stars spotted in the delivery room

The majority of stars in our galaxy come in pairs. In particular, the most massive stars usually have a companion. These fraternal twins tend to be somewhat equal partners when it comes to mass — but not always. In a quest to find mismatched star pairs known as extreme mass-ratio binaries, astronomers have discovered a new class of binary stars.

5 things to remember when considering vaccines

The measles outbreak from Disneyland is a potent reminder of a) how infectious measles actually is; and, b) what happens when people don’t vaccinate. However, despite a mountain of evidence that vaccination is safe and does not cause autism or immune dysfunction or really anything terrible at all people still refuse. I live in a county that […]

Don’t give life to the killers of yesteryear

Disneyland is in the news, and not because it is the most magical place on earth.   It also is the origin of the most recent rubeola measles outbreak, now spread to seven states and Mexico with over eighty cases diagnosed so far.  Unvaccinated children are being kept home from school in some California districts and […]

Don’t give life to the killers of yesteryear

Disneyland is in the news, and not because it is the most magical place on earth.   It also is the origin of the most recent rubeola measles outbreak, now spread to seven states and Mexico with over eighty cases diagnosed so far.  Unvaccinated children are being kept home from school in some California districts and […]

Here’s an example of bad primary care

As much as I have given the “ologists” and other members of the dysfunctional U.S. health care system a hard time in previous posts, it’s only fair that I call out bad family medicine as well. I have a great example. I recently saw patient who is relatively new to the area who had seen […]

What doctors can learn from artists and entrepreneurs

Since leaving medicine, I’ve been an entrepreneur and an independent artist. They are similar pursuits, and both have taught me about the experience of living in creative rather than reactive mode. How do you know if you’re living in reactive mode? If you define and measure yourself based on external circumstances, and you believe you […]

An optimist’s view of primary care

Patient care is at a crossroads in a rapidly changing health care landscape. Going forward, will the majority of patients receive most of their care from a highly trained, well-supported primary care physician and team they know and trust? Or, in contrast, will patients receive care through a series of loosely connected episodes, from a […]

Evidence for dark matter in the inner Milky Way

A new study is providing evidence for the presence of dark matter in the innermost part of the Milky Way, including in our own cosmic neighborhood and the Earth’s location. The study demonstrates that large amounts of dark matter exist around us, and also between us and the Galactic center. The result constitutes a fundamental step forward in the quest for the nature of dark matter.

If mechanics were paid like doctors

My friend, Trent, is an auto mechanic. When he was growing up, he loved to work on old cars. He rebuilt his first one when he was fourteen — and drove it for 11 years. He loved finding problems and figuring out how to fix them. He never cared about getting rich; his goal was […]

In the quantum world, the future affects the past

In the quantum world, the future predicts the past. Playing a guessing game with a superconducting circuit called a qubit, a physicist has discovered a way to narrow the odds of correctly guessing the state of a two-state system. By combining information about the qubit’s evolution after a target time with information about its evolution up to that time, the lab was able to narrow the odds from 50-50 to 90-10.

7 secrets to keep loyal patients for life

Loyal patients are the lifeblood of a medical clinic. And devoted patients are worth their weight in gold. It’s a lot easier to care for an established patient that lots of one-timers who never return. Beyond ease of workflow, the economic benefits are fabulous. A loyal patient panel will stay with you (and pay you) […]

Stop clinging to tradition in medicine

Walking around the ER in Tiny Community Hospital, I had a few realizations.  In medicine, we hold onto some things very tightly.  We love tradition; we love the known.  We don’t always know why, but we choose “the devil we know,” almost every time, no matter how pointy his horns. Continue reading … Your patients […]

MKSAP: 72-year-old man with dyspnea at rest

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated for dyspnea at rest. He has end-stage COPD and is on a home hospice program. He has weight loss, reduced functional capacity, and muscle atrophy. His medications are ipratropium, salmeterol, fluticasone, albuterol as needed, and prednisone. […]

MKSAP: 72-year-old man with dyspnea at rest

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated for dyspnea at rest. He has end-stage COPD and is on a home hospice program. He has weight loss, reduced functional capacity, and muscle atrophy. His medications are ipratropium, salmeterol, fluticasone, albuterol as needed, and prednisone. […]

4 things we should be teaching in medical school, but aren’t

For many years, I taught a sizable chunk of our local medical school’s second-year pathology course.  I was always energized by the students’ enthusiasm and desire to learn more about medicine.  On the other hand, I remembered feeling their same frustrations regarding the lack of fundamental practice skills included in today’s medical school curriculum. Continue […]

Top stories in health and medicine, February 6, 2015

From MedPage Today: What Is the Real Cost of a New Knee? Assuming current eligibility criteria for total knee arthroplasty (TKA), the per patient lifetime cost attributable to symptomatic knee OA is $12,400, which represents about 10% of total direct medical costs in patients with OA. Attitudes Affected Outcome in HIV Prevention Trial. In the last […]

Dear anti-vax parents: It’s not your fault

Dear anti-vax parents, In the wake of the Disneyland measles outbreak, there’s been a lot of heated talk about parents who choose not to vaccinate their children. It seems like the medical community is now protesting even louder than the anti-vax groups were a couple years ago. But I want to take a moment and […]

Physicians: How to gain insight into your tax situation

An excerpt from The Freedom Formula for Physicians. Get the last copy of your pay stub. What is your year-to-date compensation? What is your annualized compensation? Hint: Take your current compensation and multiple it by 12, divided by the number of months already compensated. For example, using an end-of-the-month May check, multiply the amount by 12 […]

Reflecting on an orthopedic surgery rotation

“Katie, If you go into surgery, you’re going to miss patients.” It was three in the morning in the ED; the resident was feeling the strain of a 24-hour trauma call, and I was loving it. I had spent the past half hour with a lovely, older woman whose foot had gone through the floor […]

Reflecting on an orthopedic surgery rotation

“Katie, If you go into surgery, you’re going to miss patients.” It was three in the morning in the ED; the resident was feeling the strain of a 24-hour trauma call, and I was loving it. I had spent the past half hour with a lovely, older woman whose foot had gone through the floor […]

Medical journals must disclose conflict of interests, not just authors

In every medical journal, authors must disclose all conflict of interests that might exist to the editors of that journal as a condition of publication.  However, as we are increasingly becoming aware, journal editors do not have to disclose payments they receive from outside sources (pharmaceutical industry, special interests, the government) to publish content in their own […]

The spookiness about sudden death

You live like this, sheltered, in a delicate world, and you believe you are living … And then some shock treatment takes place, a person, a book, a song and it awakens [you] and saves [you] from death. – Anais Nin On June 12, 2013, my driver and I were on our way to Sierpe, […]

Researchers use sound to slow down, speed up, and block light

How do you make an optical fiber transmit light only one way? Researchers have experimentally demonstrated, for the first time, the phenomenon of Brillouin Scattering Induced Transparency (BSIT), which can be used to slow down, speed up, and block light in an optical waveguide. The BSIT phenomenon permits light to travel in the forward direction while light traveling in the backward direction is strongly absorbed. This non-reciprocal behavior is essential for building isolators and circulators.

What have we lost with the progress of medical training?

Every third-year has heard it: “When I was in your position, I was taking 24-hour calls every other night. If my resident was there, I was there …” We’re regaled about the glory days, without shelf exams, without phlebotomists, and — by God — without those work-hour restrictions. The days when medical students wouldn’t dare […]

Relax the rules for approving medical devices

How informed are doctors? The answer is not obvious. Doctors know enormous amounts of data and have years of clinical experience. Many have solid science backgrounds and some conduct research keeping them at the top of their field.  Most rely on published studies to make their decisions on which products to use. Continue reading … […]

It’s time to end workplace wellness programs

There will are lots of things I hope improve in our health care system in 2015, but I’ll just mention one wish today. My wish is that the worthless wellness programs that have sprung up all over corporate America will fade away. I have criticized these programs in the past, but more ammo has come […]

Top stories in health and medicine, January 23, 2015

From MedPage Today: Eating Fish While Pregnant — Worth a New Look? In babies of women who consumed a lot of fish while pregnant, the benefits of n-3 polyunsaturated fatty acids in the fish outweighed the potential adverse effects of mercury exposure. With RA Remission, Try Cutting TNF Dose. A substantial proportion of patients in remission […]

Bill Cosby and Dr. Healthcliff Huxtable: What they mean to minority physicians

Dr. Heathcliff Huxtable.  Black America’s favorite physician is under fire.  Multiple allegations have surfaced and re-surfaced accusing Bill Cosby of various insidious perpetrations.  This blog is not intended to persecute or defend Mr. Cosby, but rather to highlight something to minority physicians that can be easily overlooked. Continue reading … Your patients are rating you […]

Fixing MOC: Will creating another board entity help?

I admire Paul Tierstein, MD’s honest attempt to create a greatly simplified alternative to the  ABMS’s Maintenance of Certification (MOC) program called the National Board of Physicians and Surgeons (NBPAS).  I hope he’s successful, but I sense there will be large headwinds for the effort ahead. Here’s why. Continue reading … Your patients are rating you online: How […]

Fixing MOC: Will creating another board entity help?

I admire Paul Tierstein, MD’s honest attempt to create a greatly simplified alternative to the  ABMS’s Maintenance of Certification (MOC) program called the National Board of Physicians and Surgeons (NBPAS).  I hope he’s successful, but I sense there will be large headwinds for the effort ahead. Here’s why. Continue reading … Your patients are rating you online: How […]