What Healthcare Can Learn from Crossfit

From humble roots in Santa Cruz, CA, CrossFit has become a national (and now international) phenomenon with not only a viral spread of some 13,000 CrossFit “boxes” across the country, but also dozens of blogs dedicated to the movement, an army of loyal fans, and even a televised international Olympics-style games.

At the same time, medicine is having to undergo a seismic shift from being solely focused on disease management to the completely new task of health creation and prevention. This new endeavor requires a different set of skills, and here are my top four things that medicine can learn from CrossFit about health creation. Read more…


How Social Media Can Invigorate Medical Conferences (and Specialties)

From the very outset of the American College of Cardiology meeting, the hashtag #ACC16 began trending. Analytics from #ACC16 demonstrated that by the event’s end, there were nearly 3600 individual tweets, 35 million individual impressions, and roughly 1500 members participating via social media platforms such as Twitter. In other words, it’s quite clear that the ACC has embraced the digital space. And that’s as it should be. As cardiologists we are innovators and social media and digital engagement should be no exception. What follows is a look at how, in reflection of this, the ACC has folded this experience into its fabric. Read more…

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Why Medicine Needs Its Stories

I was at a dinner meeting for our hospital last week, and before everyone went in to sit at their tables and hear the evening’s speeches, there was some time for the usual networking over wine in the reception room. I got chatting with an established local primary care physician. A respected member of the hospital staff who has been in practice for over 30 years. He’s quite a presence and a great clinician, someone who still finds himself coming into the hospital to work on various administrative duties. I expect every hospital in the country has characters like him wandering around. Read more…

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Are There Social Determinants for Chronic Pain?

Over the past few months, the federal government has mobilized against what is being called “the opioid crisis”: a national epidemic of fatal overdoses that in 2014 claimed more than 14,000 lives, the most ever recorded. Since most of these opioids were originally prescribed by physicians to treat pain, the Centers for Disease Control and Prevention recently finalized a guideline containing recommendations for appropriate opioid prescribing. The Food and Drug Administration will require that all opioid-containing medications be labeled with a new boxed warning about “the serious risks of misuse, abuse, addiction, overdose, and death” associated with these drugs. And the Office of the Assistant Secretary for Health has released a National Pain Strategy that is designed to complement restrictions on opioids by promoting and reducing access barriers to non-pharmacologic management options for patients with chronic pain. Read more…

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Advice to a New Class of Young Doctors

Match day has just passed and a new crop of medical students now know where they will be starting their clinical careers. One thing is for sure, these successful students – soon to be doctors – will need to learn the importance of flexibility and resilience as medicine is changing at a fast and furious pace. When I graduated from the University of Michigan School of Medicine in 1983 (so long ago it strains the memory, but it was with Summa Cum Laude designation) we did match day at a bar in town announcing the match locations one by one in front of 250 slightly sauced peers. Since that day I have had a wonderful but unpredictable career that has taught many lesson. Below, a few of the ones that helped me the most. Read more…


Road-Tested Advice for New Residents

A few years ago, the hospital where I work started new residency programs in internal medicine and family practice. Many of the residents do rotations in anesthesiology and surgery where I have an opportunity to meet and talk with them. They are eager to learn medicine of course, but they are also interested in the perspective that many of us who have been practicing medicine for many years have to offer them. Given the opportunity to speak to a large group of early career physicians or medical students, I think I would offer the following advice.

First and foremost, do not be afraid to take care of yourself. With all there is to learn and do and all the hours you’ll spend doing it, it’s easy to be consumed by your career. It’s important to have something outside of medicine that you’re passionate about. That could be your family, a hobby, a sport you play, photography, or writing the great American novel – you get the idea. Read more…


When Surgeons Learn from YouTube

A study in JAMA Facial Plastic Surgery this month reports that 64 percent of plastic surgeons describe having used online videos to learn new procedures.

What’s remarkable isn’t the 64 percent, but the fact that the study drew so much attention. Perhaps I shouldn’t be surprised. The Internet, after all, has long been seen as a sewer of misinformation. Just as the prevailing view has been that good medical information comes from textbooks. Read more…

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What Doctors Need to Know About Fat

As physicians, many of us were trained to tell our patients that eating cholesterol and fat – especially saturated fat– causes heart attacks, and that taking statin drugs provide a powerful way to reduce your risk of getting them. But is this really true?

One of the biggest refuse-to-die myths is that dietary and cholesterol levels are the enemy, and a high-fat diet causes heart attacks. Yet study after study shows no connection between total fat, saturated fat, or dietary cholesterol and heart disease. Read more…


My Education Versus Your Health

With Match Day around the corner and graduation coming shortly after, I find myself frequently reflecting on my nearly four years of medical school. Without a doubt in my mind, I can say that my favorite month was spent abroad in Guatemala. As a fourth year student on my international elective, I had the opportunity to work for four weeks in various pueblos and a local clinic for women and children outside of Quetzaltenango, Guatemala. In this short time, I learned the basics of a new healthcare system, I significantly strengthened my Spanish, and I saw hundreds of patients, many of whom I know I helped in both an acute and sustainable fashion. Still these experiences certainly come with a price, and for me that was the constant ethical dilemma I faced while seeing patients. Read more…


As Doctors, We Must Be Generous with Hope

Hope is a tricky thing. On the one hand, false hope can lead patients to opt for painful, futile treatments at the end of life. On the other, unnecessarily bleak outlooks can lead to depression and inaction. When health is at stake, presenting information with the right amount of hope can guide patients away from both suffering needlessly and/or succumbing to treatable disease.

I was reading a sad story about a patient whose physician had made her feel hopeless. She was an elderly widow with some real, but not immediately life-threatening, medical conditions. His attitude led her to believe that she was sick and useless – with little to look forward to but ongoing testing, disease progression and eventual death. His professional opinion held special weight for her, coloring her entire outlook. It wasn’t until a friend reminded her of the doctor’s fallibility that she began to question her diagnoses, treatment options, and even prognosis. Read more…