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Latest Posts

The Future Of The Doctor-Drug Rep Relationship

Patient care is increasingly under third party control.  And as a consequence I make fewer decisions regarding the brand of medication used in my patients.

So the role of a pharmaceutical rep comes into question.  If I don’t choose which medication my patients will use, why would a representative call on me?  And as American medicine becomes more centralized and standardized, I wonder how and why industry will connect with treating physicians.  Pharma it seems is asking the same question: Of the core medications I prescribe, I see far fewer reps these days and our relationships are markedly different from a decade ago.

I don’t miss the pitch.  But I find the element of human support to be important.  For example, recently the FDA issued a black box warning for the concomitant use of Remicade and 6-MP.  My representative visited to be sure that I was aware of the changes in the product insert.  Sure the information was in my mailbox – along with 6 inches of pulp spam.  It’s basic attenionomics: I’m more likely to hear a person than a letter. Read more »

*This blog post was originally published at 33 Charts*

Audio: What Is Needed Most In Haiti Now? Live Report From Hospital In Port Au Prince


Dr. Paul Auerbach And Injured Haitian Boy

Dr. Paul Auerbach is the author of the definitive textbook on Wilderness Medicine. Though he’s spent his entire emergency medicine career teaching others how to survive in the wild, even that didn’t fully prepare him for the extraordinary devastation in Haiti. He’d never seen anything like it. He hopes he never does again.

In an exclusive Skype interview with Better Health, Paul describes what it was like “on the ground” during the first week of the disaster. He goes on to explain (in part 2 below) what the current critical needs are, and which organizations and websites volunteers should go to in order to contribute in a coordinated fashion.

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Dr. Val: Do you need supplies?

Dr. Auerbach: We have lots of medications, vaccines, and small supplies. What we need most is a large autoclave to sterilize used OR equipment. Read more »

Top 10 Ways Doctors Annoy Patients

Someone suggested I was being mean or making fun of patients in my previous post. Those of you who read this blog regularly (aside from needing serious psychiatric evaluation) are aware that I am quite sympathetic of my patients’ position in this relationship.  Mine is a position of power, while they are coming to me with an admission of weakness.  There is no doubt that I would rather sit in the doctor’s chair than that of the patient – and that’s not just because my chair has wheels on it.

My intent in writing this blog is to show the doctor/patient interaction through the eyes of a physician – a perspective most people don’t get very often.  Even though I have lots to be thankful for in my profession, I still have things that regularly annoy me.  For me to voice that annoyance in a light manner is meant to both educate people of my perspective, and entertain those who share it.

Enough of that.  Now it’s time to move on to the strategies we physicians use to get back at patients for their shenanigans.  You may not realize it, but we have a special class in medical school dedicated solely to the ways to annoy and embarrass our patients.  It’s an art, really. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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