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How Many Chances Are Too Many? Treating Recurrent Infective Endocarditis in IV Drug Users

How Many Chances Are Too Many? Treating Recurrent Infective Endocarditis in IV Drug Users

How many second chances should a drug user get? As many as it takes for us — physicians, society, government, and the healthcare system — to get it right.

Prisoners to Parental Incarceration: How Do Incarceration Rates Affect Infant Mortality?

Prisoners to Parental Incarceration: How Do Incarceration Rates Affect Infant Mortality?

The staggering number of incarcerated Americans has inspired an avalanche of studies demonstrating how patterns of imprisonment exacerbate inequality and affect the life chances of entire families.

A Few Bad Apples: Managing Malpractice Claims

A Few Bad Apples: Managing Malpractice Claims

Ranking or otherwise gauging physician quality isn't just a way to assign bragging rights — performance metrics can be used to set reimbursement levels, tailor insurance, and identify physicians who are falling behind.

New Dimensions in Psychopathy: Are There Cultural Differences in Psychopaths?

New Dimensions in Psychopathy: Are There Cultural Differences in Psychopaths?

Offenders with major psychopathic traits can be identified in all ethnic groups that have been studied, including European Americans, African Americans, and Latino Americans, but some of the evidence pointing to the validity of psychopathy is stronger in European Americans.

Court-Mandated Substance Abuse Treatment: Exploring the Ethics and Efficacy

Court-Mandated Substance Abuse Treatment: Exploring the Ethics and Efficacy

While many treatments for substance use disorder are not evidence based, several evidence-based approaches have shown effectiveness in court-mandated treatment settings.

Tapping Social Media for Skin Cancer Prevention: What You Can Do

Tapping Social Media for Skin Cancer Prevention: What You Can Do

Any images and personal stories that remind people about skin cancer, what to look for, even scars after surgery, really help save lives.

Importance of PrEP for People Involved in Criminal Justice Systems

Importance of PrEP for People Involved in Criminal Justice Systems

Important strategies to consider for people involved in the criminal justice systems include linkage to antiretroviral therapy for those who are HIV positive and linkage to PrEP postrelease and/or beginning PrEP before people are released so they build up adherence.

From Needle Exchanges to Supervised Injection: Why Communities Benefit From Supervised Injection Sites

From Needle Exchanges to Supervised Injection: Why Communities Benefit From Supervised Injection Sites

Like needle exchanges before them, supervised injection sites have been shown to decrease the harms associated with injection drug use.

Tips on Improving Communication With Older Patients

Tips on Improving Communication With Older Patients

Communication with older patients can be complicated for several reasons.

Multiple Sclerosis Treatment in Millennials: Expert Q&A

Multiple Sclerosis Treatment in Millennials: Expert Q&A

As the most effective treatment for a patient with multiple sclerosis is one that is specifically tailored to the patient's individual needs and preferences, recognition of the unique characteristics, preferences, and trends shared by the millennial generation should drive innovative solutions.

What a Building Contractor Taught Me About Informed Consent

What a Building Contractor Taught Me About Informed Consent

Identifying a patient's preferences and goals leads to a care plan that can reflect those goals, and this may improve patient satisfaction.

The 'Attitude Roots' Underlying Antivaccination Beliefs

The 'Attitude Roots' Underlying Antivaccination Beliefs

Although efforts to debunk antivaccination beliefs often rely on fact-based strategies, emerging evidence suggests it may be more effective to target the psychological roots of these beliefs.

Is There a Role for Precision Nutrition in the Management of Type 2 Diabetes?

Is There a Role for Precision Nutrition in the Management of Type 2 Diabetes?

Emerging evidence shows promise regarding the potential role of precision nutrition in the prevention and management of T2D. However, considerably more research is needed before this approach can be widely applied for these purposes.

The Unintended Consequences of Cigarette Taxation

The Unintended Consequences of Cigarette Taxation

Although cigarette taxes were supposedly implemented to encourage smokers to quit, they can have a disproportionate effect on people of low-income status.

When Sparks Stop Flying: How Is Clinician Burnout Tied to Patient Outcomes?

When Sparks Stop Flying: How Is Clinician Burnout Tied to Patient Outcomes?

Physician burnout has gained traction as a public health concern because more physicians are leaving medical practice altogether, resulting in decreased patient access and continuity of care.

The Pilot, the Physician, and the Whistleblower: When Is it Okay to Sound the Alarm?

The Pilot, the Physician, and the Whistleblower: When Is it Okay to Sound the Alarm?

Airplane cockpits have a lot in common with operating rooms: both host a small team that's trusted to perform an extraordinarily complex task with the clear understanding that any misstep could spell doom.

The Ethics of Upcoding: Does Illegality Matter?

The Ethics of Upcoding: Does Illegality Matter?

Upcoding is universally illegal, but that doesn't stop physicians and nurses the world over from labeling a simple infection as septicemia or pretending that a routine office visit involves a comprehensive evaluation.

#MeToo: Helping Victims Cope With Sexual Harassment

#MeToo: Helping Victims Cope With Sexual Harassment

Mental health professionals regularly grapple with the best way to support clients navigating an onslaught of sexual violence in their daily lives.

Under the Microscope: Medicine's #MeToo Moment

Under the Microscope: Medicine's #MeToo Moment

No single solution to address sexual harassment in medicine exists, but physicians of all genders must come together to make progress.

Bully for Us: Confronting Medicine's Bullying Problem

Bully for Us: Confronting Medicine's Bullying Problem

The culture of bullying — widespread across the medical field — has been linked to poorer patient outcomes. So why can't physicians stop bullying in its tracks?

Do Not Resuscitate: Examining the Ethics of Overriding DNR Orders During Surgery

Do Not Resuscitate: Examining the Ethics of Overriding DNR Orders During Surgery

The role of an anesthesiologist during surgery is not solely to make the patient more comfortable: if a patient becomes hemodynamically unstable, the anesthesiologist is required to administer CPR — sometimes against a patient's wishes.

Improving Efforts to Prepare for Influenza Epidemics

Improving Efforts to Prepare for Influenza Epidemics

Although substantial emphasis is placed on vaccinations in considering how to limit the spread of influenza, simple hygienic methods have been found to be the most effective and should be more widely supported.

Strategies to Prevent Obesity in Children

Strategies to Prevent Obesity in Children

Of various interventions used in nonclinical settings for the prevention of childhood overweight and obesity, school-based programs that combine nutrition and exercise and include a home-based component appear to be the most effective approaches.

Navigating the Waters of Medical Malpractice and Defensive Medicine

Navigating the Waters of Medical Malpractice and Defensive Medicine

Malpractice liability reform would best be analyzed on a specialty-by-specialty basis.

Palliative Care in Movement Disorders: Recommendations for Improvement

Palliative Care in Movement Disorders: Recommendations for Improvement

Parkinsonism syndromes are associated with progressive disability and increased mortality, with symptom burden comparable to that of advanced cancer.

Surgical Outcomes and Social Media Reviews: When a 5-Star Rating Isn't All It Seems

Surgical Outcomes and Social Media Reviews: When a 5-Star Rating Isn't All It Seems

Customer service is a critical part of every physician's job, but there's a big difference between a Yelp review and a risk-adjusted mortality rate in determining

Honoring Women in Medicine: Reader Responses

Honoring Women in Medicine: Reader Responses

Medical Bag is sharing your stories about the women behind the white coats.

Colleague of the Month: Submit Your Nomination

Colleague of the Month: Submit Your Nomination

Submit your nomination for Colleague of the Month today.

In The Zone: Why Don't Surgeons Experience Flow?

In The Zone: Why Don't Surgeons Experience Flow?

"Flow" is dependent on reaching a number of optimal conditions, including intense concentration and loss of self-consciousness. So why don't surgeons feel the flow?

The Little Guy vs Big Data: Is ICD-10 Coding Still Valuable in Health Care?

The Little Guy vs Big Data: Is ICD-10 Coding Still Valuable in Health Care?

While ICD-10-CM may be an improvement on an old process, big data is the revolution that has the potential to change health care forever.

Psychology in the Age of Trump: Does the Goldwater Rule Still Apply?

Psychology in the Age of Trump: Does the Goldwater Rule Still Apply?

The Goldwater Rule has proven remarkably resilient and has not been seriously challenged for half a century — until now.

Implications of Mobile Health Device Use for Schizophrenia Research

Implications of Mobile Health Device Use for Schizophrenia Research

Mobile and digital technologies represent a valuable method for gathering real-world patient data at multiple timepoints.

Point and Counterpoint: Ethics and Legality of Pediatric Euthanasia

Point and Counterpoint: Ethics and Legality of Pediatric Euthanasia

Belgium and the Netherlands currently allow variations on pediatric euthanasia, stoking the worldwide debate surrounding the practice.

From the American Revolution to NASA: Pioneering Women in Medicine

From the American Revolution to NASA: Pioneering Women in Medicine

Women continue to propel medicine into the future. Take a glimpse at just a handful of the remarkable women in medicine making history today.

Share Your Story: Honoring Women in Medicine

Share Your Story: Honoring Women in Medicine

Do you know a woman in medicine who you would like to honor? Medical Bag is collecting your stories.

Genetics: To Test or Not to Test? That is the Question

Genetics: To Test or Not to Test? That is the Question

Even when presuming that there is a "right to test," concerns arise that patients will be misguided in their decisions based on poorly validated direct to consumer genetic tests.

Drawing the Line: Where Religious Liberty Ends and Patient Rights Begin

Drawing the Line: Where Religious Liberty Ends and Patient Rights Begin

The concept of conscientious objection has been appropriated by health care professionals who refuse to perform certain tasks related to female reproductive health.

What's Torture Good For? Absolutely Nothing

What's Torture Good For? Absolutely Nothing

Torture has always had its place as a two-faced mythical creature in American society, but no neuroscientific backing for the practice exists.

Examining the Crisis of Physician Suicides: Then and Now

Examining the Crisis of Physician Suicides: Then and Now

Since Gerry FitzGerald's suicide 80 years ago, physician suicide has become a staggering public health crisis that's gone largely ignored.

When Hard Cases Make Bad Law: Evidence-Based Recommendations vs Legal Precedence for Resuscitation of Premature Infants

When Hard Cases Make Bad Law: Evidence-Based Recommendations vs Legal Precedence for Resuscitation of Premature Infants

The decision to resuscitate an extremely premature newborn is governed by a patchwork of state-level laws that are not necessarily grounded in evidence-based medicine.

Sexual Harassment: Psychological Effects of a Shifting Public Perspective

Sexual Harassment: Psychological Effects of a Shifting Public Perspective

An expert discusses how the shifting public view of sexual harassment is affecting the nation.

Expert Opinion: Preventing Compassion Fatigue and Physician Burnout

Expert Opinion: Preventing Compassion Fatigue and Physician Burnout

Compassion fatigue affects workers across the spectrum of helping professions, and is extremely prevalent among physicians.

Priorities for Telehealth Research: Changing the Physician-Patient Relationship

Priorities for Telehealth Research: Changing the Physician-Patient Relationship

Additional studies are needed to assess the use of telehealth in urgent and primary care triage, teledermatology, and the management of serious pediatric conditions.

Improving Patient Encounters While Balancing EHR Tasks

Improving Patient Encounters While Balancing EHR Tasks

Research suggests that the growing number of tasks required by EHRs can compromise patient encounters.

The Quest for a Universal Influenza Vaccine

The Quest for a Universal Influenza Vaccine

Researchers from NIH's National Institute of Allergy and Infectious Diseases aimed to develop a universal influenza vaccine that would confer better and longer-lasting protection against the influenza virus.

A New Code of Ethics for Clinical Trial Research in the 21st Century

A New Code of Ethics for Clinical Trial Research in the 21st Century

Recent revisions to the Common Rule deal largely with improving transparency of informed consent while introducing a new concept of "broad consent" that can expand the reach of research.

Balancing Sustainability and Access to Care in Concierge Medicine

Balancing Sustainability and Access to Care in Concierge Medicine

One of the major pitfalls of concierge medicine is that physicians must limit their practice to guarantee the accessibility offered by the model in exchange for the retainer.

Promoting the Value of Adult Vaccinations Through Public Health Campaigns

Promoting the Value of Adult Vaccinations Through Public Health Campaigns

The National Vaccine Advisory Committee has highlighted 5 core concepts and strategies that can increase integration of social psychological components with health communication principles to improve the perceived benefits of adult vaccination.

How Can We Effectively Utilize Machine Learning Programs in Medicine?

How Can We Effectively Utilize Machine Learning Programs in Medicine?

Machine learning programs are accurate and intelligible, but what are the potential pitfalls of using them in a clinical setting?

Should Physicians Facilitate Lethal Injection Executions?

Should Physicians Facilitate Lethal Injection Executions?

While some support physician participation in lethal injection, others view it as a clear violation of the Hippocratic Oath.

Policy Advisor Discusses Healthcare Inequalities in the United States

Policy Advisor Discusses Healthcare Inequalities in the United States

David Himmelstein, MD, FACP, shares his insight on healthcare inequality in the United States, along with what he says is the only solution.

How Does Climate Change Affect the Incidence of Infectious Diseases?

How Does Climate Change Affect the Incidence of Infectious Diseases?

A recent study points to the potential global spread of vector-borne diseases due to global warming.

Behavior of Opioid Prescribing: Admitting What We Don't Know

Behavior of Opioid Prescribing: Admitting What We Don't Know

Opioid prescriptions should be tailored based on risk factors that correlate with future addiction rates and the pertinent outcome markers, but this information is still lacking.

When Should Patients With Dementia Stop Driving?

When Should Patients With Dementia Stop Driving?

No formal mechanisms exist in to require cessation of driving for reasons associated with dementia, so the treating neurologist is often relied upon to initiate discussions of driving.

Examining Racial Disparities in Hepatitis C Treatment Outcomes

Examining Racial Disparities in Hepatitis C Treatment Outcomes

The most pressing issues with respect to racial disparities reside in the medical system, rather than the patient.

Guidelines Released for Chronic Pain Management in Patients With HIV

Guidelines Released for Chronic Pain Management in Patients With HIV

The HIV Medicine Association of the Infectious Diseases Society of America has released new guidelines chronic pain management in patients with HIV.

Should We Close the Book on Patent Foramen Ovale Closure in Migraine?

Should We Close the Book on Patent Foramen Ovale Closure in Migraine?

Recent research has suggested that patent foramen ovale closure surgery might be a preventive measure against future migraine attacks.

Tracking Global Progress on Health and Climate Change Initiatives

Tracking Global Progress on Health and Climate Change Initiatives

Increasing temperatures and changing frequency of floods, droughts, heatwaves, and storms have direct effects on physical and mental health.

How Can Healthcare Professionals Improve Interactions With Challenging Patients?

How Can Healthcare Professionals Improve Interactions With Challenging Patients?

Karen Broquet, MD, MHPE, of the Southern Illinois University School of Medicine, discusses how clinicians can navigate interactions with challenging patients.

International C-Section Outcomes: The "C" Is Not for Certainty

International C-Section Outcomes: The "C" Is Not for Certainty

Recent data show incredible variation in C-section rates from country to country.

CMS Rule on Part B Drugs Could Lead to Steep Payment Cuts for Some Specialists

CMS Rule on Part B Drugs Could Lead to Steep Payment Cuts for Some Specialists

The Centers for Medicare & Medicaid Services issued a final rule that could result in steep payment reductions for physicians of certain specialties in 2018.

Exploring the Long-Term Effects of Head Injuries on Mental Health

Exploring the Long-Term Effects of Head Injuries on Mental Health

Mental health assessments may be a helpful aspect to the presport evaluation if those in need have access to care.

Addiction Policy Expert From Obama Administration Addresses the Opioid Epidemic

Addiction Policy Expert From Obama Administration Addresses the Opioid Epidemic

Keith Humphreys, PhD, who served as senior policy advisor at the White House Office of National Drug Control Policy in the Obama Administration, shared his views on the opioid epidemic.

Changing the Culture of Publication Bias in Neurology Research

Changing the Culture of Publication Bias in Neurology Research

The need for data transparency carries an ethical and moral obligation and requires nonselective and unbiased publication of clinical results.

Examining the Link Between Migraines and Gastrointestinal Disorders

Examining the Link Between Migraines and Gastrointestinal Disorders

Researchers are examining theories on the interplay between the GI tract and the brain.

Clinical Update: Utilizing Ischemic Preconditioning in Ischemic Stroke

Clinical Update: Utilizing Ischemic Preconditioning in Ischemic Stroke

One of the most promising avenues of research is the concept of hypoxic conditioning, or ischemic preconditioning, in which brief periods of oxygen deprivation to the brain have been shown to provide neuroprotective effects that reduce stroke infarct size and improve recovery times.

Palliative Care in Huntington Disease: What Every Clinician Should Consider

Palliative Care in Huntington Disease: What Every Clinician Should Consider

Palliative and hospice care play an important role in the long-term management of Hungtington disease, including ongoing symptom relief measures, caregiver support, and end-of-life care.

Clinical Update: Impact of Anesthetics on the Brain

Clinical Update: Impact of Anesthetics on the Brain

Findings from animal studies indicate that general anesthesia may be neurotoxic and could result in long-term central nervous system alterations and cognitive dysfunction, particularly in very young or elderly patients

Physician Burnout: Expanding the Scope of Solutions

Physician Burnout: Expanding the Scope of Solutions

Although there has been growing awareness of physician burnout in recent years, the problem has continued to increase.

Review of Current Mammography Guidelines in the United States

Review of Current Mammography Guidelines in the United States

This review analyzed mammography screening guidelines from US organizations to understand best practices in an effort to minimize the morbidity and mortality of breast cancer.

Overcrowding in the Emergency Department: Causes, Fallacies, and Fixes

Overcrowding in the Emergency Department: Causes, Fallacies, and Fixes

Overcrowding in the emergency department is a complex multifactorial problem borne of a fundamental supply-and-demand mismatch.

Should You Hire a Practice Manager for Your Office?

Should You Hire a Practice Manager for Your Office?

Hiring a manager to assist with handling the responsibilities of running a medical practice can be beneficial, but there are a few factors to consider before deciding to do so.

Psychology of Weight Loss: Why Are Supplement Infomercials So Effective?

Psychology of Weight Loss: Why Are Supplement Infomercials So Effective?

Restricted-calorie diets and increased exercise regimens produce an extremely wide range of weight loss outcomes, making glucomannan supplements seem like an attractive option for weight loss.

Staying One Step Ahead of Medical Information Hackers

Staying One Step Ahead of Medical Information Hackers

According to the Protenus Breach Barometer, which provides a monthly report of disclosed health care breaches, an average of 1 breach occurs every day. The main offender behind these breaches - now accounting for more than half of all reported breaches and 95% of total stolen records - is hackers.

Should We Be Screening Young Athletes for Cardiovascular Disease?

Should We Be Screening Young Athletes for Cardiovascular Disease?

It is a common practice for young athletes to undergo some type of preparticipation screening to detect factors associated with a high risk for injury or death, but this screening process has yet to be standardized.

Patient-Centered Communication: Every Doctor's Moral Imperative

Patient-Centered Communication: Every Doctor's Moral Imperative

One physician shares his insights on how repeated active discussions with patients about distress, treatment options, and goals can both reduce costs and help to identify when aggressive treatment is no longer appropriate.

Experts Weigh in on ACP Position Statement on Physician-Assisted Suicide

Experts Weigh in on ACP Position Statement on Physician-Assisted Suicide

Authors of recent position papers provide their opinion on the legalization of physician assisted suicide.

Harness the Power of Creativity in Health Care

Harness the Power of Creativity in Health Care

Steven Pritzker PhD, coeditor-in-chief of The Encyclopedia of Creativity, discusses how physicians can utilize creativity in health care.

Navigating the Patient-Physician Relationship With Pathological Liars

Navigating the Patient-Physician Relationship With Pathological Liars

Exploring the pathophysiology of lying and the patients who lie.

Should You Be Co-Prescribing Naloxone With Every Opioid Rx?

Should You Be Co-Prescribing Naloxone With Every Opioid Rx?

Co-prescribing naloxone with any opioid is recommended for patients that are at a high-risk for overdose.

Do Medical Scribes Negatively Impact the Doctor-Patient Relationship?

Do Medical Scribes Negatively Impact the Doctor-Patient Relationship?

There have been concerns regarding a potentially negative impact on physician-patient relationships.

How Medical Tourism is Affecting the Canadian Healthcare System

How Medical Tourism is Affecting the Canadian Healthcare System

The persistence of medical tourism speaks to capacity and resource-utilization concerns that Canada's single-payer system has been unable to effectively address.

Thinking About Buying a Practice? Here's What You Need to Know

Thinking About Buying a Practice? Here's What You Need to Know

Physicians must remember that they will be a business owner in addition to being a health care provider.

Five Uses for Virtual Reality in Healthcare

Five Uses for Virtual Reality in Healthcare

Virtual reality has become much more than just a new form of entertainment; it is increasingly being used in a wide range of medical applications.

When Does a Physician's Age Become a Medical Liability in Patient Care?

When Does a Physician's Age Become a Medical Liability in Patient Care?

There's no reason why something as critical as making sure that our surgeons are competent should be left to chance.

The Dan Plan: The Importance of Practice to the Novice Resident

The Dan Plan: The Importance of Practice to the Novice Resident

Dan's story and the story most young surgeons have both start with the same simple premise: the more you practice something, the better you get.

A Closer Look at Addressing HIPAA Security Risks

A Closer Look at Addressing HIPAA Security Risks

Health care providers do not necessarily have to meet every HIPAA standard.

Changing Healthcare Dynamics Calls for New Practice Options

Changing Healthcare Dynamics Calls for New Practice Options

Partnering with an organization is a practice option that may provide many multifaceted benefits.

Evaluating Practice Options in Today's Healthcare Environment

Evaluating Practice Options in Today's Healthcare Environment

Thriving in this new healthcare environment demands both significant capital investment and the ability to navigate increasingly complex reporting requirements and financial arrangements.

A Closer Look Into the Importance of the Physician-Patient Relationship

A Closer Look Into the Importance of the Physician-Patient Relationship

The key to a successful physician-patient relationship, in my opinion, is to recognize that the patient is not the disease being treated.

The Five Things Every Physician Needs to Know About MACRA

The Five Things Every Physician Needs to Know About MACRA

Five potentially pivotal issues physicians should understand about MACRA.

Concierge Medicine: Just the Ticket for Many Patients and Physicians

Concierge Medicine: Just the Ticket for Many Patients and Physicians

In a medical marketplace that is increasingly dominated by consumerism, concierge medicine gives many patients an attractive alternative to accessing health services.

Medical Malware: How to Protect Yourself and Your Patients

Medical Malware: How to Protect Yourself and Your Patients

No strategies are perfect for completely protecting hospital systems from ransomware attacks, but following best practices is key for prevention and protection.

A Physician Provides Insights on the 'Last Gift Study'

A Physician Provides Insights on the 'Last Gift Study'

Terminally ill people with HIV have few opportunities to participate in research, but some leave a final gift to their community.

Benefits of Using Video as a Medical Education Resource

Benefits of Using Video as a Medical Education Resource

An endocrinologist gives his insights on the benefits of using video with medical students.

WHO Guidelines for Managing HIV Drug Resistance

WHO Guidelines for Managing HIV Drug Resistance

The World Health Organization published new guidelines for managing HIV drug resistance in countries in which pretreatment HIVDR to NNRTIs is prevalent.

How to Identify Smartphone and Internet Addiction

How to Identify Smartphone and Internet Addiction

Smartphone addiction is increasingly recognized as a type of behavioral addiction, and recent research has identified criteria that help establish a diagnosis.

Are Prescribing Habits to Blame? A Closer Look at the Opioid Epidemic

Are Prescribing Habits to Blame? A Closer Look at the Opioid Epidemic

It really shouldn't take a jarring New Yorker piece to make the opioid epidemic, or my role in it, real.

Energy Drinks and the Heart: Are They Safe for Consumption?

Energy Drinks and the Heart: Are They Safe for Consumption?

Most of these cases have been associated with drinking a large volume of energy drinks, and thus, individuals who regularly consume energy drinks should be advised to use them in moderation.

Assessing Accountable Care Organization Cost Savings

Assessing Accountable Care Organization Cost Savings

With continued evaluation and adaptation, ACOs promise to provide sustainable reform of healthcare costs and management for the future.

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