It may be more dangerous to stay home.

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Photo by Tim Mossholder on Unsplash

As an emergency physician, I pride myself on taking care of anyone, anytime, for anything, no matter their condition, race, culture, beliefs, or ability to pay. It is perhaps the most important reason I chose emergency medicine as a career.

But right now I’m scared. Not because of COVID-19 or the chance of falling ill. Sure, it’s possible. But I’m scared because patients are choosing not to come to the emergency department. And while this decrease in patient volume presents a conundrum for emergency physicians across the country, it’s the patients who are suffering the most.

They’re suffering in spite of the fact that their risk of catching the virus in an ER is quite low. And there are many that still require emergency care. However, the entire country has been told — “Don’t come to the emergency department unless you absolutely need to.” This makes sense for those who have mild upper respiratory symptoms or even a mild form of coronavirus. But not for more concerning symptoms. …

It’s human nature to crave freedom. But it’s responsibility that grants freedom.

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Photo by United Nations COVID-19 Response on Unsplash

As I sit in my home looking out the window, I see neighbors without masks on standing less than 6 feet apart — more like less than 3 feet — laughing, talking, enjoying the beautiful day.

Down the street, a neighbor is attempting to have a socially-distanced party, but the crowd is starting to form, creating less than ideal spacing. Kids are running around playing with each other, touching shared objects, breathing on each other.

You’d think it was a normal day. But it isn’t. Not only are we under a stay-at-home order, but we have been advised to continue social distancing into the future until COVID-19 is under control. …

Not all medications are created equal.

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Photo by pina messina on Unsplash

Changing insurance companies due to new employment may mean you have to change your medication to a “comparable” drug that is on formulary with your new health insurance.

The financial hit would be difficult and maybe impossible so you do what any reasonable patient would do — you start the new medication.

This is all too common in the United States where insurance companies negotiate deals with pharmaceutical companies to keep costs down. Sometimes this means changing to a generic medication and other times it means switching to a completely new drug within the same class of medication.

This shouldn’t matter as long as the drugs are comparable, right? But how similar are these medications really? Have you or anyone else experienced an issue when forced to change your medication? …

One physician’s advice on how to stay clean

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Photo: PhotoAlto/Odilon Dimier/Getty Images

The doctor’s white coat. Some might imagine it pressed and sparkling, radiating confidence and demanding respect — the very symbol of a figure who heals your illness and makes you feel better.

But how clean, really, is a white coat or any of a doctor’s clothes for that matter? Why do doctors wear them? How often are they washed? And how many doctors in scrubs and white coats carry germs from person to person, unknowingly infecting patients with viral or bacterial illness?

The answer might surprise you.

The history of the white coat

The white coat was a staple of highly successful doctors many generations before our time. But the original version wasn’t the same white coat you may be used to today. Physicians in the early 1800s wanted a way to display their success to colleagues and patients, literally. At that time, they wore black clothing to signify formal dress and would wear white aprons. What better piece of clothing than a white apron to show off blood and guts — signs of a busy physician? …

A growing body of research says they’re mostly beneficial — especially in young kids. Here’s a doctor’s advice.

A worried mom on the phone, looking at a thermometer after taking the temperature of her son, who is in bed with a fever.
A worried mom on the phone, looking at a thermometer after taking the temperature of her son, who is in bed with a fever.
Photo: ljubaphoto/E+/Getty Images

Give me a fever, and I can cure any disease.— Hippocrates

Fever is one of the most misunderstood defense systems in the human body. Many people worry that fever is a sign of something dangerous. Parents give their kids Tylenol and ibuprofen the instant they spike a temperature and then flock to doctors to make sure their child does not have a serious infection. In fact, fever accounts for a whopping 20% of pediatric emergency department visits each year. As an emergency physician, this is a huge part of my clinical practice. …

Make it personal

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Photo by National Cancer Institute on Unsplash

Antibiotics are ubiquitous in today’s society. Prescriptions for these bacterial killers have become so prevalent that a wonder drug cure phenomenon for any illness has become the cultural norm. The evidence is overwhelming that antibiotics are far too overprescribed for viral illnesses. They are 100 percent ineffective against viruses. And the number of inappropriate antibiotics prescribed has been increasing for decades, as high as 30 percent in one study.

For years, we have heard that antibiotics are harmful because they have increased drug-resistant strains of bacteria. The antibiotic resistance epidemic is unarguably a crisis and deserves serious attention. If we continue at this rate, antibiotics may be ineffective for common bacterial infections, sending us 100 years into the past when basic infections could be deadly. …

In the comfort of your home.

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Photo by Velizar Ivanov on Unsplash

Nosebleeds can be annoying, especially when they start gushing out of the blue. What seems like a runny nose ends up being a red mess. But they can also be quite scary. Though many stop on their own, sometimes they’re persistent and determined to keep running like a faucet. This article will explain why nosebleeds occur, when you should seek medical care, and ways you can stop the bleeding in the comfort of your home. Generally, there is nothing to be afraid of when you’re prepared.

Why do noses bleed?

The nose is a highly vascular structure with great blood flow. Just think of all of the amazing things your nose does for your body. It allows us a sense of smell, moistens the air that we breathe into our lungs, and provides an extensive defense system against different bacteria and viruses trying to get into our body. …

Find out how well the flu vaccine works and why it could be better.

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Photo by Alexandra Gorn on Unsplash

Flu season is approaching once again. Anyone who has had the flu knows that it is a terrible experience — I can vouch for this first-hand. As much as I empathize with those affected by the flu, I am equally as disappointed by the government’s lack of response to decreasing this epidemic.

Many people are asking, should I get the vaccine? Will it prevent me from getting the flu? These are legit questions in our current skeptical climate about vaccines. Laying it out plain and simple: The influenza vaccine is the best prevention for flu in the world. I fully support our vaccination programs throughout the world. …

Anyone can think like a doctor if they know what to think about.

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Photo by Tachina Lee on Unsplash

Chest pain can be a serious symptom depending on its cause. But 99 out of 100 times, it is not very dangerous. Knowing how to evaluate chest pain is usually left to the doctor. But if you know how a doctor thinks and can analyze your own chest pain in a similar fashion, you may be able to determine what to do next.

The list of dangerous diseases for people that present with chest pain is rather small but includes problems that can lead to significant disability and even death. These include heart attack, blood clot, dropped lung, pneumonia, tearing of the aorta blood vessel, or esophagus rupture. This is why chest pain causes a large amount of anxiety in our society and brings many people into the emergency department for an evaluation. …

Are antibiotics necessary when you have a throat infection? A different way of thinking that challenges the status quo.

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Photo by kgrkz on Unsplash

I was sitting in a lecture from a highly published infectious disease doctor. He had been around the world, treating crazy infections and researching diseases we have only heard of in textbooks.

But his main research focused on rheumatic heart disease, a condition thought to be directly related to infection by Streptococcus pyogenes, or Group A Strep, the bacteria that causes modern-day strep throat.

The basic premise is that the antibodies you create for strep attack one of your heart valves, which can obviously have serious consequences for your health. …


Greg Gafni-Pappas

Emergency physician, patient advocate, entrepreneur, sci-fi novelist, always challenging the status quo

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