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Doc Gurley's Urban Health Beat

Doctor-blogger Jan Gurley writes about practicing medicine on the margins of society, and what we can learn from it.

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How did we get to the point where we actually pay popular doctors more for our health care? No such system exists in any other professional or non-professional field. You can’t even pay your plumber less if she has a lower customer satisfaction score.

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There’s a growing recognition of the role that complex post-traumatic stress disorder plays in trapping people in long-term homelessness. Understanding how PTSD unfolds can help us better understand the homeless and their health issues.

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It may be hard to connect well-paid and well-conditioned pro football players with the homeless guy elbow-deep in the trashcan on your sidewalk. But when it comes to brain injuries, they have more in common than you might think.

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Most Americans know what's killing us. Stop smoking, eat better, exercise, and wear your seatbelt — just those four simple steps, alone, could save hundreds of thousands of lives every year. Here are 10 ways to help people hear that message.

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In one year, 477 people in San Francisco, most of them homeless, used $20 million worth of urgent/emergency services — an average of $42,067 each — and taxpayers paid the bill. Knowing who they are is the first step towards treating their illnesses, injuries, and addictions.

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What happens when someone dies who has no assets – or friends or relatives – to pay for his burial? Procedures for pauper's burials vary widely by jurisdiction. It is one of those little-discussed arenas of public health, a topic that often intersects with the deaths of the homeless.

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Many professions have their version of a post-event analysis of what went wrong, and how to prevent it. The autopsy report is medicine's. Journalists can find a trove of stories in a review of death certificates.

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In today's hyper-evolving social media world, it might seem quaint, if not downright foolish, to believe that old school journalism's low-tech and low-cost approaches — a pen, a pad, and shoe-leather investigation — could result in an article that ignites a global furor.

 

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Every ER has patients like "Sam." The staff call them "frequent fliers" because they patch them up and discharge them, only to watch them return an hour or a day or a week later with another problem.  How much should the health care system spend to help someone who won't help himself? 

 

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San Francisco's City Clinic has been dishing out frank talk about sex for 100 years. The shocking thing is not how much things have changed, but how much they haven't.

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