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<description><![CDATA[  JOB DETAILS    We Are Currently Interviewing Candidates With An Active Florida License To Our Jacksonville Area Outpatient Opportunity.    This Is A Managed Care Opportunity And We Do Offer Training ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_north_carolina/page_12.html">
<title>Family Practice jobs in &#x22;Winston-Salem/Greensboro, NC  $200K!  Primary/Urgent Care&#x22; - NC</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_north_carolina/page_12.html</link>
<description><![CDATA[  JOB DETAILS    Immediate Need For A Family Practice Urgent Care Physician Between Greensboro And Winston-Salem.  $200K For Experienced Physicians  20 Year Established Practice  Full Benefits With Paid ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_michigan/page_8.html">
<title>Family Practice jobs in &#x22;Grand Rapids, Michigan Outpatient Internal Medicine Job&#x22; - MI</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_michigan/page_8.html</link>
<description><![CDATA[  JOB DETAILS    Outpatient Internal Medicine Job Opening In Grand Rapids, Michigan For A Board Certified Or Board Eligible Internist.   The Position Provides A Strong Starting Salary Based On Experience. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_78.html">
<title>Family Practice jobs in &#x22;Brooklyn, NY Opportunity  -  Outpatient Family Practice&#x22; - NY</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_78.html</link>
<description><![CDATA[  JOB DETAILS    Experienced Family Physician Needed For Solo Opportunity In Brooklyn, NY    This Is An Employed Position With A Base Salary Of $140,000  Paid Malpractice W/ Tail Coverage  Health Benefits ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_117.html">
<title>Family Practice jobs in &#x22;Southwestern Pennsylvania Family Medicine Job Opening&#x22; - PA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_117.html</link>
<description><![CDATA[  JOB DETAILS    Opportunity For A Board Certified Or Board Eligible Family Physician To Establish A Practice With Full Hospital Support Or To Join One Of Several Primary Care Groups In The Area.   In ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virgin_islands/page_1.html">
<title>Family Practice jobs in &#x22;Family Practice Job Opening in the U.S Virgin Islands&#x22; - VI</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virgin_islands/page_1.html</link>
<description><![CDATA[  JOB DETAILS    Critical Need For A Family Physician In The U.S. Virgin Islands.  Seeking The Services Of A Full Time Board Certified Or Board Eligible Family Practice Physician To Provide Primary Medical ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_tennessee/page_50.html">
<title>Family Practice jobs in &#x22;4-4.5 Work Week 30 minutes from Knoxville, Tennessee&#x22; - TN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_tennessee/page_50.html</link>
<description><![CDATA[  JOB DETAILS    Join A Dynamic Group Of 2 Physicians Situated 30 Minutes Outside Of Knoxville.   This Is A Traditional Family Medicine Opening Admitting And Rounding At 1 Hospital.   Call 1:3 With Every ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_1.html">
<title>Family Practice jobs in &#x22;Outpatient Family Medicine Job - One hour to Chicago&#x22; - IN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_1.html</link>
<description><![CDATA[  JOB DETAILS    Family Medicine Opportunity Available In Physician Friendly Northwest Indiana.    This Is Truly A Great Opportunity And Location, Being Only One Hour From Chicago.    Can Be 100% Outpatient ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_4.html">
<title>Family Practice jobs in &#x22;Southeast Virginia Outpatient Practice Opportunity&#x22; - VA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_4.html</link>
<description><![CDATA[  JOB DETAILS    Employed Family Practice Opportunity Minutes To Williamsburg Or Hampton VA  Join Two Others In An Employed Setting In Southeast VA.  Beautiful Clinic Building Only 7 Years Old  Base Salary ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_alabama/page_61.html">
<title>Family Practice jobs in &#x22;Primary Care Physician Jobs in Birmingham, Alabama&#x22; - AL</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_alabama/page_61.html</link>
<description><![CDATA[  JOB DETAILS    Hospital Is Looking To Financially Support 3 Physicians To Start A Clinic  2 Year Income Guarantee, $20,000 Sign On Bonus, And Loan Repayment  Monthly Stipend For Residents  Hospital ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_113.html">
<title>Family Practice jobs in &#x22;New York&#x22; - NY</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_113.html</link>
<description><![CDATA[  JOB DETAILS    Family Physician Needed For A New Opportunity 1.5 Hours Outside Of New York City.   Earn A Strong Base Salary  Partner Track Positions Available  Full Family Medical Insurance  Paid Malpractice ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_texas/page_13.html">
<title>Family Practice jobs in &#x22;New primary care opportunity in downtown Houston&#x22; - TX</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_texas/page_13.html</link>
<description><![CDATA[  JOB DETAILS    Brand New Opening For An Internal Medicine Or Family Practice Physician To Work In The Heart Of Houston, Texas.   Join An Established Health System And Live In The Largest City In Texas, ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_georgia/page_20.html">
<title>Family Practice jobs in &#x22;Great Primary Care Opportunity in Metro Atlanta&#x22; - GA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_georgia/page_20.html</link>
<description><![CDATA[  JOB DETAILS    We Are Expanding Our Facilities In The Beautiful Suburbs Of Atlanta, Georgia! We Are Seeking Top Quality BE/BC Family Practice Physicians Who Can Provide Excellent Service In Our Modern ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_18.html">
<title>Family Practice jobs in &#x22;Tremendous Outpatient Position in Indianapolis&#x22; - IN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_18.html</link>
<description><![CDATA[  JOB DETAILS    The Newly Renovated Office Is Almost On The Hospital Campus  The Position Is An Outpatient Only With Minimal Call Of 1 In 8   Employed Position With Hospital Physician Network  Salary ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_20.html">
<title>Family Practice jobs in &#x22;York&#x22; - NY</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_20.html</link>
<description><![CDATA[  JOB DETAILS    Internal Medicine Physician Needed For A Practice Opportunity In An Upscale New York City Community  The Position Is In The Outpatient Setting  Earn A Base Salary Of Up To $165,000 Based ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_washington/page_7.html">
<title>Family Practice jobs in &#x22;Tacoma, Washington Family Practitioners Needed&#x22; - WA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_washington/page_7.html</link>
<description><![CDATA[  JOB DETAILS    Join A Thriving Practice In Tacoma. The Practice Is Overwhelmed With Patients And Must Add Additional Providers Soon.   The Practice Is Focused On Quality Care, So The Incoming Physicians ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_12.html">
<title>Family Practice jobs in &#x22;Norfolk, Virginia Family Practice Position&#x22; - VA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_12.html</link>
<description><![CDATA[  JOB DETAILS    Board Certified Or Board Eligible Family Medicine Physician Sought For A Practice Opportunity In Norfolk, Virginia.   This Opportunity Provides A Competitive Hourly Pay Rate Along With ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_110.html">
<title>Family Practice jobs in &#x22;Family Practice Jobs;  New York, New York&#x22; - NY</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_110.html</link>
<description><![CDATA[  JOB DETAILS    Outgoing, Personable Physicians Who Provide Excellent Clinical Services Needed For Practice Opportunities In New York City.   The Physicians Will Staff Two Different Offices, One In Brooklyn ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_north_carolina/page_127.html">
<title>Family Practice jobs in &#x22;Practice within 45 miles of Asheville, NC&#x22; - NC</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_north_carolina/page_127.html</link>
<description><![CDATA[  JOB DETAILS    We Are Actively Recruiting For 2-3 Family Physicians For Our Community Located 45 Miles Outside Of Asheville, NC.   The Incoming Physicians Can Join An Existing Group, Become Employees ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_minnesota/page_14.html">
<title>Family Practice jobs in &#x22;Twin Cities Suburb FP and FP/OB Openings&#x22; - MN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_minnesota/page_14.html</link>
<description><![CDATA[  JOB DETAILS    Opportunity For Family Practice With Or Without OB In Minneapolis Area  We Are Searching For Candidates Interested In Joining A Successful And Established Private Practice In The Twin ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_ohio/page_84.html">
<title>Family Practice jobs in &#x22;Dayton, Ohio Family Medicine Opening&#x22; - OH</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_ohio/page_84.html</link>
<description><![CDATA[  JOB DETAILS    Family Physician Needed For A Practice Opportunity In Dayton, Ohio.  The New Physician Will Typically Work Monday-Friday 8am-5pm With Call By Phone Consults.   Earn A Competitive Starting ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_mississippi/page_36.html">
<title>Family Practice jobs in &#x22;4 day work week on the Gulf Coast&#x22; - MS</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_mississippi/page_36.html</link>
<description><![CDATA[  JOB DETAILS    Fantastic Opportunity For A Family Practice Physician That Would Allow You To Work A 4 Day Week And Live In One Of The Best Communities On The Gulf Coast  There Are No Newborns, But Otherwise ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_53.html">
<title>Family Practice jobs in &#x22;Western/State College area&#x22; - NY</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_53.html</link>
<description><![CDATA[ &nbsp;   We have an outstanding opportunity available for a BC/BE Family Medicine Physician in the Western area of NY.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted.   &nbsp; ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_10.html">
<title>Family Practice jobs in &#x22;Western/State College area&#x22; - NY</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_10.html</link>
<description><![CDATA[ &nbsp;   We have an outstanding opportunity available for a BC/BE Family Medicine Physician in the Western area of NY.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted.   &nbsp; ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_oklahoma/page_44.html">
<title>Family Practice jobs in &#x22;Northwest of Oklahoma City&#x22; - OK</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_oklahoma/page_44.html</link>
<description><![CDATA[   We have an outstanding opportunity located Northwest of Oklahoma City, OK for a BC/BE Family Medicine Physician.          &nbsp;       Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_california/page_77.html">
<title>Family Practice jobs in &#x22;Monterey&#x22; - CA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_california/page_77.html</link>
<description><![CDATA[           Our client in the Greater Monterey Bay area of CA is looking for two BC/BE Family Medicine Physicians with interest in Geriatric patient care.            &nbsp;        Board Certified is preferred ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_9.html">
<title>Family Practice jobs in &#x22;Greater State College&#x22; - PA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_9.html</link>
<description><![CDATA[ Our client in the Greater State College area of PA is looking for a LOCUMS Family Medicine or Internal Medicine Physician.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_3.html">
<title>Family Practice jobs in &#x22;Greater State College&#x22; - PA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_3.html</link>
<description><![CDATA[ Our client in the Greater State College area of PA is looking for a LOCUMS Family Medicine or Internal Medicine Physician.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_illinois/page_34.html">
<title>Family Practice jobs in &#x22;Northwest of Peoria&#x22; - IL</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_illinois/page_34.html</link>
<description><![CDATA[   We have an excellent opportunity in a facility located Northwest of Peoria, IL for a BC/BE Family Medicine Physician.          &nbsp;       Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_texas/page_70.html">
<title>Family Practice jobs in &#x22;Greater San Antonio&#x22; - TX</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_texas/page_70.html</link>
<description><![CDATA[   We have an outstanding LOCUMS opportunity available for BC/BE Family Medicine Physician in the Greater San Antonio area of Texas to join an excellent facility.          &nbsp;       Board Certified ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_93.html">
<title>Family Practice jobs in &#x22;Greater Fort Wayne&#x22; - IN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_93.html</link>
<description><![CDATA[ &nbsp;   Our client in the Greater Fort Wayne area of IN has an excellent LOCUMS BC/BE Family Medicine opportunity available.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_92.html">
<title>Family Practice jobs in &#x22;Greater Fort Wayne&#x22; - IN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_92.html</link>
<description><![CDATA[ &nbsp;   Our client in the Greater Fort Wayne area of IN has an excellent LOCUMS BC/BE Family Medicine opportunity available.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_83.html">
<title>Family Practice jobs in &#x22;Greater South Bend&#x22; - IN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_83.html</link>
<description><![CDATA[ &nbsp;   Our client in the Greater South Bend area IN currently has a Locums opportunity available for a BC/BE Primary Care Physician.   &nbsp;   Board Certified is preferred but Board Eligible will ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_california/page_185.html">
<title>Family Practice jobs in &#x22;Greater Sacramento&#x22; - CA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_california/page_185.html</link>
<description><![CDATA[   Our client in the Greater Sacramento area of CA is currently looking to bring on a BC/BE Family Medicine Physician to join their group.          &nbsp;       Board Certified is preferred but Board ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_california/page_132.html">
<title>Family Practice jobs in &#x22;Greater Sacramento&#x22; - CA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_california/page_132.html</link>
<description><![CDATA[   We have an outstanding opportunity for a BC/BE Family Medicine Physician to join a prestigious facility located in the Greater Sacramento area of CA.          &nbsp;       Board Certified is preferred ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_77.html">
<title>Family Practice jobs in &#x22;Greater Fort Wayne&#x22; - IN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_77.html</link>
<description><![CDATA[   An excellent opportunity exists in Greater Fort Wayne, IN for a BC/BE Family Medicine Physician to join a very well-trained group.          &nbsp;       Board Certified is preferred but Board Eligible ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_alabama/page_6.html">
<title>Family Practice jobs in &#x22;Northern/Suburban&#x22; - AL</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_alabama/page_6.html</link>
<description><![CDATA[ Our very prestigious client in Northern/Suburban AL is currently seeking a LOCUMS Family Medicine Physician to join their group.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_alabama/page_12.html">
<title>Family Practice jobs in &#x22;Northern/Suburban&#x22; - AL</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_alabama/page_12.html</link>
<description><![CDATA[ Our very prestigious client in Northern/Suburban AL is currently seeking a LOCUMS Family Medicine Physician to join their group.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_130.html">
<title>Family Practice jobs in &#x22;Greater Buffalo&#x22; - NY</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_york/page_130.html</link>
<description><![CDATA[ Our client in the Greater Buffalo area of NY has an excellent LOCUMS opportunity available for a BC/BE Family Medicine Physician.   &nbsp;   Board Certified is preferred but Board Eligible will be accepted. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_ohio/page_41.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - OH</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_ohio/page_41.html</link>
<description><![CDATA[Permanent Family Practice Job in Ohio's Heartland! Join a hospital employed group with the option of either an outpatient only practice or combination in and outpatient practice. This community has recently ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_98.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - IN</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_indiana/page_98.html</link>
<description><![CDATA[A facility in northwest Indiana seeks a permanent Board Certified or Board Eligible physician who specializes in FP to begin as soon as possible. Occ Med experience is a plus! You will be providing occupational ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_illinois/page_94.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - IL</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_illinois/page_94.html</link>
<description><![CDATA[A multi-specialty group is in need of a Family medicine physician located in the Campaign, Illinois area. Qualified candidates must be Board Certified in Family Practice unless recently out of residency ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_wyoming/page_15.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - WY</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_wyoming/page_15.html</link>
<description><![CDATA[A rural community in Wyoming is seeking immediate and ongoing coverage for their free-standing Emergency Department/Clinic (Level IV designated trauma facility). You'll be scheduled Monday through Friday ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_washington/page_67.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - WA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_washington/page_67.html</link>
<description><![CDATA[Our client in Tacoma, WA seeks to hire a permanent primary care physician for their new clinic. Candidates must be licensed to practice medicine in Washington and be Board Certified or Board Eligible ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_georgia/page_13.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - GA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_georgia/page_13.html</link>
<description><![CDATA[A clinic in central Georgia seeks to hire an employed Family Practitioner. Candidates must be board certified or board eligible in Family Practice with an active Georgia medical license. This is a traditional ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_michigan/page_64.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - MI</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_michigan/page_64.html</link>
<description><![CDATA[A locum tenens physician is needed to perform primary care services at a Native American owned clinic in Michigan. The assignment will begin immediately and will continue for a minimum of three months ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_4.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - PA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_4.html</link>
<description><![CDATA[A medical center located in an affluent college town in north central Pennsylvania seeks locum tenens coverage in the specialty of Hospitalist with preferred residency training in Family Medicine. Internal ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_arizona/page_23.html">
<title>Family Practice jobs in &#x22;NW of Phoenix&#x22; - AZ</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_arizona/page_23.html</link>
<description><![CDATA[   An outstanding opportunity exists Northwest of Phoenix, AZ for two BC/BE Family Medicine Physicians to join a very well-trained group.           &nbsp;        Board Certified is preferred but Board ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_montana/page_47.html">
<title>Family Practice jobs in &#x22;Not Disclosed&#x22; - MT</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_montana/page_47.html</link>
<description><![CDATA[Our client in Western Montana, about 40 minutes from Helena, is looking to add a permanent, experienced ER physician who is board certified in Family Practice. (Board eligible within 1 year considered). ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_25.html">
<title>Family Practice jobs in &#x22;West/Central&#x22; - PA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_25.html</link>
<description><![CDATA[ &nbsp;   We have an outstanding opportunity for you to come join a solo hospital based practice. in the West/Central area of PA as a BC/BE Family Medicine Physician.   &nbsp;   Board Certified is preferred ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_16.html">
<title>Family Practice jobs in &#x22;West/Central&#x22; - PA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_16.html</link>
<description><![CDATA[ &nbsp;   We have an outstanding opportunity for you to come join a solo hospital based practice. in the West/Central area of PA as a BC/BE Family Medicine Physician.   &nbsp;   Board Certified is preferred ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_ohio/page_32.html">
<title>Family Practice jobs in &#x22;Brown County&#x22; - OH</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_ohio/page_32.html</link>
<description><![CDATA[  Exciting Opportunity for a Family Practice Physician only  One Hour to Cincinnati, Ohio!       We are looking for a physician to help rebuild an  outpatient practice  that recently had a major change ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_96.html">
<title>Family Practice jobs in &#x22;Philadelphia&#x22; - PA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_pennsylvania/page_96.html</link>
<description><![CDATA[ Hello Dr,   I have a client in Philly with a locums opportunity starting the end of Jan ongoing.   They are in need of an FP or an IM   20ppd   Outpatient   M-F   8-5   Manuel&nbsp;charting   EMR will ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_jersey/page_22.html">
<title>Family Practice jobs in &#x22;Northwestern&#x22; - NJ</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_new_jersey/page_22.html</link>
<description><![CDATA[  We have a great opportunity for a BC/BE Family Medicine Physician in a suburban setting located in Northwestern, NJ.         &nbsp;      Board Certified is preferred but Board Eligible will be accepted. ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_arizona/page_37.html">
<title>Family Practice jobs in &#x22;Near Phoenix&#x22; - AZ</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_arizona/page_37.html</link>
<description><![CDATA[     We have a need for ongoing locums coverage starting in January for an outpatient clinic in Arizona.           Facility is only an hour and a half drive from Phoenix.         Can pay 75.00 an hour ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_michigan/page_52.html">
<title>Family Practice jobs in &#x22;Confidential&#x22; - MI</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_michigan/page_52.html</link>
<description><![CDATA[Barton Associates has an  ongoing locum tenens family medicine position in Michigan  from mid December until April. The locum tenens family practice doctor will work Monday to Saturday 8am to 8pm and ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_oregon/page_73.html">
<title>Family Practice jobs in &#x22;Southwestern&#x22; - OR</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_oregon/page_73.html</link>
<description><![CDATA[    We have a great opportunity for you to come join a well-established facility located in the Southwestern area of OR as a IM Family Medicine Physician.             &nbsp;         Board Certified is ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_iowa/page_3.html">
<title>Family Practice jobs in &#x22;Confidential&#x22; - IA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_iowa/page_3.html</link>
<description><![CDATA[Barton Associates has a  locum tenens family medicine position in Iowa  on an ongoing basis beginning in December. The locum tenens family practice doctor will work one full day and three afternoons three ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_54.html">
<title>Family Practice jobs in &#x22;Northern&#x22; - VA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_54.html</link>
<description><![CDATA[ I am working with a client in Virginia that has Locum Tenens coverage needs 3/31/12 to 4/8/12; 5/31/12 to 6/11/12 and 7/27/12 to 7/28/12.&nbsp; These dates are for vacation coverage.&nbsp; The need is ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_25.html">
<title>Family Practice jobs in &#x22;Northern&#x22; - VA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_25.html</link>
<description><![CDATA[ I am working with a client in Virginia that has Locum Tenens coverage needs 3/31/12 to 4/8/12; 5/31/12 to 6/11/12 and 7/27/12 to 7/28/12.&nbsp; These dates are for vacation coverage.&nbsp; The need is ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_48.html">
<title>Family Practice jobs in &#x22;Southern&#x22; - VA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_48.html</link>
<description><![CDATA[ I am working with a client in Virginia that has a Family Practice opportunity starting ASAP-ongoing.&nbsp; The clinic hours are 7am to 7pm, Monday-Friday.&nbsp; The average number of patients per day ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_8.html">
<title>Family Practice jobs in &#x22;Virginia&#x22; - VA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_virginia/page_8.html</link>
<description><![CDATA[Northern VA facility is currently looking to add one more family medicine physician to a group of 3. The new physician will see roughly 15-20 patients per day and good mix of all age groups. The office ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_montana/page_10.html">
<title>Family Practice jobs in &#x22;FP 53851&#x22; - MT</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_montana/page_10.html</link>
<description><![CDATA[Big Sky Country Loan Repayment Available  Up to $100k Low Cost of Living with Salary up to the 65th Percentile   Join a practice where your skills will be highly rewarded!  &nbsp;&nbsp;&nbsp; Competitive ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_california/page_114.html">
<title>Family Practice jobs in &#x22;FP 24817&#x22; - CA</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_california/page_114.html</link>
<description><![CDATA[ NORTHERN CALIFORNIA COAST  FAMILY MEDICINE  100% OUTPATIENT           A Full Practice awaits you - consider the following       Enjoy a collegial work environment with outstanding support staff    Established ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_nevada/page_22.html">
<title>Family Practice jobs in &#x22;Northern&#x22; - NV</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_nevada/page_22.html</link>
<description><![CDATA[           A fast-growing multi-specialty group located in Northern, NV is looking to bring on a BC/BE Family Medicine Physician to join their group.           &nbsp;       Board Certified is preferred ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_maine/page_31.html">
<title>Family Practice jobs in &#x22;Northern&#x22; - ME</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_maine/page_31.html</link>
<description><![CDATA[  I am working with a client in Maine that has a Family Practice opportunity starting ASAP-ongoing. &nbsp;  This need is 100% outpatient. &nbsp;  The clinic hours are Monday-Friday, 8:00 am to 5:00 pm. ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_alaska/page_3.html">
<title>Family Practice jobs in &#x22;Cordova&#x22; - AK</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_alaska/page_3.html</link>
<description><![CDATA[ Hello Dr.   I have an opportunity for an FP with ER experience. The need is from March 14th thru April 16th M T W 8-5 Thurs Administrative day 8-12 ppd in clinic ER call on Sats Must be within 15 min ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_montana/page_53.html">
<title>Family Practice jobs in &#x22;Eastern&#x22; - MT</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_montana/page_53.html</link>
<description><![CDATA[   I am working with a client in Eastern Montana that has a Family Practice starting ASAP-ongoing.            &nbsp;        BC/BE          &nbsp;        This is 100% outpatient.           &nbsp;      ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_north_carolina/page_41.html">
<title>Family Practice jobs in &#x22;Raleigh&#x22; - NC</title>
<link>http://www.physemp.com/physician_jobs/all_family_practice_jobs_in_north_carolina/page_41.html</link>
<description><![CDATA[   Amazing Opportunity for a Family Practice Physician in Beautiful Raleigh/Durham North Carolina!&nbsp;          Youll join an established  outpatient family practice  looking to add a physician due ]]></description>
</item>

<item rdf:about="http://www.docnotes.com/2011/12/12-years-of-bloggin-about-medicine-technology-and-the-intersection.html">
<title>12 years of blogging .. about medicine, technology and their intersection ...</title>
<link>http://www.docnotes.com/2011/12/12-years-of-bloggin-about-medicine-technology-and-the-intersection.html</link>
<description><![CDATA[This post from November 26th, 1999 - was the first on this blog. There were a few months of previous posts, but due to several platform changes back then - these seem to be lost. No matter. 12 years is...]]></description>
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<item rdf:about="http://www.docnotes.com/2011/10/on-platforms-.html">
<title>On Platforms .. </title>
<link>http://www.docnotes.com/2011/10/on-platforms-.html</link>
<description><![CDATA[This is one of the best essays on software product definition/ direction etc. that I've read in a very long time.]]></description>
</item>

<item rdf:about="http://www.docnotes.com/2011/09/prevent-spam-marathon-fundraising.html">
<title>PREVENT SPAM! - Marathon Fundraising</title>
<link>http://www.docnotes.com/2011/09/prevent-spam-marathon-fundraising.html</link>
<description><![CDATA[I'm sending out the following e-mail to my friends and family on Monday. You can prevent this spam .. (I'm learning from Public Radio!) .. but only if you make a generous donation TODAY! Don't put it off! .. -----------...]]></description>
</item>

<item rdf:about="http://www.docnotes.com/2011/08/oesh-running-shoe-review.html">
<title>Oesh Running Shoe Review</title>
<link>http://www.docnotes.com/2011/08/oesh-running-shoe-review.html</link>
<description><![CDATA[Oesh (shoe spelled sideways and backwards) had gotten some good press lately. I've read a handful of Casey Kerrigan's papers on gait and movement - so my interest was piqued when I learned that she and her husband had created...]]></description>
</item>

<item rdf:about="http://www.docnotes.com/2011/08/google.html">
<title>Google+</title>
<link>http://www.docnotes.com/2011/08/google.html</link>
<description><![CDATA[So I'm trying out google+ for blog posting today. Today's post]]></description>
</item>

<item rdf:about="http://www.docnotes.com/2011/07/health-it-workforce-curriculum-initial-impression-c.html">
<title>Health IT Workforce Curriculum - initial impression</title>
<link>http://www.docnotes.com/2011/07/health-it-workforce-curriculum-initial-impression-c.html</link>
<description><![CDATA[I've spent a number of hours today reviewing the ONC HIT Workforce Curriculum materials, and since I've seen many tweets referencing them .. I've seen little substantive narrative on their value - so I'll offer a bit here - with...]]></description>
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<item rdf:about="http://www.docnotes.com/2011/07/compliance.html">
<title>&#x22;compliance&#x22;</title>
<link>http://www.docnotes.com/2011/07/compliance.html</link>
<description><![CDATA[This post on the-blog-that-used-to-be-kevin's-blog (alas, Kevin Pho writes rather few posts these days) ... is accurate, but I wish that the medical community was saying the same thing. In general - we are not. Patients who have guts will say...]]></description>
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<item rdf:about="http://www.docnotes.com/2011/06/google-health-was-a-dumb-idea-anyway-.html">
<title>Google Health Was a Dumb Idea Anyway ...</title>
<link>http://www.docnotes.com/2011/06/google-health-was-a-dumb-idea-anyway-.html</link>
<description><![CDATA[It's been nearly a week since the big announcement and I've read a herd of thoughtful reviews of why google decided to shutter their health experiment. But I've not yet seen anyone say what was obvious from the outset: It...]]></description>
</item>

<item rdf:about="http://www.docnotes.com/2011/06/health-it-tweeting-blogging.html">
<title>Health IT Tweeting &#x26; Blogging</title>
<link>http://www.docnotes.com/2011/06/health-it-tweeting-blogging.html</link>
<description><![CDATA[I've been blogging for a very long time. Tweeting since before Twitter had an "e" .. (it was called twittr) .. Blogging since Blogger was just a little feature of a long-dead product called Pyra. Raise your hand if you...]]></description>
</item>

<item rdf:about="http://www.docnotes.com/2011/06/inbox-management-the-healthcare-version-1.html">
<title>Inbox Management:  The Healthcare Version</title>
<link>http://www.docnotes.com/2011/06/inbox-management-the-healthcare-version-1.html</link>
<description><![CDATA[Mitch Joel's posting: "5 Ways to survive your inbox" describes a set of habits one might use to maintain control: Create folders. Create rules. Get it done. Create a hierarchy of response. Tell people - in your emails - how...]]></description>
</item>

<item rdf:about="http://medpundit.blogspot.com/2008/01/years-end-blogs-end-ive-been-making-my.html">
<title></title>
<link>http://medpundit.blogspot.com/2008/01/years-end-blogs-end-ive-been-making-my.html</link>
<description><![CDATA[Year's End, Blog's End: I've been making my annual year end inventory - deciding what to keep and what to toss. It's become obvious in the past several months that this blog is one of the things that it's time to toss. This will be the last post for Medpundit.  Truly.  Wishing you all the best in 2008 and the years beyond.Click to enlarge]]></description>
</item>

<item rdf:about="http://medpundit.blogspot.com/2007/11/pilgrim-medicine.html">
<title>Pilgrim Medicine</title>
<link>http://medpundit.blogspot.com/2007/11/pilgrim-medicine.html</link>
<description><![CDATA[Thanksgiving Remembrance: Mayflower Medicine.]]></description>
</item>

<item rdf:about="http://medpundit.blogspot.com/2007/11/genetic-prejudice.html">
<title>Genetic Prejudice</title>
<link>http://medpundit.blogspot.com/2007/11/genetic-prejudice.html</link>
<description><![CDATA[Any Excuse Will Do: Any excuse to justifying prejudice, or to stir up fear mongering of what may come: At the same time, genetic information is slipping out of the laboratory and into everyday life, carrying with it the inescapable message that people of different races have different DNA. Ancestry tests tell customers what percentage of their genes are from Asia, Europe, Africa and the Americas. The heart-disease drug BiDil is marketed exclusively to African-Americans, who seem genetically predisposed to respond to it. Jews are offered prenatal tests for genetic disorders rarely found in other ethnic groups.Such developments are providing some of the first tangible benefits of the genetic revolution. Yet some social critics fear they may also be giving long-discredited racial prejudices a new potency. The notion that race is more than skin deep, they fear, could undermine principles of equal treatment and opportunity that have relied on the presumption that we are all fundamentally equal."We are living through an era of the ascendance of biology, and we have to be very careful," said Henry Louis Gates Jr., director of the W. E. B. Du Bois Institute for African and African American Research at Harvard University. "We will all be walking a fine line between using biology and allowing it to be abused."We have been living in an era of ascendant biology since Darwin. Remember eugenics? Jews have been offered prenatal testing long before the mapping of the human genome, as have African-Americans. But prenatal screening is not quite the same as the eugenics movement heyday. So why the hyperventilating? It turns out that the Times is taking its cue from blogs commenting on studies studies like this. Well, if the blogs say that genetics justifies prejudice, it must be true! I never thought I would see the day that the New York Times took that attitude on its front pages. It must be part of their plan to join the internet age. Here's the part that's gotten the Times convinced that genetics is going to bring back the days of institutionalized prejudice:There exists a publicly available gene database, The HapMap Project, that contains random samples of genetic sequences from people in China, Japan, Nigeria, and people in the United States with European ancestry. It’s now possible to search the HapMap database for genes that have been linked with intelligence in published scientific studies. In this manner, we can determine if high intelligence genes occur with greater or lesser frequency in the various races.Now, here’s an interesting point. If even a single gene correlated with intelligence occurs with different frequencies in the different races, this alone proves that there are racial differences in intelligence. How is that? Well, the egalitarian theory holds that every race has identical intelligence. Therefore, whatever genes there are that affect intelligence, they must be distributed exactly equally in all human races. Once even a small race difference is proven, the egalitarian theory is proven false. At that point, it’s only a matter of determining which race has the higher average intelligence based on the genetic evidence.Oh, please. Here's a take home lesson for everyone on the science of genetics, and one that should never be forgotten - these studies are about associations of genes with traits, not the concrete coding of a trait by a given gene. Just because a locus on a chromosome can be found more often in people with schizophrenia than in the general population doesn't mean that everyone with that genetic code in that spot will have schizophrenia, anymore than it means that every sibling of a schizophrenic will have the disease. Ditto with intelligence. Ditto, too, with cancer risks and most other traits and diseases human genome mapping is linking to genes. The essence of a man is not written into his DNA. Here's another important point to remember - our science is still young and uncertain:These genomewide association studies have been able to examine interpatient differences in inherited genetic variability at an unprecedented level of resolution, thanks to the development of microarrays, or chips, capable of assessing more than 500,000 single-nucleotide polymorphisms (SNPs) in a single sample. This "SNP-chip" technology capitalizes on a catalogue of common human genetic variations that is provided by the HapMap Project, which was made possible by the completion of the consensus human-genome sequence.......The main problem with this strategy is that, because of the high cost of SNP chips, most studies are somewhat constrained in terms of the number of samples and thus have limited power to generate P values as small as 10–7. In addition, most variants identified recently have been associated with modest relative risks (e.g., 1.3 for heterozygotes and 1.6 for homozygotes), and many true associations are not likely to exceed P values as extreme as 10–7 in an initial study. On the other hand, a "statistically significant" finding in an underpowered study is more likely to be a false positive result due to chance than is such a finding in an adequately powered study, and "statistically significant" associations could be attributable to systematic bias (e.g., from confounding due to ethnic ancestry, also known as population stratification). Thus, the sine qua non for belief in any specific result from a genomewide association study is not the strength of the P value in the initial study, but the consistency and strength of the association across one or more large-scale replication studies. Robust replication should permit the identification of true positive results and the weeding out of false positive results.In other words, take these genome studies that link intelligence and race just as about as seriously as you would take studies linking intelligence to sex, or that predict elections with brain scans.UPDATE: Best of the Web draws an important distinction:Note that "the presumption that we are all fundamentally equal" is quite different from the notion "that all races are equal." The former is a moral principle, a premise about the basic dignity of every individual; the latter is an empirical presumption about group averages in measurable traits. Someone with an IQ of 80 is as human as someone with an IQ of 120; and this is so regardless of whether the average IQ of one race is different from that of another.What worries people like those in the Times story is that racial differences in IQ or other traits seem to lend empirical support to racist theories. But those theories are qualitatively wrong, so that no empirical evidence could make them right. If all individuals are of equal dignity and worth regardless of IQ, then a group is not fundamentally superior or inferior to another group by virtue of differences in average IQ.It seems that some very smart people mistakenly think that intelligence is a measure of fundamental worth. Maybe they're a little too impressed with their own brilliance.]]></description>
</item>

<item rdf:about="http://medpundit.blogspot.com/2007/11/in-remembrance-winged-victory-veterans.html">
<title>Veteran&#x27;s Day Remembrance</title>
<link>http://medpundit.blogspot.com/2007/11/in-remembrance-winged-victory-veterans.html</link>
<description><![CDATA[In Remembrance: Winged VictoryVeteran's Day movie recommendation - Wooden Crosses.Veteran's Day medical reading - the influence of World War I on heart surgery.]]></description>
</item>

<item rdf:about="http://medpundit.blogspot.com/2007/11/word-about-mrsa.html">
<title>A Word About MRSA</title>
<link>http://medpundit.blogspot.com/2007/11/word-about-mrsa.html</link>
<description><![CDATA[A Word About MRSA: I've been fielding a lot of doorknob questions about MRSA lately. (Doorknob questions= questions thrown out just as my hand reaches the doorknob to leave the room.) Little wonder. It's been in the news again and again, and has even prompted the closing of schools and cancelling of football games. Despite what some editorialists say, it is being framed as a threat to our children. Here's an example of the typical coverage: A 16-year-old Springfield High School junior remained in serious condition Friday in the intensive-care unit of Akron Children's Hospital with a drug-resistant staph infection.  Michael Forester of Lakemore was hospitalized Oct. 24 and was to undergo surgery Friday, said his mother, Mary Baxter.  "The more prayers I can get, the better," Baxter said Friday at the hospital.  On Wednesday, Springfield School Superintendent William Stauffer, in a letter sent to parents, acknowledged that a student had become ill and was admitted to the hospital.  The superintendent said rumors that the student has a contagious disease that puts other students at risk and that the high school has an ongoing problem with staph infections are not true.  Stauffer could not be reached for comment Friday.What is this MRSA? A better question might be "What is SA"? The "SA" in MRSA is Staphylococcus aureus, a bacteria that resides in our nasal passages and skin. That is its habitat. Normally, it causes us no problem, but if conditions are right, it can make us quite ill. It's often the culprit behind boils and styes and cellulitis and urinary tract infections. It can also cause more serious infections such as pneumonia (as in the case of the young man in the linked to article above), meningitis, sepsis, endocartditis, and osteomyelitis. It is one of the most common causes of sepsis. Penicillin conquered Staph infections for a little while, but the bacteria acquired resistance within a few years of the antibiotic's introduction. When penicillin became widely used in the community, the population of Staph aureus living in noses and on skin shifted toward those containing an enzyme that could cut the betalactam ring on penicillin, rendering it ineffective.  New antibiotics were developed to get around this. One of those antibiotics was methicillin, which brings us to the "MR" part of "MRSA". We don't use methicillin any longer. We use drugs like Augmentin instead. But, when we say that a Staph aureus infection is "methicillin resistant" we mean that it's resistant to all penicillins, even those that were developed to get around the betalactam-eating defenses of the Staph aureus population. This doesn't mean that it's resistant to all antibiotics, however, just the ones that we typically use for a Staph infections. In the hospital, we often use vancomycin for MRSA infections. In the outpatient setting, we use drugs like Bactrim and clindamycin. In most cases, the infections respond nicely to these drugs. There is, however, concern that the bacteria may one day develop resistance to these, too, as we use them more to treat the growing resistant population of Staph. So here are the take home points about MRSA:1) It isn't running amok in our schools like the blob or killer tomatoes. It's living on our skin and nasal passages just as it always has before it developed resistance to penicillin and its cousins.2) One of the reasons bacteria acquire resistance is because we expose them to antibiotics when we don't need to. Don't insist on an antibiotic for every runny nose, even if the snot is yellow. And don't insist on one of the special antibiotics for MRSA for every pimple or pustule or red scratch. If we overuse our remaining effective antibiotics, we'll only end up with a population of Staph aureus that is resistant to those, too.3) Don't freak out if you or your child develops a skin infection. Most staph infections are easily treatable. Even most MRSA infections are easily treatable.4) When you read the newspaper, always remember that they lean to the dramatic in all things. It makes for more entertaining reading.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/11/trusty-dentist.html">
<title>Trusty Dentist</title>
<link>http://medpundit.blogspot.com/2007/11/trusty-dentist.html</link>
<description><![CDATA[Trusty Dentist: Not so trusty with music and a drill.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/11/all-saints-medical.html">
<title>All Saints Medical</title>
<link>http://medpundit.blogspot.com/2007/11/all-saints-medical.html</link>
<description><![CDATA[All Saints' Day: A list of medical saints - albeit an incomplete one.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/11/lipo-etching.html">
<title>Lipo-Etching</title>
<link>http://medpundit.blogspot.com/2007/11/lipo-etching.html</link>
<description><![CDATA[Forever Young, Forever Firm: Lipo-etching- maybe not all it's cracked up to be.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/11/statistics-politics-and-medicine.html">
<title>Statistics, Politics, and Medicine</title>
<link>http://medpundit.blogspot.com/2007/11/statistics-politics-and-medicine.html</link>
<description><![CDATA[Lies, Damned Lies, and, Well, You Know: The New York Times is parsing Rudy Guiliani's prostate cancer statitistics:"I had prostate cancer five, six years ago," Mr. Giuliani, a Republican presidential candidate, said in a speech that has been turned into the radio commercial. "My chance of surviving prostate cancer — and, thank God, I was cured of it — in the United States? Eighty-two percent. My chance of surviving prostate cancer in England? Only 44 percent under socialized medicine.".... The Office for National Statistics in Britain says the five-year survival rate from prostate cancer there is 74.4 percent. And doctors also say it is unfair to compare prostate cancer statistics in Britain with those in the United States because in the United States the cancer is more likely to be diagnosed in its early stages."Certainly, if you intensively screen for prostate cancer, you will find early disease,” said Dr. Ian M. Thompson, chairman of the department of urology at the University of Texas at San Antonio. "And simply because you find it earlier, you will always have longer survival after the disease is diagnosed."One reason that prostate cancer is diagnosed earlier in the United States than in Britain is that they don't screen for it at all in Britain - at least not at the expense of the NHS. (Which is one of the reasons they spend less on healthcare than the United States. They don't indulge in as much screening as we do.) At any rate, his statistics don't appear to be all that far off the mark, at least for men in their 80's. But even the NHS admits that prostate cancer survival is increasing because more people are starting to have their PSA checked - meaning that slow growing early cancers are being added to the mix, just as happens here in the US. As it happens, even back in 2002, the five year survival rate for prostate cancer in the US was 99% - still a much better figure than the UK's 71%. But, as the astute bloggers point out, prostate cancer isn't the best example of the benefits of screening. Prostate cancer is, in most cases, slow growing - and although our screening policies detect many early cancers that would never do harm if left undetected, we also end up spending a lot more money treating these same cancers. When given the choice between watchful waiting and removal, many choose removal. (Another reason why we end up spending more and being less healthy in surveys like this.) But the Astutes take a closer look at cancer in England and cancer in the US:See this report, entitled "Cancer Survival Rates Improving Across Europe, But Still Lagging Behind United States" (and remember that England's rates, not broken out, are among the worst in Europe).Taking recent figures, female five-year cancer survival rates are 62.9 per cent on average in the US and 52.7 per cent in England. To compare America's privately insured with England's NHS patients, you'd need to bump up that American survival rate a bit (the uninsured most likely have lower survival rates--otherwise why worry about universal coverage) and bump down the English one (because some Brits have private insurance, and so buy better care).Nationally, American cancer survival rates are significantly better. Certainly not by the 40-point margin Giuliani implied, but still.Looks like the truth is somewhere between Rudy and the Times.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/eliminating-cold-medicine.html">
<title>Eliminating Cold Medicine</title>
<link>http://medpundit.blogspot.com/2007/10/eliminating-cold-medicine.html</link>
<description><![CDATA[Take Some Tylenol and Call Me in the Morning: What will we do without cough and cold medicine? I can hear it now, that familiar refrain - "Tylenol doesn't do anything." And it doesn't, at least not for runny noses, sneezes, and coughs, despite what the expert says:Children’s Tylenol and Children’s Motrin, when sold by themselves, were excluded from the discussions because the medicines in those products, acetaminophen and ibuprofen, respectively, are safe and effective in treating fevers and aches even in young infants.Tylenol and Motrin are sold in syrupy concoctions that help coughs because the syrup coats the back of the throat and calms cough receptors, said Dr. Ian Paul, a pediatrician at Penn State Children’s Hospital in Hershey, Pa., who consults for industry.The committee skipped any lengthy discussion of antihistamines like Benadryl, because there is little debate that such medicines are effective for allergies. Benadryl, also known as diphenhydramine, also puts some children to sleep. But nearly all the experts said deliberate sedation should be discouraged.The medicines that earned the most scorn were those commonly sold to treat coughs, runny noses and congestion, including dextromethorphan and phenylephrine.None of them have any proven effect on children’s cold symptoms. All have risks.The advisory panel is right, however, about the effectiveness of the medications. They are effective mostly in that they give a parent something to do so they don't feel as if they're standing by while their child suffers. The number of children injured by the drugs, however, has been exceedingly small:A study by the Centers for Disease Control and Prevention found that at least 1,519 children younger than 2 had serious health problems from 2004 to 2005 after having been treated with common cold medicines. Three children died, the disease control agency found.But the argument is, that if they don't do any good in the first place, then why tolerate any risk? But, according to this story, the pharmaceutical companies say the issue is accidental overdosage, not inherent risk in properly dosed drugs:The Consumer Healthcare Products Association (CHPA), which represents manufacturers and distributors of over-the-counter medicines, said in a statement: "The data clearly show that these medicines are very safe when used as directed and that harm to this age group, while very rare, is attributable in most cases to accidental ingestion an issue of safekeeping that is best addressed through education."So what to do? My recommendation would be not to use them. Runny noses and coughs aren't in the category of intolerable suffering, and these products aren't likely to be much benefit anyway.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/screening-for-autism.html">
<title>Screening for Autism</title>
<link>http://medpundit.blogspot.com/2007/10/screening-for-autism.html</link>
<description><![CDATA[I Screen, You Screen: The American Academy of Pediatrics is recommending that all children be screened for autism. They've only press-released their recommendations, however, so it's difficult to assess them. Wouldn't it be nice if professional organizations actually released their recommendations to their members before they did so to the public? It would make it so much easier for doctors to discuss the news stories with their patients. They're releasing them today at their annual conference, and later in the November issue of their journal, which is not yet available online. (Though it may be in AAP member's mailboxes.) Part of any well child visit is screening for developmental delays, so one has to wonder what's different about these recommendations. Are they setting lower limits for what's abnormal so that those mild cases of autism (which some argue aren't really autism or even disease) can be treated? If that's the case, then don't be surprised when a couple of years from now there's a upward spike in the number of cases of autism. And don't blame it on vaccines.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/magnet-free-europe.html">
<title>Magnet-Free Europe</title>
<link>http://medpundit.blogspot.com/2007/10/magnet-free-europe.html</link>
<description><![CDATA[Magnet-Free Europe: For some reason, the EU was proposing severe restrictions on the use of MRI scans, a proposal which has been halted- for now. Here's the reasoning behind the original restrictions:The Directive was drafted by DG Employment, with the aim of minimising workers’ exposure to electromagnetic fields (EMF). Currently eight million MRI patient examinations per year are carried out in Europe, said Professor Dag Rune Olsen, who works in experimental radiation therapy at the Norwegian Radiation Hospital, Oslo, Norway, and is chairman of the physics committee of the European Society for Therapeutic Radiology and Oncology (ESTRO). “But these are likely to have to stop, since the Directive sets limits to occupational radiation exposure which will mean that anyone working or moving near MRI equipment will breach them, thus making it possible for them to sue their employers. Even those maintaining or servicing the equipment may be affected,” he said.Radiation exposure? MRI's don't emit radiation, they detect the magnetic spin of atoms. The EU is worried that workers will be mesmerized by the MRI's. Sally Szwarc has more.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/spooky-skulls.html">
<title>Spooky Skulls</title>
<link>http://medpundit.blogspot.com/2007/10/spooky-skulls.html</link>
<description><![CDATA[Spooky Skulls:Spooky brain pictures. Background here.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/preventing-alzheimers.html">
<title>Preventing Alzheimer&#x27;s</title>
<link>http://medpundit.blogspot.com/2007/10/preventing-alzheimers.html</link>
<description><![CDATA[Of Mice and Mazes: Do high blood pressure medications prevent Alzheimer's? They do in mouse brains - in test tubes and in mazes:The researchers then tested Diovan in mice that were genetically at risk for Alzheimer's disease.Some of the mice drank water laced with Diovan. Their Diovan dose was lower than that used for people with high blood pressure.For comparison, other mice got ordinary water without Diovan.After drinking their assigned water for 11 months, the mice took a memory test in which they had to learn and remember the path through a watery maze.The mice that drank the Diovan water fared best in the maze test.But when the researchers tested mice without the dementia gene glitch, Diovan treatment didn't help or hurt the mice navigate the watery maze. We'll have to wait a while to see how this pans out. What works on mice in mazes doesn't necessarily work on men in mazes.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/in-error.html">
<title>In Error</title>
<link>http://medpundit.blogspot.com/2007/10/in-error.html</link>
<description><![CDATA[Errors, Errors: The sad story of a medical error and learning to deal with errors.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/inspiring-lives.html">
<title>Inspiring Lives</title>
<link>http://medpundit.blogspot.com/2007/10/inspiring-lives.html</link>
<description><![CDATA[Inspiring Lives: Speaking of the supreme champion of eugenics, here's an inspiring story from the days of his reign.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/medical-sci-fi-contest-please-meet.html">
<title>Medical Sci-Fi Contest: Please Meet the Winner! - Medgadget - www.medgadget.com</title>
<link>http://medpundit.blogspot.com/2007/10/medical-sci-fi-contest-please-meet.html</link>
<description><![CDATA[Medical Science Fiction: Late to the party, but here are the winners of Medgadget's Medical Sci-Fi Contest. Enjoy.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/eugenics-past-and-present.html">
<title>Eugenics Past and Present</title>
<link>http://medpundit.blogspot.com/2007/10/eugenics-past-and-present.html</link>
<description><![CDATA[Eugenics Past and Present: I've been reading an essay from 1907 by David Starr Jordan, a great mind of his time - scientist, peace activist, president of Standford, and eugenicist. The essay is the The Human Harvest, an anti-war argument grounded in eugenics. From a eugenics perspective, wars are bad because they kill the best men, leaving behind the weakest to perpetuate the race- and weaken the human harvest.  Even in the service of a profound good the the callousness and cruelty of eugenics:Startling results may follow from the selective breeding and preservation of paupers. In the valley of Aosta in northern Italy, and in other Alpine regions, is found the form of idiocy known as cretinism. What is the primitive cause of the cretin, and what is the causal connection of cretinism with goiter, a disease of the thyroid glands which always accompanies it, I do not know.It suffices for our purpose to notice that the severe military selection which ruled in Switzerland, Savoy, and Lombardy for many generations took the strongest and healthiest peasants to the wars, and left the idiot and goitrous to carry on the affairs of life at home. To bear a goiter was to be exempt from military service. Thusin some regions the disease has been a local badge of honor. It is said that when iodine lozenges were given to the children of Savoy in the hope of preventing the enlargement and degeneration of the thyroid gland, mother would take this remedy away from the boys, preferring the goiter to military service.In the city of Aosta the goitrous cretin has been for centuries an object of charity. There is a special hospice or asylum devoted to his care and propagation. The idiot has received generous support, while the poor farmer or laborer with brains and no goiter has had the severest of struggles. In the competition of life a premium has thus been placed on imbecility and disease. The cretin has mated with the cretin, the goiter with the goiter, and charity and religion have presided over the union. The result is that idiocy is multiplied and intensified. The cretin of Aosta has been developed as a new type of man. In fair weather the roads about the city a re lined with these awful paupers - human beings with less intelligence than the goose, with less decency than the pig.No acknowledgment that those cretins might have even a glimmer of a soul. The disabled are genetically impure. Eugenics caught up with the goitrous of Aosta. They were forbidden to marry and ceased to be a pollute the public streets. They also became a celebrated example of the power of eugenics to improve the human harvest public health. Many an American eugenicist cited the success of Aosta in ridding itself of goitrous cretins when advocating state eugenic boards.David Jordan Starr must have been horrified by World War I and it's toll on the best and brightest. he died in 1931, before the supreme triumph of eugenics in Europe. No doubt, he would have argued that eugenics was misused in Europe precisely because the best men had all perished on the battlefields of World War I. But the problem with eugenics is its denial of the humanity of those it deems unworthy - whether they be cretins or those with seizure disorders (they were sterlized, too, under the compulsory sterilization laws) or Jews.Science (and society) has pretty much given up on the old fashioned eugenics that relied on controlling reproduction the same way one would in plants or livestock. But we still flirt with eugenics using modern methods of  RichardDawkins.net>genetic selection. It might not seem like eugenics because it isn't imposed by the state, but it is. It may be framed as a personal choice, but the end result is the same - to cull those deemed inferior or undesirable. Today prospective parents can prevent a Down's syndrome child from being born, or a child with cystic fibrosis. Tomorrow they may be able to de-select the hyperactive child or the child prone to depression.  It seems like such a positive thing when framed as a personal choice that improves the life of a family, but is it good to kill off certain traits? Don't we diminish biological diversity when we do that?]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/micropractice-vs-reality.html">
<title>Micropractice vs. Reality</title>
<link>http://medpundit.blogspot.com/2007/10/micropractice-vs-reality.html</link>
<description><![CDATA[My Long Absence: I have been away too long from the internets and blogosphere. These forced, long absences always leave me a little depressed. But just as I was leaving for a conference in Chicago about a month ago, events forced me into an ideal micropractice. What does that mean? It means I'm short staffed and doing a lot of extra work myself. There are two schools of thought when it comes to the business of running a medical practice. The conventional wisdom is that it's a waste of a doctor's productivity to do the small things - rooming a patient, getting the vital signs, giving shots, performing EKG's. It's a better use of resources to have someone else do those things while the doctor concentrates on treating the patient. Some physicians take it even farther - they have ancillary staff take the history and they just concern themselves with the exam and plan. (Not being someone who practices this way, I give them the benefit of the doubt and assume that they confirm that history before acting on it.) In theory, this allows them to see more patients. This is basically my style of practice. Except for this short staffed month.This month, I've been almost practicing the ideal micropractice way. In the ideal micropractice the doctor does everything himself to reduce overhead. At least, that's the original intent, but even the micropractice guru has hired a nurse to help him out.  One of my friends has a micropractice, and she keeps telling me that I do, too, but I don't believe I do. Once you start hiring staff, are you really a micropractice or just a solo practice?The truth of the matter is that micropractices work only for micropopulations. Most people who practice that way limit themselves to 200-500 patients, whereas traditional practices handle 1500-2000. So which is better for the public good? A practice that can treat more patients and provide jobs or one that sees few patients and has no employees?]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/talladega-germs.html">
<title>Talladega Germs</title>
<link>http://medpundit.blogspot.com/2007/10/talladega-germs.html</link>
<description><![CDATA[Talladega Germs: This was some overly cautious and politically foolish advice:NASCAR fans might seem rabid, but are they actually contagious?Getting a hepatitis shot is standard procedure for travelers to parts of Africa and Asia, but some congressional aides were instructed to get immunized before going to Lowe's Motor Speedway in Concord and the racetrack in Talladega, Ala.....Staff who organized the trips advised the NASCAR-bound aides to get a range of vaccines before attending -- hepatitis A, hepatitis B, tetanus, diphtheria and influenza.Some thoughts: 1) It isn't influenza season, so getting a flu shot now to protect you in Alabama for the weekend is useless. (But not a bad idea if you're thinking forward to January or February 2008.) 2) The hepatitis B vaccine is a series of three shots given over six months. They won't be getting much protection from one shot given just before the trip. Unless the staff is travelling to Alabama with the expectation of one night stands and IV drug needle sharing, the hepatitis B vaccine seems a bit superfluous. (Even for international travel, it's only recommended if a person is expected to have contact with blood or the sex industry.) 3) If there's been an outbreak of hepatitis A among food vendors at the race track, then that makes sense, but evidently that isn't the case. 4) Tetanus is everywhere. Always keep your tetanus booster (which comes included with diphtheria) up to date.In defense of Congress, the organizers say that their staffers were going to be visiting hospitals and police stations where they had the potential to be exposed to hepatitis. Maybe. But unless they were planning to subdue the criminal elements and nurse the ill themselves, they didn't really need the shots. As it turns out, what they really needed was carpal tunnel splints:Walker said he hadn't recommended the immunizations, nor were they necessary. He suggested a possible health risk to them was the voluminous notes they took."I'm sure they needed to soak their wrists, they wrote so much," he said.UPDATE: More on the thinking behind the advice:Homeland Security Chairman Bennie Thompson of Mississippi said he never meant to offend or scare anyone about health risks at the races. The measure was advised to provide congressional staff with the same disease protection first responders get, especially as they head out on a series of fact-finding missions around the country."It's not about whether the people have shots. ... Our staffs as they go forward will be going into sterile areas, they will be working in public health facilities, they will be talking to many holding facilities where criminals are being held...."The NASCAR event is just one date, but after that they will be doing a number of things," said Thompson, adding that the World Series and Super Bowl are two other mass gatherings that are going to be researched for readiness.During the trip to North Carolina, staffers were to visit a medical facility with patients at the Lowe's Motor Speedway. They were also set to inspect an empty mobile hospital. After the House physician told Republican staffers that shots were not necessary to go to North Carolina, they didn't get them. Democratic staffers reportedly did.That explains the influenza shots, anyway.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/alzheimers-and-duty.html">
<title>Alzheimer&#x27;s and duty</title>
<link>http://medpundit.blogspot.com/2007/10/alzheimers-and-duty.html</link>
<description><![CDATA[Blessed are the Dutiful: Being a conscientious person prevents Alzheimer's dementia:The Rush University Medical Center in Chicago examined nearly 1,000 Catholic nuns, priests and brothers.Those who rated themselves highly conscientious had an 89% lower risk of Alzheimer's than those who thought they were the least self-disciplined.What do you suppose the term "conscientious" means to a person in holy orders? Does it mean the same to those of us who are non-religious or living in the secular world? To me, conscientious means trying hard not to overlook any detail in a history, physical, lab, or x-ray result. To a nun or brother, it's more likely to mean praying a lot. Not quite the same sort of brain activity.The full text isn't available without a fee, but here's the abstract. The BBC report provides some details, though:None of the participants had dementia when the study started in 1994, but 176 went on to develop the disease.The researchers asked the volunteers to rank themselves on a five-point scale to determine just how conscientious they were. They also carried out medical and neurological tests each year until 2006.The average score on the conscientious test was 34. Those who scored 40 or higher were found to be much less likely to develop Alzheimer's, and had a slower general rate of mental decline than those who scored 28 or lower.When the researchers took into account a combination of risk factors, including smoking, inactivity and limited social connections, they still found that the dutiful people had a 54% lower risk of Alzheimer's compared to people with the lowest scores for conscientiousness. We don't know how significant that "54% lower risk" is, however. It could be the difference between 2 and 1, or between 100 and 50. Take this one with a grain of salt.]]></description>
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<item rdf:about="http://medpundit.blogspot.com/2007/10/wife-factor.html">
<title>The Wife Factor</title>
<link>http://medpundit.blogspot.com/2007/10/wife-factor.html</link>
<description><![CDATA[Intrusive Homelife: Does it matter if a candidate is glued to his wife?The fact is that people inside the Giuliani campaign are appalled at the number of times their candidate has felt compelled to interrupt public appearances to take calls from his wife. The estimate from those in a position to know is that he has taken such calls more than 40 times in the middle of speeches, conferences and presentations to large donors. "If it's a stunt, it's not one coming from him," says one Giuliani staffer. "It's an ongoing problem that he won't take advice on."And in trying to explain his odd behavior, Mr. Giuliani has only dug himself in deeper. On Friday he told David Brody of CBN News that since 9/11, when he and Mrs. Giuliani get on a plane, "most of the time . . . we talk to each other and just reaffirm the fact that we love each other." He admitted he had taken calls from his wife "before in engagements, and I didn't realize it would create any kind of controversy." That's hardly possible. Giuliani staffers say he has been warned over and over again that the phone calls are rude and inappropriate and have alienated everyone from local officials to top donors to close friends.Consider a spring incident in Oklahoma City. Mr. Giuliani spoke twice at the Oklahoma History Center, first at a small private roundtable for $2,300 donors and then to 150 people who donated $500 apiece. Ten minutes into the roundtable, Mr. Giuliani's phone rang. He left the room to take the call, apparently from Mrs. Giuliani, and never returned. The snubbed donors received no explanation. "The people there viewed it as disrespectful and cheesy," says Pat McGuigan, a local newspaper editor who was asked by the Giuliani campaign to moderate the roundtable.An hour or so later, Mr. Giuliani was speaking to the bigger group of donors when his phone rang again. While he spoke with his wife, he invited her to say hello to the assembled crowd. "It was remarkable, and was not viewed by the audience in a positive way," public relations executive Brenda Jones told me.I've been told of many other incidents, from a California fund-raiser to a Florida speech to a gathering with top donors at Bear Stearns in New York. At the Bear Stearns meeting, Mr. Giuliani took a call from his wife and then noting the strained faces of his supporters, he sheepishly tried a joke. "I've been married three times," he explained. "I can't afford to lose another one. I'm sure you understand." (Mr. Giuliani's media office didn't return a call I made to them on Friday afternoon.)This brought back memories of people I've known. There was the doctor who was always a half hour late coming back from lunch (sp
