June 2011

All Stories

Sometimes the treatment is worse than the disease

by | in Conditions | 5 responses

To do nothing is sometimes a good remedy. -HippocratesEdna Frost is 88 years old, a slender, slow-talking woman with a dry sense of humor and a blood pressure that’s all over the place. At best, she runs ten points higher than any of her previous doctors wanted to put up with. At worst, she flirts with systolics over 200, but that doesn’t seem to be a common occurrence.Edna has been my ...

The first brain a medical student sees in anatomy lab

by | in Education | one response

Arriving in anatomy lab there was an obvious discontent in the air. People were slower to arrive than usual and then they were even slower to get changed in the locker room. Girls would start casual conversation, or would wait for 15 minutes for others to move from in front of their locker, just in the hopes that they would get 5 more minutes ...

A monetary value on each life saved

by | in Policy | 4 responses

by Benjamin P. Geisler, MD, MPHA recent New York Times article on how to value a life drew almost two-hundred heavy-handed comments. It discussed how different governmental agencies such as the Food and Drug Administration (FDA), the Environmental Protection Agency (EPA) or the Department of Transportation (DoT) place a monetary value on each life saved.In many public policy areas, cost-benefit Analysis (CBA) is being used to assess whether an investment ...

When you close an abdomen after a failed rescue, the OR is silent

by | in Physician | 17 responses

I didn't know her name until it was over, much too late.What I knew was she was thirteen and that on this winter day someone in her family had been pulling her behind their car, on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl -- probably screaming (fear? delight?) -- held onto the sled as ...

Summer palpitations

by | in Conditions | no responses

It was early Saturday morning, I was making my plans for the day, crossing-off a few items that seemed unreasonable with others that had been accomplished. As I moved toward the kitchen, a voice from the living room bellowed "the coffee is ready."Turning my head I could see bright rays of sunshine making a visible path through the open front door.  My morning greeting followed ...

Online physician access is key to future patient communications

by | in Tech | 7 responses

Imagine using Skype to contact your physician for a consult.In the midst of this rapidly progressing technologic era, our delivery of medical services is being transformed by health information technology (HIT), electronic medical records (EMR), and advanced telecommunications.  In meeting criteria for "meaningful use," physicians are driven to use these technologies to empower patients with communication through electronic medical records.  A primary goal is to allow patients to ...

Pharmacies selling prescription information to data mining companies

by | in Meds | 4 responses

Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.The data privacy and security concerns surrounding the transfer of de-identified data are significant.  To "de-identify" what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in federal ...

The decision point psychiatrists faced with psychotherapy

by | in Physician | 9 responses

There's been plenty of buzz about a recent New York Times story, "Talk Doesn't Pay, So Psychiatry Turns Instead to Drug Therapy" by Gardiner Harris. The story is essentially a profile of Dr. Donald Levin, a 68 year old psychiatrist who has a private practice in Doylestown, Pa.It is a poignant example of a common situation in psychiatry. Older psychiatrists were trained during a time when there ...

Using gender as sole determinant for a choice of doctor

by | in Patient | 11 responses

It happened 25 years ago and I never forgot it. I’d been in the forefront of women’s consciousness-raising; I recognized that women had been professionally downtrodden for years (in certain fields), and hoping to do my part to balance the inequity, I opted for female doctors whenever possible.But using gender as sole determinant for my choice of doctor would prove to be a huge mistake … as I’d learn.At ...

How autism affects social interaction

by | in Conditions | 4 responses

One of the problems with understanding the natural history of autism is the lack of well-designed outcome studies in the disorder.  Outcome studies tend to be expensive and grant agencies commonly do not fund studies longer than a few years. However, given the increased interest and funding in autism, I suspect there will be more research in this area.An example of how outcome studies help in understanding the natural ...

Google Health failed because consumers did not see the value of a PHR

by | in Tech | 17 responses

To measure is to know.-Lord KelvinIf you can not measure it, you can not improve it. -Lord KelvinVersus:Asking science to explain life and vital matters is equivalent to asking a grammarian to explain poetry. -Nassim Nicholas TalebTechnology is at its best when it is invisible. -Nassim Nicholas TalebHow can technology help us live healthier lives? Why did Google Health fail? Why are Klout and Twitter Grader publicly issuing a number to me ...

Reverse our attitudes and values to control health costs

in Policy | 10 responses

by John KaegiWe all complain about the cost of health care and health insurance.  Ours is by far the most expensive health care system in the world.  And for the money, our health isn’t so hot either.  On the world stage, the U.S. ranks 37th in health care efficiency (a measure of health outcomes such as infant mortality, incidence of chronic disease, etc.) as reported by the World Health Organization.  ...

Patients are often intimidated and confused by the medical experience

by | in Patient | 15 responses

As a recently minted physician, I am often on the receiving end of the gripes and grouses about the medical profession.Often I get complaints of office visits that are too short, doctors who seem too preoccupied to hear their patients' complaints, medical bills that are too high and medications that do nothing but cause adverse effects. On the other hand, I can't count the number of times I have ...

Examining medicine through the lens of women’s rights

by | in Education | 12 responses

I’ve always had a hard time identifying myself as a feminist.I work for healthcare equality and human rights. Women’s rights seemed to me a part of human rights work (and as Hilary Clinton and others have said, woman’s rights are human rights). Tying myself to the feminist movement then seemed to be looking backwards – clinging to a term that was anachronistic, divisive and too narrowly defined in what activism ...

How ordering tests sometimes have consequences for patients

by | in Physician | 4 responses

Sometimes, you just can’t win!  In medicine, sometimes is way too often.  "Doc, do I need that test?" reviewed the issues surrounding screening colonoscopy exams.  The dilemma is always the same.  Do I order a test or don’t I?If I order a test, there are consequences.  Some are obvious; some are not.  Tests cost money and money is in short supply.  One consequence of ordering ...

Why doctors shouldn’t leave their emotions behind

by | in Physician | 10 responses

Part of the reason I became a physician was because I got tired of watching those close to me as they suffered through illness and eventually died, while I stood helplessly by, unable to do a thing.Throughout my training I watched as my mentors interacted with their patients, displaying a political correctness matched with just enough outward emotion so that there was no telling the difference between the good news and the bad.“Don’t ...

Avoiding confrontations and the difficulty of standing up for yourself

by | in Patient | 8 responses

When I was 8, my mom went to a parent-teacher night at school.  When she sat down with my teacher, the teacher smiled and said: "So how are Susan’s swimming lessons going?"My mom frowned, confused.  "Susan isn’t taking swimming lessons - perhaps you’ve confused her with someone else?""No, I’m sure," my teacher insisted.  "Susan told me that she has to leave at 3 o’clock every afternoon, right when the bell ...

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