Decisions in medicine are supposed to rest on concrete observations and hard evidence. Often, hard evidence does not exist or when it does, it isn't used.  Why is this? Concrete observations, too, are increasingly missed as we stare at computer screens longer and patients less.  Yet we persist. Why? This is our reality now, our evolving medical world. But if we stop and think about it, medicine, by definition, is a world of technological ...

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An excerpt from Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond (Rowman & Littlefield, 2013. All rights reserved.) There are plenty of books out there to teach us how to boldly and proudly advocate for ourselves in the doctor’s office. ...

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Hal Movie buffs and science fiction fans certainly remember HAL, the computer in 1968’s hit movie “2001:  A Space Odyssey”.  Considered one of the greatest villains in film history, HAL was capable of reasoning and language processing to assist the astronauts on their space mission.  Ultimately, however, HAL decided that its best course of action was to kill all the astronauts. “I am ...

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A study published in the British Medical Journal highlights the importance of carefully choosing which children should receive diagnostic CT scans.  As a diagnostic test, CT scans utilize ionizing radiation that can cause cellular DNA damage, increasing the risk of cancer.  Children who received a CT scan were 25% more likely to develop a cancer in 10 years after radiation exposure, according to a study of 11 million ...

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A JAMA Pediatrics article found that the use of pediatric CT scans rose in the late 1990′s and early 2000′s. Further, research shows that these CT scans can increase risk for future cancer diagnoses. Authors calculated the risk: they estimate that for every 4 million pediatric CT scans preformed annually, some 4800 children will go on to develop cancer as a result. Like many studies published this decade, the ...

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Who is responsible for mistakes in health care?  Who should take credit for success or blame for failure?   Most families, patients and obviously the courts, hold the doctor responsible.  It seems to me this is reasonable; it is the obligation physicians assume and which society returns with empowerment and respect.  However, is this changing because of the Internet and big data? In 2013, most patients have spent hours on the Internet ...

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A fascinating op-ed piece by Brigham and Women's physician and Harvard Medical School professor Jerry Avorn appeared on June 11th in the New York Times. It's called "Healing the Overwhelmed Physician." What the 'overwhelmed physician" about whom Dr. Avorn writes is overwhelmed by may surprise you. It surprised me. Looking at the title of the piece, I thought it might be about the emotional toll of practicing medicine, which may contribute ...

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Patients do need the power to complain about bad doctors and, trust me, there are some bad doctors out there.  That being said, the other way for patients to get some retribution is to stop seeing that doctor.   Word of mouth will spread, like any other business, and that doctor’s business goes under. Right now, state boards allow patients to complain about anything and they have to investigate that complaint. ...

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On June 10, 2013 a 32-year-old pregnant woman was reported to have died after having an ovary removed instead of her inflamed appendix. As the infected appendix festered, she became septic and succumbed to multiple organ failure. This tragedy occurred in the UK in late 2011, but has just come to light. How could this have happened? Let me count the ways. The surgery was performed by two trainee surgeons. Their ...

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I’ve learned a few things about children over the years.  While most have come from raising children, the rest have come from caring for them as patients.  Knowing children, knowing their hearts and their ways, gives me great joy.  I like to think that as I know them better, I become more like them, and while my time on earth may not be any longer for it, it may be ...

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