Jan Henderson, PhD

For doctors who suffer from burnout, the ultimate tragedy is suicide

by | in Physician | 2 comments

The British medical journal The Lancet surveyed a number of studies that discuss troubling statistics on suicide and depression among American physicians. The subject is not new, but the studies attempt to provide a few new insights.A 2004 analysis in The American Journal of Psychiatry found that male doctors were 1.41 times more likely to commit suicide than other men. The statistic for female doctors was significantly ...

Doctors are asking whether the physical exam is becoming a lost art

by | in Physician | 14 comments

The physical exam – looking into the eyes and throat, taking the blood pressure, sounding the chest – is part of the process of medical diagnosis. It’s one way a physician attempts to determine the cause of a patient’s complaint.In recent times, doctors have asked themselves whether the physical exam is becoming a lost art. It’s been replaced by an array of laboratory tests and high tech machines that ...

FDA regulation, and off label use of atypical antipsychotic drugs

by | in Meds | 17 comments

Abilify, Seroquel, Zyprexa, Risperal – these are among the atypical antipsychotics for which Americans paid $10 billion in 2008. $6 billion of that was for off-label use.The FDA only approves drugs when their safety and efficacy have been tested for specific conditions. For example, an antipsychotic might be approved for the treatment of schizophrenia. When it’s prescribed for anxiety or depression, that’s ...

Marcus Welby and the relentless growth of specialization

by | in Physician | 32 comments

In the very first episode of the TV series Marcus Welby, MD, our hero delivers an after dinner speech to a group of young interns. As he’s introduced, he hastily scribbles the title of his talk and hands it to the hospital director: “The future of the general practice of medicine, if any.” The year was 1969.In his introduction, the director somewhat tactlessly remarks that many “eminent specialists” have addressed ...

How the pharmaceutical industry changed psychiatry

by | in Meds | 15 comments

What’s happened to psychiatry over the last 15 to 20 years? That’s a big subject, discussed in many recent and excellent books. One of those books is by Daniel Carlat, author of Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in CrisisHow the pharmaceutical industry changed psychiatry.One of the problems Carlat readily acknowledges is that psychiatry is excessively focused on psychopharmaceuticals at the ...

How a tyranny of health is bad for both patients and physicians

by | in Physician | 21 comments

Something happened to the public perception of health and medicine in the 1970s. People began to adopt — and financial interests and the media began to profit from – “healthy lifestyles.”This was not without consequences.• Americans became increasingly preoccupied with diet, exercise, and health habits.• There was a big uptick in the use of alternative “medicine” and stress reduction practices – acupuncture, chiropractic, herbalism, naturopathy, nutritional therapies, yoga, massage, biofeedback.• ...

Are physicians today active in the arts?

by | in Physician | 15 comments

Physician/poets such as William Carlos Williams are an honorable tradition in the history of medicine, following in the footsteps of Keats, Schiller, and Oliver Wendell Holmes (of “Chambered Nautilus” fame). Physicians have also been writers, painters, musicians, philosophers, and – at least in more recent times –photographers.Yet in 1980 the historian G.S. Rousseau expressed concern that modern physicians no longer embodied the humanist tradition of their predecessors. Now that medicine ...

Bacterial resistance to chronic antibiotics, and why it’s a problem

by | in Conditions | 11 comments

Unlike climate change, where there’s a large contingent of denialists who spread doubt about the scientific evidence, no one denies that antibiotic resistance is a problem. There is controversy, however, on the question of just how much the widespread use of antibiotics contributes to the problem.The mechanism is not in dispute: If you expose bacteria to antibiotics, they will mutate to become resistant. But “overuse” of antibiotics is not the ...

Ranking prestige of medical diseases

by | in Conditions | 16 comments

Among medical specialties, some are more prestigious than others. You can generally tell which ones are more prestigious by how well they pay. Surgery and cardiology, for example, rank at the top of the prestige scale. Psychiatry and dermatology are near the bottom.One can also ask if some diseases are considered more prestigious than others, in the opinion of doctors.A Norwegian doctor, Dag Album, has been investigating the prestige ...

What medicine was like in ancient Babylonian society

by | in Potpourri | 2 comments

Each issue of the Journal of the American Medical Association includes an excerpt from an issue of exactly 100 years ago (JAMA has been published continuously since 1883).The May 7, 1910 issue of JAMA included remarks on how much physicians were paid and, by implication, how they were regarded in 2250 B.C.Ability to pay and malpracticeAccording to the famous Babylonian Code of Hammurabi (“an eye for an eye”), a physician’s ...