A small case with big implications almost escaped my notice this week.  The Boston Globe reported a case in which a family sued after a 23-year-old man died after being diagnosed with a lung infection. According to the Globe, the young man went to one of the Boston Emergency Rooms complaining of cough, fever, and chest pains.  Ok, stop right there all you armchair diagnosticians.  What does this man most ...

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A few months ago while I was working in the interventional gastrointestinal unit I noticed something because it was driving me nuts.  One of the monitors in the holding area that slaved to one of the procedure rooms was beeping.  Just a low, constant blip blip blip blip.  The screen read, "no data." So I asked one of the nurses "can we turn that monitor off?  No one is using procedure ...

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Let’s talk for a moment about medical education.  I went to a work-related party recently and rode in the elevator with a dear friend who is my contemporary, and a more senior and highly regarded faculty member known for her work in medical education.  Both were afraid for the future of medical education in different ways. My contemporary was concerned that the emphasis on the use of advanced technologies like ultrasound ...

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I have written a good amount about automation, the good, the bad and the ugly.  I have written about doctors and ancillary providers and physician extenders, also good, bad and ugly.  A recent comment on Karen Sibert’s excellent blog A Penned Point caught my eye as an amalgamation of these subjects. This person wrote, and I hope he doesn’t mind my quoting him:

American anesthesiologists should focus much more on ...

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I hate being told what to do.  I will scratch and claw when ordered around.  It takes a conscious act of will to smile and say, “sure, I’ll get going on that right now.” This is a problem since, as an anesthesiologist, I get told what to do all the time.  My kids order me around all the time.  When I was a nurse I used to bristle at the term ...

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Over the last month I have received several comments from readers who have or who are trying to make the choice between nursing and medicine.  And may I just say what a great problem we have now, to be able to choose.  I’ve been thinking about this and I submit there are three considerations: philosophical, practical, and logistical. 1. Philosophical.  Many of you have heard of the “medical model,” the idea ...

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The Institute of Medicine (IOM) recently released a report on the state of cancer care in the United States.  The IOM generally knows what it’s talking about.  It’s a non-profit, non-governmental advisory group essentially.  To get on one of their advisory boards you have to be a national, if not international, expert in whatever field is being studied. According to the cancer advisory board, the state of cancer ...

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Good old Earl Blumenauer.  A bespectacled and bowtied Congressman from Oregon.  He of the “death panel” proposal.  Thank God he’s still here.  Presuming that the crazy talk over the provision in the Affordable Care Act that would have paid doctors to discuss end-of-life issues with patients is over, he has introduced a separate bill with this provision and hopes to get it passed in the next couple of ...

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With immigration reform under hot debate, it’s important to remember that all of us except the Native Americans are foreigners.  It’s what has made our culture so diverse.  People from foreign countries ideally bring the best of their cultures to the US and enrich us all with the diversity of life.  This advantage lessens considerably when those visitors want to enter fields in which understanding of endemic American culture is ...

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The Mayo Clinic Proceedings came out with a study that shows that many of the treatments that doctors once swore by are useless or worse. The New York Times did a piece on it and the commentary contained a great deal of doctor-bashing.  So of course I opened my big mouth and pointed this doctor hatred out.  The comment I got back was this:  "It’s not hatred, it’s fear." Wow.  If people ...

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