“The unintended consequences of these seemingly well-intentioned laws are doctors who can’t apologize for harming their patients even if they want to …” A recent JAMA article about disclosing medical error described a hypothetical situation involving a dermatologist who, after completing skin biopsies on two patients, discovered that the instruments had not been sterilized. He wondered if he should tell the patients and what he should say. The authors of ...

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"I graduated this July and took the QE (written general surgery boards) on July 19th. I got my results today, and I failed. Not only did I fail but my score placed me in the 5th percentile. Needless to say, I'm disappointed. You hear stories about CE (oral exam) failure but never about QE failure. I never blew the ABSITE out of the water (50, 29, 20, 34, ...

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Can you trust online physician ratings? Many people believe you can. But here’s what a recent article in the Harvard Business Review (HBR) about the reliability of online user ratings regarding buying a product. The authors concluded that online ratings were generally not to be trusted for three important reasons:

  1. The reviews are usually based on a small sample of users. The authors said, “We can be more confident ...

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Every few months when things are slow, someone publishes an article about the imaginary dangers associated with doctors wearing scrubs in public. A recent version is from The Atlantic. An associate editor saw some people in scrubs having lunch in a restaurant and was, of course, horrified. She questioned the magazine’s medical editor, Dr. James Hamblin, whose response was remarkably reasoned (until the end). He pointed out that it ...

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Recently, the Joint Commission issued a statement written by its executive VP for healthcare quality evaluation Dr. David W. Baker, explaining why it was not to blame for the opioid epidemic. If you haven’t already read it, you should. Here is the first paragraph of that document: “In the environment of today’s prescription opioid epidemic, everyone is looking for someone to blame. Often, The Joint Commission’s pain standards take that ...

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On the morning of the tragic mass shooting in Orlando, a tweet by CNN stated, “The White House waived HIPAA regulations so that hospitals could talk with family members of shooting victims, says Orlando Mayor Buddy Dyer.” Many, including me, retweeted this thinking that it was probably unprecedented. Later that day, several Twitter followers informed me that HIPAA had been waived during Hurricane Katrina. Despite rumors to the contrary about 9/11, Katrina ...

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Ezekiel Emanuel, the University of Pennsylvania physician and ethicist, has written an opinion piece suggesting many changes in both pre-medical education and the medical school curriculum. He would do away with many of our hallowed medical school prerequisites such as calculus, physics, and organic chemistry, feeling that those subjects are simply used to "weed out" certain students. I confess I once believed that such subjects were worthwhile. However, Emanuel makes a ...

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"Was the delay in deciding to open influenced by the presence of an audience of 100 surgeons expecting to see a laparoscopic liver resection?" “In addition to his tumor, the patient had hepatitis and cirrhosis. Was he a good candidate? A major complication was inevitably to occur during a live broadcast.” As I predicted last year, it had to happen sooner or later. In that post, I wrote, “A major complication ...

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A JAMA Viewpoint suggests that doctors should be aware that patients may be surreptitiously recording their conversations. The author, a neurosurgeon, takes a very benign view of this issue and recommends that if a doctor suspects that patient is recording a conversation, "the physician can express assent, note constructive uses of such recordings, and educate the patient about the privacy rights of other patients so as to avoid any ...

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For the last couple of days, the Twitter medical community has been discussing the latest in a long line of papers attempting to estimate the role of medical error as a cause of death. A recent entry appeared in the BMJ and was by a surgeon at Johns Hopkins, Dr. Martin Makary, who claims that 251,454 patients die from medical error every year. Makary's review extrapolated that figure from three papers ...

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