Does owning cancer equipment change treatment patterns? Today’s article follows the money trail to expose a different form of bias: the kind that takes place when doctors own their own diagnostic and therapeutic equipment. For people living with cancer, this kind of bias can have a particularly painful impact. Radiation therapy brings out medical bias In the United States, cancer is the second most common cause of death, killing nearly 600,000 ...

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I have a new favorite doctor show, “The Knick” on Cinemax, airing on Friday nights.   The show stars Clive Owen as the charismatic cocaine-addicted chief of surgery Dr. John Thackery at a fictitious New York City hospital called The Kickerbocker at a time when surgery was one foot out of the barbershop.  The tagline is, as they say, priceless: “Modern medicine had to start somewhere.” On the third episode, last Friday ...

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The electronic medical record that my office uses features a clinical protocol button that we are encouraged to click during patient visits to remind us about potentially indicated preventive services, such as obesity and tobacco counseling and cancer screenings. I once tried it out while seeing a 90-year-old with four chronic health problems. The computer suggested breast cancer, colorectal cancer, and cervical cancer screenings: three totally inappropriate tests for the ...

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Oh yeah.  Hot dang.  All right.  Groovy. Boom goes the dynamite. I had a very great day yesterday. I saw three patients who had recent diagnoses of cancer.  Yeah, those two statements seem to contradict.  They don't.  Each person I saw gave me a clear view of how the practice I've been building over the past 18 months is making a difference.  A big, big difference. The first patient was a guy who is ...

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Delivering bad news: Dont pass the buckWhen I was a fellow, part of our training involved doing consults for patients, most of whom had just learned they had cancer or recurrence of disease. These consults were never easy, but the importance of sitting with someone who had just learned of their diagnosis was an integral part of learning the medicine and art of oncology. Even after many ...

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Last week a patient said to me, "You live your whole life thinking you're going to have time to enjoy life later on, and then this happens." Then he started to cry because we had just reviewed his recent CT scans and some of his lab results and he had a new diagnosis of a type and stage of cancer that meant he likely had about eight months to live. ...

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A baby’s smile reflects the purity in their heart.   An infant’s world is a marvelous place of possibility and love.   Children see themselves as special, capable, even omnipotent.   Time teaches failure, loss, and mortality.  How much we lose of that original perfection, that first excitement, that natural confidence, determines how we face the challenges and tragedies of life; whether we will be happy.  It may even determine how we cope ...

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Today’s article highlights the lingering problem of physicians buying and selling prescription medications to patients -- at a profit. The medical profession has struggled with this controversial practice  for more than 150 years. In George Eliot’s 1874 novel “Middlemarch,” an idealistic young doctor named Tertius Lydgate questions the ethics of fellow physicians who make handsome profits prescribing and dispensing their own remedies to the townsfolk. His medical colleagues shun him for it. Around ...

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I am so sorry I didn’t make this different for youThe telephone message arrived in my EMR’s inbox. A patient’s daughter had called and wanted to ask some questions about her mother. Her mother, Louise (name changed), had died about two weeks before. I hesitated before calling her, recalling her mother’s cancer course. Louise had been diagnosed with cancer at a relatively young age, in her late 40s. She received curative chemotherapy ...

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At the critical time when our nation has made meaningful and measurable progress against colorectal cancer incidence, threats to reimbursement for colonoscopy screening for Medicare beneficiaries are looming, which may jeopardize the effectiveness of public health strategies to increase screening and prevention of colorectal cancer in the U.S. New data from the American Cancer Society indicate that colorectal cancer has declined by 30% in just the last decade among those aged 50 ...

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