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5 Tips For Diagnosing Yourself Online

“What’s the highest peak in North America, Mt. McKinley or Denali?” This is a great question the Web can answer for you. “What’s that lump on my neck?”  This is another great question — but not one you should rely on the Web to solve.

Best Doctors recently conducted a Twitter-based poll to find out what channels of information people use to get healthcare advice.  It turns out, 54 percent of respondents use the Web as their primary source of information. Is this kind of do-it-yourself medicine a good idea?

I’m a firm believer that you should do everything you can to make sure you’re getting the right care when you’re sick. But before you start your do-it-yourself journey, here are five things to keep in mind:

1. To get the right answer, you need to ask  the right questions. If you decide that that lump on your neck is a sign of lymphoma, you’re going to get very worried and start researching everything you can on lymphoma. You may see your doctor and when he tells you it’s actually a benign cyst, you’re going to have a hard time believing him. Now, your skepticism is a good thing, but before you start driving yourself crazy with serious conclusions, make sure you have your facts straight. Read more »

*This blog post was originally published at See First Blog*

The “Lies” Of Medical Science: What’s An e-Patient To Do?

There’s an extraordinary new article in The Atlantic entitled “Lies, Damned Lies, and Medical Science.” It echos an excellent article in our Journal of Participatory Medicine (JoPM) a year ago by Richard W. Smith, 25-year editor of the British Medical Journal, entitled “In Search Of an Optimal Peer Review System.

JoPM, Oct 21, 2009: “….most of what appears in peer-reviewed journals is scientifically weak.”

The Atlantic, Oct. 16, 2010: “Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong.”

JoPM 2009: “Yet peer review remains sacred, worshiped by scientists and central to the processes of science — awarding grants, publishing, and dishing out prizes.”

The Atlantic 2010: “So why are doctors — to a striking extent — still drawing upon misinformation in their everyday practice?”

Dr. Marcia Angell said something just as damning in December 2008 in the New York Review of Books: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” (Our post on Angell is here.)

What’s an e-patient to do? How are patients supposed to research if, as all three authorities say, much of what they read is scientifically weak? Read more »

*This blog post was originally published at e-Patients.net*

A Grassroots Leukemia Mission

I am just back from Phoenix where I spent the weekend with people living with CML, chronic myelogenous leukemia. The operative words are “living with” because it wasn’t very long ago when people did not live long with this disease. However, medical science and dedicated researchers like Dr. Brian Druker at OHSU in Portland, Oregon have brought us what first appear to be “miracle” pills (Gleevec, Sprycel, and Tasigna) that can keep patients alive and doing well.

My weekend was spent with several people, all taking one of the tyrosine kinase inhibitor drugs, as they were planning next steps for a new advocacy organization, The National CML Society. The Society is the creation of Greg Stephens of Birmingham, Alabama, a business consultant who lost his mother to CML. Now he has devoted his life to giving voice to patients, researchers, and building a vibrant community.

CML is not common. There are just over 4,000 new cases in the U.S. each year. And, now that there are three powerful and approved medicines, some people feel the disease is “cured” and not in urgent need of public discussion. The patients I met with said this was “baloney” and they were driven to support the new society because they felt the obvious advocacy group, The Leukemia and Lymphoma Society, was not giving them enough attention nor listening carefully to their stories. Read more »

*This blog post was originally published at Andrew's Blog*

The Reality Of Participatory Primary Care

No matter where one stands on appropriateness and advantages of each patient being involved in self-diagnosis and treatment of their own medical problems there are two inevitable conclusions:

•    First of all, self diagnosis and treatment are as natural as breathing and as impossible to extinguish as thought itself.

•    Secondly, given today’s healthcare system, there always will exist a dynamic tension between self-determination of the individual patient and the powerful healthcare system which often insists on patients falling back in line and complying with orders.

Few would argue against the need for a powerful alliance that embraces the benefits brought to the table by both the practitioner and the patient. Simplistically, the physician would carry the role of healthcare consultant and guidance while the patient ultimately becomes responsible for the choices. Read more »

In The Hospital To Rest And Recover, Right?

MSU Coach: Mark DantonioNobody is in the hospital these days feeling good. Regulations have made it so sick people are hospitalized and not-so-sick people are usually outpatients. People who are horizontal are there to have procedures, take heavy duty meds, rest and, hopefully, get better.

Hospitals have increasingly put in sophisticated television systems so you can be in bed and distracted and entertained. But that is not restful for everyone. Here’s an example from this past weekend that stands out:

Mark Dantonio, the coach of the Big Ten’s Michigan State Spartan college football team, was diagnosed with a heart attack right after last week’s game. Boom. He was hospitalized. Boom. He had a stent put in to unblock at least one artery. This past Saturday he was still in the hospital resting and recovering, right? In the hospital, yes. Resting, no! Are you kidding? Keep the coach down during the big game against Wisconsin, a Big Ten rival? Read more »

*This blog post was originally published at Andrew's Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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