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Latest Posts

Physician Learns A Lot Doing AFib Research With No Funding

I learned a lot from putting together an abstract for a national heart meeting.

  • More than just learning how to e-submit, e-upload and e-print a large poster;
  • More than what t-tests and chi-squares measure;
  • More than learning that females respond differently to AF ablation;
  • And surely more than which coffee shop offers the best work place.

Putting this thing together showed me stuff: the process of discovery, it’s role in helping us be better doctors and the difficulties inherent in doing this kind of valuable research in our current system.

So of course…bloggers blog.

First: Many have asked why we bothered doing research? What’s the motivation? Money? Fame? A greater purpose?

It was none of these. Read more »

*This blog post was originally published at Dr John M*

Keeping Up With New Things: Nurse Decides To Go Back To School

Nursing instructors grading Exams in the 1950s. Courtesy of Johns Hopkins Medical Archives on Flickr.

I remember it well. Cramming all night for a nursing exam, taking the test, and hoping for the best. It was a nerve racking experience for the students, but I’ve always wondered what it was like for the instructors. Check out these old gals. Grading papers was time consuming before computerized tests, but I bet they got some pretty entertaining answers.

Miss Jones, Medical Surgical Instructor: “Oh my God, I can’t believe this answer. It’s right up there with the excuse, “my dog ate my care plan.”

Mrs. Smith, OB/GYN Instructor: “I know what you mean. These young people are the future of our profession. Read more »

*This blog post was originally published at Nurse Ratched's Place*

Are MDs More Effective At Running Hospitals Than MBAs?

It’s been more than five years since Henry Mintzberg released the enlightening book ‘Managers, not MBAs’, a well-reasoned criticism of prevailing management education that basically revolves around Master in Business Administration (MBA) programs. Financial crisis was not even in sight but Mintzberg, a professor at McGill University in Montreal and one of the most important guiding lights in the questionable field of management, already pointed out that it was a serious danger for modern organizations to rely on professionals that had just finished their MBAs as the prime source for senior managerial positions.

Mintzberg focused his criticism on two essential aspects. First, most programs are aimed at people with no previous experience or knowledge about organizations and how they look like from the inside… and these same people then storm into companies believing that the real world works exactly as business school taught them it does. The second point is that many of these business schools spread a perverted set of values, such as the hunt for short-term profit, the belief that a good aim justifies any means and the urge to translate all human behaviors into accountable figures (the ‘countophrenia’ depicted by Vincent de Gaulejac in his must-read ‘La Société Malade de la Gestion’).

Then the crisis rose, and many CEOs of the biggest organizations had their share of responsibility for it, as they were enjoying multi-million dollar bonuses while taking their companies to the edge of bankrupcy. Most of them came from the most famous business schools in the world. I have outlined in the past the outrageous conflict of interests of many of these institutions, starting with Harvard, as Charles Ferguson perfectly displayed in his brilliant documentary ‘Inside Job’.

‘Social Science and Medicine’ published in its August issue a very interesting work by Amanda Godall, professor at the IZA Institute for the Study of Labor in Bonn, Germany. Godall’s is the first empirical research on the correlation between hospital results and having MDs in their top managerial positions. Read more »

*This blog post was originally published at Diario Medico*

The Best Doctors Are Constantly Learning

Monday’s New Yorker has a story, Personal Best, by Atul Gawande. It’s about coaching, and the seemingly novel idea that doctors might engage coaches – individuals with relevant expertise and experience — to help them improve their usual work, i.e. how they practice medicine.

Dr. Gawande is a surgeon, now of eight years according to his article. His specialty is endocrine surgery – when he operates it’s most often on problematic glands like the thyroid, parathyroid or appendix. Results, and complications, are tracked. For a while after he completed his training he got better and better, in comparison to nation stats, by his accounting. And then things leveled off.

The surgeon-writer considered how coaches can help individuals get better at whatever they do, like playing a sport or singing. He writes:

The coaching model is different from the traditional conception of pedagogy, where there’s a presumption that, after a certain point, the student no longer needs instruction. You graduate. You’re done. You can go the rest of the way yourself…

He wonders about how this might apply in medicine: Read more »

*This blog post was originally published at Medical Lessons*

The Natural Evolution Of Science: As Knowledge Grows, Treatments Change

I read with interest a blog post by Robert Krulwich of NPR fame on why there is so much public resistance to accept changes in truth with new scientific discoveries (some of which was new to even me)…

1) Triceratops with their beautifully placed 3 horns is actually the teenage dinosaur version of the adult Torosaurus (who had ugly asymmetric horns). Now… a decision had to be made regarding which name to stick with. Ultimately, “Triceratops” won out, perhaps because of the “Save the Triceratops” Facebook page???

2) The same unfortunately is not true for the Brontosaurus. It was clear that Apatosaurus is the same dinosaur and as such, the “Brontosaurus” name is no more much to the dismay of many lay public… Read more »

*This blog post was originally published at Fauquier ENT 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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