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Latest Posts

Some Things About Medicine Will Never Change

I just can’t imagine life today as a medical student. Every medical publication in the palm of your hand. The capacity to create an audience and publish at your own will.  Real-time dialog between students, faculty, anyone. Global reach from your phone. It’s mind-boggling really.

This is in stark contrast to my experience. My world was centered on index cards, textbooks and pens with different colors. We communicated via Post-it notes on the door of the student lounge. There were no apps and our only game was foozball. As a first year I scheduled time to compose H&Ps on the library’s only Macintosh II computer. This was plugged into the new Apple LaserWriter with WYSIWYG. Hi tech we were. We thought.

Being distractible and restless, I’m going to guess that if I had access to the communication platforms and tools available to today’s students, I might not have made it through. The inputs must be staggering and I imagine that discipline with personal bandwidth has become a critical key to survival. Read more »

*This blog post was originally published at 33 Charts*

Physician Lifestyle Is Criteria When Choosing A Medical Specialty

Medical students today consider lifestyle an essential criteria when choosing a specialty. It’s become a cliche that most are looking towards the ROAD (radiology, ophthalmology, anesthesiology and dermatology) to happiness.

There’s been some recent media attention at how women are lured to specialties that offer a greater balance between their family lifestyle and professional demands. Claudia Golden, a Harvard economics professor, recently noted that,

high-paying careers that offer more help in balancing work and family are the ones that end up luring the largest numbers of women. Surprisingly, colon and rectal surgery is one of these, because of rapid growth in routine colonoscopies that can be scheduled in advance, giving doctors control over their time. Goldin says 31% of colon and rectal surgeons under 35 years of age were female in 2007, compared with only 3% of those ages 55 to 64, and 12% of those ages 45 to 54, reflecting the fact that younger women are flocking to the field.

Of course, what’s not said is the grueling training that it takes to become a colorectal surgeon — but the numbers cited above do not lie. The new generation of doctors — both men and women — want greater control of their time. That means more shift-work and a predictable call schedule. Read more »

*This blog post was originally published at*

Do Foreign Medical Graduates “Doctor” Better?

Yes, according to a study in today’s Health Affairs. (The full text of the study is available only to subscribers, but Kaiser Health News Daily has a good summary of its findings and links to other news reports.)

The study compares inpatient death rates and lengths of stay for patients with congestive heart failure or acute myocardial infarction when provided by U.S. citizens trained abroad, citizens trained in the United States, and non-citizens trained abroad. Treatment was provided by internists, family physicians, or cardiologists. The differences were striking, according to the authors:

“Our analysis of 244,153 hospitalizations in Pennsylvania found that patients of doctors who graduated from international medical schools and were not U.S. citizens at the time they entered medical school had significantly lower mortality rates than patients cared for by doctors who graduated from U.S. medical schools or who were U.S. citizens and received their degrees abroad.”

Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

An Emergency Medicine Myth?

Eyebrow lacerationI’ve internalized all the dogma of medicine, for good and bad.

When I was an EMT, green as a twig in an ER, I learned the basics: For any wound with hair employ the razor, and get the hair away from the laceration so the doc could do a good closure.

So, employment week #3: Eyebrow laceration? Shaved that sucker clean off. ER doc freaked out, and I learned some medical dogma: Don’t shave eyebrows, they don’t grow back. Heard it later, too — all the way through training, in fact. Read more »

*This blog post was originally published at GruntDoc*

Defining Family Practice

Family DoctorI like Dr. Rob, the one with the “distractible mind.” And although I thoroughly agree with the stance he takes in his recent post against cholesterol screening in kids, I must take issue with his opening statement:

I have a unique vantage point when it comes to the issue universal cholesterol screening in children, when compared to most pediatricians. My unique view stems from the fact that I am also an internist who deals with those children after they grow up on KFC Double Downs.


“Unique: existing as the only one or as the sole example; single; solitary in type or characteristics.”

Your med-peds training allows you to follow patients from birth to death (but no obstetrics or gynecology). You can care for all organ systems and all stages of disease (but without as much training in psychiatry). Congratulations! You’ve just (re)invented family practice (except for the above shortcomings). Oh, wait — that’s already a recognized specialty with its own residency programs, boards and everything like that, forty years now.

This misuse of the word “unique” is one of my pet peeves. “Unique?” I don’t think that word means what you think it means. After twenty years in practice, I agree that there probably isn’t much difference between what Dr. Rob does and what I do. After twenty years, I’m not even sure how much relevance remains from our “training.” Still, there remains a great deal of confusion about the very real differences between family practice and med-peds residencies. Read more »

*This blog post was originally published at Musings of a Dinosaur*

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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