June 9th, 2011 by AnneHansonMD in Opinion
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I can’t find it now, but on one of our posts somewhere MovieDoc has stated that doctors can never ethically write about their patients since they are incapable of giving truly informed consent. Besides the obvious “huh?’ response I have to the idea that patients aren’t capable of making decisions like this, I question the basic assumption that this should never happen.
The medical literature is replete with published anonymized case studies of patients with various maladies. For psychiatry in particular, early psychiatric classification was based on longitudinal descriptions of diseases. If it weren’t for the early case descriptions of Kaposi’s sarcoma in gay men published in the 1980’s, AIDS would not have been identified as a new disease. Case studies can and should be published to advance medical science. Read more »
*This blog post was originally published at Shrink Rap*
April 27th, 2011 by AnneHansonMD in Health Tips, Opinion
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Sideways Shrink posed a great question recently in a comment on my post “When A Thick Skin Helps.” The question was whether or not physicians are allowed to hit a patient who tries to assault them.
Certainly, physical assaults on patients are not the standard of practice in psychiatry or any other medical specialty. Psychiatrists do undergo some training about physical management of violent patients: I remember in residency we had to get trained in “take down” and restraint procedures. As a group we practiced applying pressure point joint locks on each other in order to make a patient break a grip on us, and to do two person restraints to hold someone immobile until security could arrive. None of this involved any “Crouching Tiger, Hidden Dragon”-type kung fu moves, there was no kicking or hitting or loud kiai karate yells. There was a lot of talk about the importance of being as least forceful as possible. Frankly, I’m not sure how much of that I would have remembered if I had ever been in a position to have to use it. The few times when I was actually assaulted by patients the incidents happened so fast there really wasn’t anything I could have done. (OK, so the little manic lady who hit me with a stuffed dog really couldn’t count as an assault, and she was already restrained in a geri-chair to begin with.)
But the real question is: will a doctor get into trouble for defending him or herself? Read more »
*This blog post was originally published at Shrink Rap*
March 29th, 2011 by AnneHansonMD in Opinion, Research
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I briefly scanned the Robert Wood Johnson synthesis report on mental and medical co-morbidity so I thought I’d summarize the highlights for the blog. If you’d rather watch the recorded web seminar you can hear it here.
The report relied on systemic literature review to look at the relative risk and mortality associated with co-morbid medical and mental health conditions. The looked at studies using structure clinical interviews, self-report, screening instruments and health care utilization data (diagnostic codes reported to Medicaid).
This is what they found:
- 68 percent of adults with a mental disorder had at least one general medical condition, and 29 percent of those with a medical disorder had a comorbid mental health condition
- These findings support the conclusion that there should be strong integration of medical and mental health care Read more »
*This blog post was originally published at Shrink Rap*
January 21st, 2011 by AnneHansonMD in Better Health Network, Opinion
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There’s been a lot of stories in the news lately about homicides committed in hospitals. Just out of curiosity, I went to the Bureau of Labor Statistics (BLS) website and pulled some data from their Census of Fatal Occupational Injuries. It confirmed what I suspected — that homicides of workers in hospitals have increased at twice the rate as correctional facilities, where worker homicides have remained stable. Here’s the graph I was able to make from the BLS data:
The red bars (hospital murders) are up to six and seven homicides per year while the blue bars (correctional facility murders) have remained stable at about three per year. This is only for the employees who have been murdered, not all murder victims.
When we consider the cost and repercussions of increased hospital security, think about this trend. We people wonder if it’s safe to be a forensic psychiatrist in corrections, and I will bring out these numbers. It does seem to be safer to work in prison than in a hospital.
*This blog post was originally published at Shrink Rap*
January 5th, 2011 by AnneHansonMD in Better Health Network, Humor, News, Research
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I was surfing around the Net one day and I found this article about scientists who are creating a machine that will detect acetone in someone’s breath. Acetone can be a sign that someone suffers from diabetes, so in theory this machine could use scent to diagnose this disease.
That story brought to mind other stories I’ve heard about people using dogs to sniff out cancer in people. According to this article:
“The results of the study showed that dogs can detect breast and lung cancer with sensitivity and specificity between 88% and 97%. The high accuracy persisted even after results were adjusted to take into account whether the lung cancer patients were currently smokers. Moreover, the study also confirmed that the trained dogs could even detect the early stages of lung cancer, as well as early breast cancer.”
People have even tried “smelling” schizophrenia. Read more »
*This blog post was originally published at Shrink Rap*
