July 28th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, News, Opinion, Research
Tags: ACOG, American College of Obstetricians and Gynecologists, Breast Cancer, Cervical Cancer, Early Intervention, Family Medicine, General Medicine, Guidelines, Healthcare Rationing, Healthcare reform, HPV, Human Papilloma Virus, Internal Medicine, Mammogram, Pap Smears, Pap Test, Preventive Health, Primary Care, Prostate Cancer, PSA Screening, Rationing Of Care, Screening Tests, Sexual Health, sexually transmitted diseases, STDs, Women's Health
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The American College of Obstetricians and Gynecologists (ACOG) recently reiterated their position that Pap smears should be performed on healthy women starting at age 21. This is different from the past which recommended screening for cervical cancer at either three years after the time a woman became sexually active or age 21, whichever occurred first.
How will the public respond to this change?
Over the past year there have been plenty of announcements from the medical profession regarding to the appropriateness of PSA screening for prostate cancer and the timing of mammogram screening for breast cancer. Understandably, some people may view these changes in recommendations as the rationing of American healthcare. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
July 28th, 2010 by DrRob in Better Health Network, Opinion, True Stories
Tags: A Patient's Death, A Patient's Funeral, Chronic Disease, Chronic Illness, Compassion, Doctor-Patient Communication, Doctor-Patient Connection, Doctors Are Falliable, Doctors Are Humans, Doctors Are Imperfect, Doctors Have Limits, Failure For A Doctor, Family Medicine, General Medicine, Internal Medicine, Pain and Suffering, Patient Dies, Patient-Doctor Relationship, Primary Care, Sympathy, To Feel With People
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I went to a patient’s funeral this past weekend. I generally don’t do that for people whose relationship I’ve built in the exam room. It’s a complex set of emotions, but invariably some family member will start telling others what a nice doctor I am and how much the person had liked me as a doctor. It’s awkward getting a eulogy (literally good words) spoken about me at someone else’s funeral. This patient I had known prior to them becoming my patient, and his wife had been very nice to us when we first moved here from up north.
But that’s not why I am writing this. As I was sitting in the service, the thought occurred to me that a patient’s funeral would be considered by many to be a failure for a doctor. Certainly there are times when that is the case — when the doctor could have intervened and didn’t, or intervened incorrectly, causing the person to die earlier than they could have. Every doctor has some moments where regrets over missed or incorrect diagnosis take their toll. We are imperfect humans, we have bad days, and we don’t always give our patients our best. We have limits. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
July 28th, 2010 by Toni Brayer, M.D. in Better Health Network, News, Opinion, Research, True Stories
Tags: Altruism, Altruistic Behavior, Brooklyn, Chose Not To Help, Emergency Medical Care, Emergency Medical Technicians, Emergency Medicine, EMTs, Eutisha Rennix, Failed To Help, FDNY, Fire Department of New York, General Medicine, Good Samaritans, Healthcare Professionals, Jason Green, Medical Professionals, New York City, On A Break, Patient Dies, Seizure
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A few weeks before Christmas, Eutisha Rennix, a pregnant restaurant worker, collapsed while working. She started having a seizure and her co-workers were screaming for help.
There were two EMT workers in line at Au Bon Pain shop in Brooklyn and they refused to help. They told onlookers to call 911 and they walked out of the store after picking up their bagels, presumably because they were on a coffee break. An ambulance was called and the 25-year-old woman and her baby girl died shortly afterward. She is survived by a 3-year-old son. Read more »
*This blog post was originally published at EverythingHealth*
July 28th, 2010 by SteveSimmonsMD in Better Health Network, Opinion, Primary Care Wednesdays, True Stories
Tags: Becoming A Doctor, DocTalker Family Medicine, Dr. Steve Simmons, Future Doctors, General Medicine, Internal Medicine, Joining the Medical Profession, Medical School, Medical Students, Medicine as a Career of Choice, Plans To Become A Physician, Primary Care, Primary Care Shortage, Primary Care Wednesdays, Young Doctors
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As a physician, I’ve had several people ask my “honest” opinion of their plans to become a doctor. I know what my response is to this question, but I wonder what others in my profession would answer. Would your response depend, in large part, on who’s doing the asking — could you answer your own child as you would someone you just met? Be careful, your answer to this question, if honestly given, might shine an unsettling light on your own feelings about your current career choice.
Last week I spoke with a college junior working to fulfill her lifelong plans to become a physician. She told me about a recent conversation with her own doctor where she shared her plans to go to medical school and he’d tried to dissuade her. She couldn’t recall a single cogent reason given for avoiding the medical profession, yet it appeared to me that his odium had negatively imprinted her image of the medical profession, which is a shame. At this time more than ever, we –- doctors and patients alike — need to encourage the most talented of our youth to join the medical profession. Read more »
July 27th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
Tags: Bad Backs, Benefits Vs. Harms, Christopher Snowbeck, Diagnostic Radiology, Doctor-Patient Encounter, Driving Up Healthcare Costs, Gary Schwitzer, General Medicine, Good Medical Decision Making, Healthcare Cost Drivers, Healthcare Decision Making, Healthcare Economics, Healthcare reform, Healthcare spending, HealthNewsReview.org, Imaging Tests, Jeremy Olson, Lower Back Pain, Medical Imaging, Medical Overuse, Medicare Data, Minneapolis Star Tribune, Minnesota, Minnesota Hospital Association, MRI, Neurology, Orthopedics, Overtreatment, Rate of Utilization, Shared Decision-Making, St. Paul Pioneer Press, Too Many Medical Tests, Too Much Testing
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Kudos to Christopher Snowbeck and the St. Paul Pioneer Press for digging into new Medicare data to report that the state the newspaper serves is out of whack with the rest of the country in how many expensive MRI scans are done on Minnesotans’ bad backs.
Snowbeck artfully captures the predictable rationalization and defensive responses coming from locals who don’t like what the data suggest. Because what they suggest is overuse leading to overtreatment. So here’s one attempt a provider makes to deflect the data:
“The Medicare billing/claims data, which this report is generated from, would not capture conversations between a patient and provider that may have addressed alternative therapies for lower back pain,” said Robert Prevost, a spokesman for North Memorial Health Care. “It’s important to recognize the limitations of this data.”
No, data don’t capture conversations. But wouldn’t it be fascinating to be a fly on the wall during those many patient-physician encounters that led to an MRI to see what level of truly informed shared decision-making (if any) took place? Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
The American College of Obstetricians and Gynecologists (ACOG) recently reiterated their position that Pap smears should be performed on healthy women starting at age 21. This is different from the past which recommended screening for cervical cancer at either three years after the time a woman became sexually active or age 21, whichever occurred first.
