February 7th, 2010 by GruntDoc in Better Health Network, Opinion
Tags: Academic Centers, Community Hospitals, Emergency Medicine, Moonlighting, Real World, Residency, Training
1 Comment »
Emergency Medicine News:
February 2010 – Volume 32 – Issue 2 – p 5, 24, 25, 26
Residents training in large urban centers typically see more than 200 patients a day. They have access to all subspecialty care, typically available 24 hours a day. Residents have around-the-clock access to angioplasty, interventional radiology, hand surgeons, neurosurgeons, and plastic surgeons. Most practice emergency medicine with cardiologists and neurologists in the building or a short phone call away. Decision-making is shared, and occurs with a relative surplus of information and opinions and in a milieu of shared risk.
In reality, though, these very large and highly-specialized EDs with Level I trauma comprise less than five percent of U.S. EDs, according to the American College of Surgeons. Read more »
*This blog post was originally published at GruntDoc*
February 6th, 2010 by Dr. Val Jones in Health Policy, Opinion
Tags: ACP, America, Bob Doherty, Distributive Justice, Dr. Rich, healthcare, Medical Ethics, New Ethics, Social Beneficence, US
3 Comments »
Dr. Rich recently posted a 3-part series on the shortcomings of medicine’s new ethics. While I personally find Dr. Rich’s writing style both nuanced and entertaining, there is no doubt that his posts require some focused attention. And so I thought I’d provide a “Cliff’s Notes” version for my regular readers (since Google analytics tells me they are unlikely to spend more than 2 minutes here at a time). 😉
Advances in science and technology have provided us with valuable new treatment options for many diseases and conditions. Unfortunately, these new drugs, devices, and procedures are so expensive that we cannot (as a country) afford to make them accessible to everyone who could benefit from them. Medical technology has outpaced our ability to pay for it. This leaves us with an ethical dilemma: how do we ration access to modern medicine? Read more »
February 6th, 2010 by DrRich in Better Health Network, Health Policy, Opinion
Tags: ACP, Costs, healthcare, Medical Ethics, New Ethics, Physicians Charter, Professionalism Charter
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A few days ago Mr. Doherty (who is also the ACP’s Senior Vice President of Governmental Affairs and Public Policy), graciously agreed to engage in this discussion, and promised to do so after consulting with the ACP’s Committee on Ethics, Professionalism, and Human Rights.
DrRich had hoped that Mr. Doherty would reply with a post on his ACP blog, which (since it likely has a vastly greater readership than the CRB), would more effectively give this topic some much-needed airing – and in particular, might engage some of the ACP’s membership (specialists in internal medicine) in this important discussion. DrRich was disappointed, then, when the reply came today in the form of a comment, which was tacked on to a long queue of reader’s comments at the end of DrRich’s posting.
DrRich was also very disappointed by the content of the reply which, fundamentally, was: This is a non-issue, and even if it was an issue, it’s now a settled issue. (So go away.) Read more »
*This blog post was originally published at The Covert Rationing Blog*
February 6th, 2010 by DrRich in Better Health Network, Health Policy, Opinion
Tags: ACP, ACP Advocate, Bob Doherty, Covert Rationing, Distributive Justice, DrRich, Medical Ethics, New Ethics, Physician's Charter On Ethics, Societal Beneficence
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In his last post, and not without some little trepidation over the propriety of doing so, DrRich offered to enter into a “constructive dialogue” with Bob Doherty of the ACP Advocate Blog, regarding the important topic of medical ethics. What occasioned this offer was the fortuitous selection of each of us as finalists in the 2009 Medical Weblog Award Competition, in the category of Best Health Policy/Ethics Blog.
Ever since the inception of the Covert Rationing Blog (and even before that, in his book) DrRich has taken strong exception to the new code of “medical ethics for a new millennium,” formally promulgated in 2002 by the American College of Physicians and several of its equally respected sister organizations (a grouping DrRich has termed the Millennialists). And when he saw that the ACP Advocate Blog (an official publication of a principle component of the Millennialists) had become a co-finalist for a Weblog Award in the category of medical ethics, DrRich could not resist offering to engage in a discussion over same. Read more »
*This blog post was originally published at The Covert Rationing Blog*
February 6th, 2010 by DrRich in Better Health Network, Health Policy, Opinion
Tags: ACP, ACP Advocate Blog, Blog Awards, Bob Doherty, Cardiology, Covert Rationing, Doctor Patient Relationship, Internal Medicine, Medgadget, Medical Ethics, Medical Professionalism In The New Millennium, Smack Down
No Comments »
Yesterday, DrRich noted (with his usual affecting humility, modesty, self-deprecation, &c.) that the Covert Rationing Blog has been named a Finalist in the 2009 Medical Weblog Award Competition, in the category of Best Health Policy/Ethics Blog. He now calls to his readers’ attention the fact that, among the other two finalists – both of which are of very high quality and undoubtedly are more deserving of this award than DrRich – is none other than the ACP Advocate Blog.
The ACP Advocate Blog, written by Bob Doherty, is a publication of the American College of Physicians, and its purpose is to explain, elaborate on and advocate for the ACP’s positions on important matters related to health policy and medical ethics that affect its members, namely, internal medicine specialists. Doherty – who DrRich does not know, but of whom he has heard many very complimentary things – is an insightful analyst of matters related to healthcare policy, and to boot he is an excellent writer. DrRich is a loyal reader of the ACP Advocate Blog, which in fact has habitually led off DrRich’s blogroll.
Here’s why this is interesting. While both the ACP Advocate Blog and DrRich’s blog are finalists in the medical ethics category, it so happens that DrRich and the ACP are far apart on that very issue. Read more »
*This blog post was originally published at The Covert Rationing Blog*
