August 31st, 2011 by Bryan Vartabedian, M.D. in Opinion, True Stories
Tags: Digital Age, Doctor Patient Relationship, Doctor-Patient Communication, Doctors, Health 2.0, Information, Information show of force, Informed Patient, Patients, Texas Medical Center
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Sometime around 1998 in the Texas Medical Center:
DrV: (enters exam room) Hey, How are you? I’m Bryan Vartabedian (extends hand).
Father: (arms crossed, smiling, leaning against wall) Oh I know who you are, Doc. And I know where you went to school, where you’ve lived, if you’ve been sued and a few other things. And I’m fine, by the way.
DrV: Um, Okay. (Shakes hands with father. Looking to child, scruffing his hair). And this must be Caleb.
An odd moment, for sure. When it happened I didn’t know what it was about. After similar encounters I understood. It was about where patients found themselves in the early days of the information revolution. And there was the father who wheeled into the exam room two large boxes of printouts perched on a dolly. Inkjet validation of his role in the decision about his son’s surgery.
These situations illustrate Read more »
*This blog post was originally published at 33 Charts*
August 30th, 2011 by Dinah Miller, M.D. in Humor, Opinion
Tags: Anderson Cooper, Discomfort, Embarrassment, Empathy, giggling, laughter, Projection, Psychiatry, Psychology, Ridiculist List, Uncomfortable
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If you haven’t seen Anderson Cooper catch a case of the giggles on live TV, you can still watch it on YouTube. I missed the first showing, but saw Mr. Cooper replayed it on his own Ridiculist List. But what’s this doing on Shrink Rap?
I watched the re-run, and I found myself laughing out loud. Only, it wasn’t a good, happy, hearty laugh, it was an embarrassed and uncomfortable laugh, and I realized I’d taken on the feelings of the newsman. If I were a psychiatrist (oops, I am, even in August), I might say that Anderson Cooper Read more »
*This blog post was originally published at Shrink Rap*
August 30th, 2011 by Lucy Hornstein, M.D. in Health Policy, Opinion
Tags: Demographic, E-prescribing, Electronic Medical Record, EMR, Ethnicity, Government, Hispanic, Language, Meaningful Use, Medical, Medical History, Medicare, Non-hispanic, Race
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Race is a medically meaningless concept.
Spare me the few tired cliches about prostate cancer, diabetes, and sarcoidosis being more common in blacks than whites, or even the slightly increased risk of ACEI cough in patients of Asian descent. We screen Jews of Ashkenazi descent for Tay Sachs without any racial labeling. All that information is readily accessible under the Family History section of the medical history. It is no more than custom which dictates the standard introductory format including age, race, and gender. It turns out I’ve blogged about this before at some length (pretty good post, actually). What is new is the advent of electronic medical records.
Much hullabaloo has been made about federal stimulus funds allocated to doctors as payments for adopting EMRs; “up to $44,000!” Here’s the problem with that figure, though, including how it breaks down (source here): Read more »
*This blog post was originally published at Musings of a Dinosaur*
August 30th, 2011 by Happy Hospitalist in Opinion
Tags: Costs, debt, Family Medicine, Hospitalist, Income, Internal Medicine, Loans, Med Student, Medical School Debt, Medicare National Bank, Payment Model, Primary Care, Specialties, Student Loans, Tuition
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The total debt cost of medical school has become obnoxious. When I started medical school 15 years ago this month, I took out approximately $2,000 a month in loans. $1,000 a month for all living expenses, including food, rent, utilities and entertainment and $1,000 a month for tuition and related expenses. I got out of medical school with just under $110,000 in loans for which I am currently paying back at a rate of $500 month for 30 years.
I learned the other day that a family medicine resident recently completed medical school with almost $250,000 in medical school loans. Family medicine? $250,000? Are you crazy? If that resident can lock in a 30 year loan at 3.5%, they’re looking at monthly payments of $1,200 a month for the rest of their lives. With current tax rates, this family resident will need to earn at least Read more »
*This blog post was originally published at The Happy Hospitalist*
August 29th, 2011 by Harriet Hall, M.D. in Opinion, Research
Tags: Chinese Traditional Therapy, Cold, Complications, Fever, Flu, Flu Symptoms, H1N1, Herbal Remedies, Herbs, Influenza, Maxingshigan–Yinqiaosan, Oseltamivir, Placebo, Research, Science Based Medicine, Side Effects, Study, TCM
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During the early days of the 2009 H1N1 influenza A pandemic, the popular herbal formula maxingshigan–yinqiaosan was used widely by TCM practitioners to reduce symptoms. (It’s hard to pronounce and spell, so I’ll refer to it as M-Y.) A new study was done to test whether M-Y worked and to compare it to the prescription drug oseltamivir. It showed that M-Y did not work for the purpose it was being used for: it did not reduce symptoms, although it did reduce the duration of one sign, fever, allowing researchers to claim they had proved that it works as well as oseltamivir.
“Oseltamivir Compared With the Chinese Traditional Therapy: Maxingshigan–Yinqiaosan in the Treatment of H1N1 Influenza” by Wang et al. was published in the Annals of Internal Medicine earlier this month. The study was done in China, which is notorious for only publishing positive studies. Even if it were an impeccable study, we would have to wonder if other studies with unfavorable results had been “file-drawered.” It’s not impeccable; it’s seriously peccable.
It was randomized, prospective, and controlled; but not placebo controlled, because they couldn’t figure out how to prepare an adequate placebo control. They considered that including Read more »
*This blog post was originally published at Science-Based Medicine*
