August 7th, 2010 by KevinMD in Better Health Network, News, Opinion, Research
Tags: Annals Of Internal Medicine, Doctors' Diagnosis, Failure to Individualize Care, Family Medicine, Fixing Primary Care, General Medicine, Medical Diagnosis, Patient Disclosure, Patient Loads, Patient Social Factors, Patient-Doctor Relationship, Pay Doctors By The Hour, Primary Care Doctors, Primary Care Economics, Saul Weiner, Social Situations of Patients, Socioeconomics, Underlie a Patient's Symptoms
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A recent study from the Annals of Internal Medicine found that doctors often discounted a patient’s social situation when making a medical diagnosis.
Lead researcher Saul Weiner “arranged to send actors playing patients into physicians’ offices and discovered that errors occurred in 78 percent of cases when socioeconomic concerns were a significant factor.”
Evan Falchuk, commenting on the results, provides some context:
It’s hard to expect even the most gifted clinician, trying to make it through yet another week of a hundred or more patient encounters, to get these difficult decisions right. Too much of the context of a patient’s care gets lost in the endless churn of patient visits that the health care system imposes on doctors.I suspect this is enormously frustrating for doctors, although it’s worse for patients. What the researchers call a failure to “individualize care,” a patient might call “not being paid attention to.” It’s a dynamic that anyone who’s been ill has probably seen firsthand.
These findings are entirely unsurprising. Read more »
*This blog post was originally published at KevinMD.com*
August 6th, 2010 by Medgadget in Better Health Network, Humor, News, Research
Tags: Cardiopulmonary Resuscitation, Defibrillator, ED, Emergency Department, Emergency Medicine, Emergency Room, ER, Medical Humor, Medical Technology, QRS, Shay Carmon, Toast/e/r
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This clever and funny Toast/e/r (“ER” included in the name) is by designer Shay Carmon. Note the QRS complex grill:
Concept page: Toast/e/r…
(via Gizmodo)
*This blog post was originally published at Medgadget*
August 5th, 2010 by David Kroll, Ph.D. in Better Health Network, Humor, Opinion, Research
Tags: Andreas Marx, Biology, Chemical & Engineering News, Chemistry, Dr. Carmen Drahl, Five Favorite Drugs, Five Favorite Molecules, General Medicine, Medical Humor, Pharmacology, Princeton, Remote Desert Island, ScienceOnline2010, Sole Occupant, Survival, Thomas Mayer, University of Konstanz
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This post follows a lengthy conversation I had with my wife, a physician-scientist, about this very topic.
Many of you who attended the ScienceOnline2010 conference here last January probably met Carmen Drahl, the Princeton-trained chemist who now writes for Chemical & Engineering News and their appropriately-named drug discovery blog, The Haystack, as well as their Newscripts feature.
For the latter, Dr. Drahl pointed us toward a recent “Crosstalks” paper in Chemistry & Biology by Thomas U. Mayer and Andreas Marx of the University of Konstanz (and her interview with the authors) who mused as follows from their abstract:
Which five molecules would you take to a remote island? If you imagine yourself as a castaway on an island you might pick water, glucose, penicillin, and ethanol in combination with aspirin. However, as a scientist, you may ask yourself which molecules impressed you most by their chemical or biological property, their impact on science, or the ingenuity and/or serendipity behind their discovery. Here, we present our personal short list comprising FK506, colchicine, imatinib, Quimi-Hib, and cidofovir. Obviously, our selection is highly subjective and, therefore, we apologize up front to our colleagues for not mentioning their favorite compounds.
The authors pose two different questions: a) Which molecules, drug or not, would you take as the sole occupant of a desert island? and b) Which drugs most impress you with their chemistry, biology, or impact on science? Read more »
*This blog post was originally published at Terra Sigillata*
August 5th, 2010 by RamonaBatesMD in Better Health Network, News, Research
Tags: Asclera, Blood Vessels, Cosmetic Surgery, Dermatology, FDA, Food and Drug Administration, Plastic Surgery, Poliocanol, Spider Veins, Varicose Veins, Vascular Surgery
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The FDA recently (March 2010) approved Asclera (poliocanol) injection for the treatment of small spider veins (tiny varicose veins less than 1 millimeter in diameter) and reticular veins (those that are 1 to 3 millimeters in diameter).
Asclera is a detergent sclerosant and produces endothelial damage through interference with the cell’s surface lipids.and acts by damaging the cell lining of blood vessels. This causes the blood vessel to close, and it is eventually replaced by other types of tissue. Read more »
*This blog post was originally published at Suture for a Living*
August 5th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
Tags: Dogma-Based Medical Models, EBM, Evidence Based Medicine, Hard Science, MCAT, Medical College Admission Test, Medical School, Medical Students, Pre-Med Students, SBM, Science Based Medicine
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One of the recurring themes of this blog, not surprisingly given its name, is the proper role of science in medicine. As Dr. Novella has made clear from the very beginning, we advocate science-based medicine (SBM), which is what evidence-based medicine (EBM) should be. SBM tries to overcome the shortcomings of EBM by taking into account all the evidence, both scientific and clinical, in deciding what therapies work, what therapies don’t work, and why.
To recap, a major part of our thesis is that EBM, although a step forward over prior dogma-based medical models, ultimately falls short of making medicine as effective as it can be. As currently practiced, EBM appears to worship clinical trial evidence above all else and nearly completely ignores basic science considerations, relegating them to the lowest form of evidence, lower than even small case series. This blind spot has directly contributed to the infiltration of quackery into academic medicine and so-called EBM because in the cases of ridiculously improbable modalities like homeopathy and reiki, deficiencies in how clinical trials are conducted and analyzed can make it appear that these modalities might actually have efficacy. Read more »
*This blog post was originally published at Science-Based Medicine*
