June 10th, 2010 by Mark Crislip, M.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
Tags: Anti-Vaccine Movement, Autovaccine, Blood Irradiation Therapy, CDC, Centers For Disease Control and Prevention, Children's Vaccinations, Debate, Dr. Robert Rowen, Dr. Wakefield, Encephalitis, High-Dose Vitamin C IV, Immune System, Immunization, Immunology, Infectious Disease, Measles, Medical Voices, MMR, Natural Mumps, New Mumps Outbreak, Orchitis, Ozone Therapy, Pseudoscience, Tear To Shreds, Toxin Gambit, Vaccination
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I write this post with a great deal of trepidation. The last time I perused the Medical Voices website I found nine questions that needed answering. So I answered them. One of the consequences of that blog entry was the promise that Medical Voices was poised to “tear my arguments to shreds.” Tear to shreds! Such a painful metaphor.
They specified that the shred tearing would be accomplished during a live debate, rather than a written response. While Dr. Gorski gave excellent reasons why such a debate is counterproductive, I am disinclined for more practical reasons. I am a slow thinker and a lousy debater and have never, ever, won a debate at home. If I cannot win pitted against my wife, what chance would I have against the combined might of the doctors and scientists at Medical Voices? My fragile psyche could not withstand the onslaught.
Still, there is much iron pyrite to be mined at Medical Voices and it may provide me for at least a years worth of entries. Please forgive me if I seem nervous or distracted. I have a Sword of Damocles hanging over my head and it may fall at any time. My writings may, without warning, be torn to pieces by the razor sharp logical sword of Medical Voices. Or maybe not. It is my understanding that Medical Voices will only answer with a debate, so maybe I am safe from total ego destruction.
This month, as I perused Medical Voices, I found it difficult to choose an article. So much opportunity and I have limited time to write. I finally decided on Why the New Mumps Outbreak Puts You At Risk by Robert J. Rowen, M.D. Read more »
*This blog post was originally published at Science-Based Medicine*
June 10th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
Tags: Belief-Based Medicine, Belief-Threatening, Certainty, Evidence Based Medicine, Journal of Applied Social Psychology, Knowledge, Munro, New Evidence, Pseudoscience, Science Based Medicine, Science-Based Evidence, Scientific Impotence, Scientific Method, Scientific Research, Skepticism, Subject To Change, USPSTF
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“I don’t want knowledge. I want certainty!” — David Bowie, from Law (Earthlings on Fire)
If there’s a trait among humans that seems universal, it appears to be an unquenchable thirst for certainty. It is likely to be a major force that drives people into the arms of religion, even radical religions that have clearly irrational views, such as the idea that flying planes into large buildings and killing thousands of people is a one-way ticket to heaven.
However, this craving for certainty isn’t expressed only by religiosity. As anyone who accepts science as the basis of medical therapy knows, there’s a lot of the same psychology going on in medicine as well. This should come as no surprise to those committed to science-based medicine because there is a profound conflict between our human desire for certainty and the uncertainty that is always inherent in so much of our medical knowledge. The reason is that the conclusions of science are always provisional, and those of science-based medicine arguably even more so than many other branches of science. Read more »
*This blog post was originally published at Science-Based Medicine*
June 9th, 2010 by RamonaBatesMD in Better Health Network, Health Policy, Opinion, Research, True Stories
Tags: Doctors Are Victims, Dr. Lisa Chu, Dr. Robert Goldwyn, Dr. Ryan Flesher, Emergency Medicine, General Medicine, Hand Surgeon, Hand Surgery, Internal Medicine, Patient Care, Physician Burnout, Plastic and Reconstructive Surgery, Practicing Medicine, Primary Care, Teaching Violin, The Vanishing Oath, Work-Life Balance, Workaholic, Working Overtime, Working Too Much
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Dr. Wes and Kevin, M.D. have both written reviews of the documentary film “The Vanishing Oath.” I started the process rolling of trying to get the film shown locally. No date yet, but looks like it will happen before the year is out.
This is not a new phenomenon in medicine (or any profession). Dr. Robert Goldwyn wrote a nice essay on the some of the issues that can lead to burnout, though not once did he mention burnout specifically. The title says much:
“I Bargained on Working Hard as a Surgeon, Not Working Hard to Be Able to Work Hard as a Surgeon”
The preceding title is a quote from a letter written by a resident in the last year of his training (S. A. Teitlebaum, August 20, 1994). It reflects the gloom besetting the young in particular but certainly not them exclusively. We all are uneasy about our futures, professionally and economically. Bandied in the corridors at a national meeting was a dismal figure: 1:100,000, the presumed proper ratio, as determined by Health Maintenance Organizations, of plastic surgeons to population. That 1 million Americans need only 10 plastic surgeons seems wrong and idiotic to me, but it makes good economic sense to health providers and insurance companies. Their coffers swell as they collect the same or higher premiums while curtailing what they provide. Read more »
*This blog post was originally published at Suture for a Living*
June 9th, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy, News, Opinion, Research
Tags: Family Medicine, General Medicine, Group Health, Healthcare Economics, Healthcare Policy, Healthcare reform, Healthiest Patients, Internal Medicine, Low-Income Patients, Medical Home, New Primary Care Models, Ontario, Physician Income, Poor Patients, Primary Care Physicians, Primary Care Shortage, The Poor, Urban Poor, Wealthiest Patients
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In a recent blog posting, I described Group Health’s medical home for 8,000 patients. It proved to be a boon for primary care physicians, who were able to reduce the size of their patient panels, see fewer patients per day, refer more patients to specialists, and maintain or increase their incomes.
Patients liked it, too. And Group Health was happy because expenditures per patient were 2 percent lower. But poor patients had trouble getting through the front door of the medical home, so based on demographic differences alone, expenditures should have been lower by 10 percent or more. Nonetheless, they declared victory.
Now news filters south from Ontario’s eight-year experiment with medical homes for 8,000,000 patients, and the news is similar. Participation is skewed to healthier and wealthier patients who, in the absence of risk adjustment, yield profitable capitation for primary care physicians. Incomes have soared an average of 25 percent. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
June 8th, 2010 by StaceyButterfield in Better Health Network, Health Policy, News, Opinion, Research
Tags: Children's Health, Daily Diet, Diet and Nutrition, Dietetics, Educational Programs, Family Medicine, Food Advertisements, Food and Nutrition, General Medicine, Good Food Choices, Health Diet, HealthDay, Imbalanced Food Selections, Internal Medicine, Pediatrics, Primary Care, Public Awareness, Public Health, Saturday Morning Cartoon Viewer, Television Consumers, TV Commercial Food
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We’ve been slacking in the “Medical news of the obvious” department lately. Seems like research has been either actually newsworthy or so obvious that you could spot it yourselves (for example, the continuing investigations of whether smoking and being lazy are bad for you).
But we couldn’t let this one slide by: “A new study that analyzes what would happen if a person were to eat 2,000 calories of foods that are advertised on the tube,” as HealthDay describes. As even the average Saturday morning cartoon viewer could have predicted, the food in commercials turns out to be bad for you. Read more »
*This blog post was originally published at ACP Hospitalist*
