May 6th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research, True Stories
Tags: AACR, American Association for Cancer Research, American Society for Clinical Oncology, Anoikis, Apoptosis, ASCO, Barrett's Esophagus, CAM, Carcinoma, Cell Biology, Cell Death, Chemotherapy, Chronic Inflammation, Complicated, Complimentary and Alternative Medicine, Cure for Cancer, Douglas Adams, Dr. Allan Balmain, Dr. Joan Brugge, Dr. Lisa Coussens, Dr. Sean Morrison, Eradication of Cancer, Evidence-Based, Gastroesophageal Reflux Disease, Genetic Network, Genetics, GERD, Harvard Medical School, Hulda Clark, Malignant, Medical Quackery, Metabolic Derangements, Metabolism, Metastasize, NECSS, Nicholas Gonzalez, Northeast Conference of Science and Skepticism, Oncogenes, Pancreatic Cancer, President Richard Nixon, Quackademic Medicine, Robert O. Young, Science Based Medicine, stem cells, TCGA, The Cancer Genome Atlas, The Complexity of Cancer, Tumor Angiogenesis, Tumor Cell Anchorage, Tumor Suppressor Genes, UCSF, University of Michigan, Unscientific Medicine, War On Cancer, Warburg Effect
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[Recently] I participated in a panel discussion at the Northeast Conference of Science and Skepticism (NECSS) with John Snyder, Kimball Atwood, and Steve Novella, who also reported on the conference. What I mentioned to some of the attendees is that I had managed to combine NECSS with a yearly ritual that I seldom miss, namely the yearly meeting of the American Association for Cancer Research (AACR) meeting.
There are two huge cancer meetings every year — AACR and the annual meeting of the American Society for Clinical Oncology (ASCO). AACR is the meeting dedicated to basic and translational research. ASCO, as the word “clinical” in its name implies, is devoted mainly to clinical research.
Personally, being a translational researcher myself and a surgeon, I tend to prefer the AACR meeting over ASCO, not because ASCO isn’t valuable, but mainly because ASCO tends to be devoted mostly to medical oncology and chemotherapy, which are not what I do as a surgeon. Each meeting draws between 10,000 to 15,000 or even more clinicians and researchers dedicated to the eradication of cancer. Read more »
*This blog post was originally published at Science-Based Medicine*
May 5th, 2010 by Edwin Leap, M.D. in Better Health Network, Opinion, True Stories
Tags: Dehumanized, Doctors, Exhaustion, Family Medicine, Fatigue, Human, Patient Immunity, Personal Life, Physicians, Physics, Physiologic Phenomena, Primary Care, Stress, The Practice of Medicine
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It’s all too easy to try and quantify everything in medicine. We are, after all, under the widely held delusion that medicine is like physics. A thing that follows fixed, predictable mathematical models. A thing reproducible if only algorithm A is followed for this disease and algorithm B is followed for that disease.
This belief is also held by the government, which doesn’t want to pay for readmissions or mistakes. Because it is believed that all things in medicine can be known from an exam, some labs, some tests, and some studies.
Nevertheless, things happen. Disease are transmitted in public or by families. Medications don’t always work. Bodies change. Bodies age. Humans are non-compliant. Humans are suffering from physiologic phenomena we can’t yet comprehend. Viruses are synergistic with other diseases.
The immunity of our patients is affected by their happiness, their diet, their work history, their family. The algorithms necessary to make medicine anything like physics would be mathematically beyond comprehension. Read more »
*This blog post was originally published at edwinleap.com*
May 5th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
Tags: Defensive Medicine, Doctor-Patient Connection, Doctor-Patient Responsibility, Family Doctor, Family Medicine, Friends, Genuine Personal Investment, Getting Older, Getting Sick, Long-Term Patients, Medicare Cuts, Mid-Level Healthcare Providers, Patient-Doctor Relationship, Personal Stake in Health, Primary Care Medicine, Relational Medicine, The Joy of Primary Care, To Know and Be Known, Walgreens
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I was happy when I looked at [the day’s] schedule. Two husband-and-wife pairs were on my schedule, both of whom have been seeing me for over 10 years. Their visits are comfortable for me — we talk about life and they are genuinely interested in how my family is doing. They remember that I have a son in college, and want to know how my blog and podcast are doing. I can tell that they not only like me as a doctor — they see me, to some degree, as a friend.
Another patient on the schedule is a woman from South America. She has also been seeing me for over 10 years. I helped her through her husband’s sudden death in an accident. She brings me gifts whenever she goes on her trips, and also brings very tasteful gifts for my wife. Today she brought me a Panama hat.
I know these people well. I know about their past illnesses and those of their children. I know about their grandchildren, having hospitalized one of them over the past year for an infection. I know about the trauma in their lives as well as what they take joy in. They tell me about their trips and tell me their opinions about the healthcare reform bill.
I spend a large part of their visits being social. I can do this because I know their medical situation so well. I am their doctor and have an immediate grasp of the context of any new problems in a way that nobody else can. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
May 5th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, Opinion, True Stories
Tags: Disappointment, Disconnected Physician, Doctor-Patient Connection, Ethical Obligation, Family Medicine, Forgotten Piece of Medical History, General Medicine, Heartbreaking, Internal Medicine, Lost Generation of Medicine, Medical Profession, Older Doctors, Online Conversation, Paradigm of Care, Paternalism, Patient Advocacy, Patient Empowerment, Patient-Doctor Relationship, Personal Boundaries, Physician Control, Primary Care, Quality of Care, Social Health Media, Social Media Platform, Transparency, Younger MDs
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I [recently] visited a small town in west Texas to address a local medical society on the emerging role of social media in healthcare.
My presentation involves social media and the evolving relationship that patients share with doctors. I discuss challenges and opportunities -– especially as it relates to transparency, personal boundaries, and even the ethical obligation to participate in the online conversation. I target the disconnected physician and offer education as well as a compelling argument for involvement.
When I arrived at the venue I found that the meeting was attended predominantly by physicians much older than myself. While waiting to speak, I was concerned that my message of connection and changing relationships would elicit pushback. After all, isn’t it this era of physicians we hold accountable for paternalism and control in dealing with patients? That’s what I’d been lead to believe. Read more »
*This blog post was originally published at 33 Charts*
May 5th, 2010 by SteveSimmonsMD in Better Health Network, Health Policy, Humor, Opinion, Primary Care Wednesdays, True Stories
Tags: Continuous Restrictive And Punitive Paperwork, CRAPP, DocTalker Family Medicine, Dr. Steve Simmons, Healthcare Insurance Industry, Healthcare reform, Medical Acronym, Medical Paperwork, Patient-Doctor Relationship, Primary Care, Primary Care Practitioners, Primary Care Shortage, Quality of Care, Uncle Sam
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In medicine, hardly a week passes without the introduction of some new acronym, previously unspoken in the average practice, which then grows to prominence — take HIPAA, PECOS, CPT, ICD, etc. — the list goes on and on.
I believe that after 14 years of practice I’ve earned the right to introduce an acronym of my own: CRAPP. For the last several months, my partner and I have used this term to describe the volumes of denials, pre- and prior- authorizations (is there really a difference?), and faxes that seem to grow like weeds on the fertile planting grounds of our desks.
More specifically, in our office the acronym CRAPP stands for: Continuous Restrictive And Punitive Paperwork. To put it blithely, CRAPP could represent any document you wish someone had put on your partner’s desk instead of yours.
On a more emotional level, this acronym captures the visceral response I have whenever my attention is drawn away from my patients and redirected towards some nonsensical busywork — much like someone yelling at a golfer during their backswing.
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