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Mammography: An Important Discussion To Keep Alive

This is a thoughtful “sounding board” piece in the New England Journal of Medicine this week: Lessons from the Mammography Wars.

It is so important to keep this discussion alive. The miscommunication that took place last November of what the U.S. Preventive Services Task Force tried to convey, and the complicity of some news organizations in adding to that confusion, provide lessons from which we simply must learn to do better.

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Locally Grown Medical Students More Likely To Stick Around

Nearly a third of medical graduates at the University of North Dakota continue in primary care, down from nearly half just two years ago. This is the university that leads the nation for the percentage of students (about 20 percent) choosing family medicine.

North Dakota overall will be short about 160 physicians by 2025, and the need is now affecting urban areas as well as rural ones, said Joshua Wynne, FACP, dean of the university’s School of Medicine and Health Sciences.

Keeping medical students interested in practicing primary care in rural America depends upon whom medical schools choose to admit. For example, one-fourth of the University of North Dakota’s student population hails from small towns, and 80 percent are in-state.

More and more medical schools are looking at locally grown talent to fill their residencies, believing that these students are more likely to stay after graduation. Read more »

*This blog post was originally published at ACP Internist*

Emergency Rooms Overused For Routine Care

The Patient Protection and Affordable Care Act (our government’s name for healthcare reform) may make our already crowded emergency rooms swarm with more patients.

A new study from Health Affairs shows that more than a quarter of patients who currently visit emergency departments in the U.S. are there for routine care and not an emergency. New complaints like stomach pain, skin rashes, fever, chest pain, cough or for a flare up of a chronic condition should not be treated in emergency rooms. They are best worked up and treated by an internist or family physician, preferably one who knows the patient. So why are these patients waiting for hours and spending up to 10 times as much money for emergency department care? Read more »

*This blog post was originally published at EverythingHealth*

Letting Doctors Care For Their Patients

“Ouch! That really hurts! You win, please stop torquing my arm behind my back. “Uncle! I said, Uncle!!”

Yes, the threshold has been reached. We docs no longer need a tennis court or a Mercedes, our kids are fine in public schools, and we will happily buy our own damn pens.

But, please, just give us some modicum of autonomy. Throw us a measly scrap and let us take care of our patients as we see best. Like Dr. Saul Greenfield so beautifully said today in the Wall Street Journal. The paragraph that stood out the most for me is as follows:

Physician autonomy is a major defense against those who comfortably sit in remote offices and make calculations based on concerns other than an individual patient’s welfare. Uniformity of practice is a nonsensical goal that fails to allow for differing expression of disease states.

Really, it isn’t hyperbole to surmise that the overwhelming majority of doctors would decide, if faced with a choice between less compensation and less autonomy, to choose less compensation.

As a teen my dad told me the best part of being a doctor would be the autonomy. He was right, and that’s what hurts the most these days.

JMM

*This blog post was originally published at Dr John M*

How To Energize And Engage The Doctor-Nurse Team

Some patients struggle to communicate effectively with their doctors and some doctors and nurses find it difficult to communicate and collaborate with each other.

Historically, the dynamic symbiotic relationship between doctors and nurses has been a little shaky, evidenced by the lack of engagement and respect for one another.

Hospitals are chaotic and stressful. Working in such an environment can lead to frustration and it can take a toll on the staff. Instead of a good working relationship (which may never have been fostered to its full potential from the start), doctors and nurses become a fractured team. As a result, the fractured team will not effectively communicate and patient care may suffer devastating consequences. Read more »

*This blog post was originally published at Health in 30*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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