August 5th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
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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*
July 28th, 2010 by SteveSimmonsMD in Better Health Network, Opinion, Primary Care Wednesdays, True Stories
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As a physician, I’ve had several people ask my “honest” opinion of their plans to become a doctor. I know what my response is to this question, but I wonder what others in my profession would answer. Would your response depend, in large part, on who’s doing the asking — could you answer your own child as you would someone you just met? Be careful, your answer to this question, if honestly given, might shine an unsettling light on your own feelings about your current career choice.
Last week I spoke with a college junior working to fulfill her lifelong plans to become a physician. She told me about a recent conversation with her own doctor where she shared her plans to go to medical school and he’d tried to dissuade her. She couldn’t recall a single cogent reason given for avoiding the medical profession, yet it appeared to me that his odium had negatively imprinted her image of the medical profession, which is a shame. At this time more than ever, we –- doctors and patients alike — need to encourage the most talented of our youth to join the medical profession. Read more »
July 26th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, News, Opinion, Quackery Exposed
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I’m embarrassed to say this, but the nursing profession is making a mockery of healthcare education by downgrading the post-graduate degree process. The nursing education requirements in the advertisement seen here are an embarrassment to the nursing profession.
Mrs. Happy pointed out an advertisement from her nursing magazine offering advanced nursing education opportunities. This advertisement for the doctor nurse practitioner (DNP) training track at Creighton University is a mockery of the rigorous educational requirements necessary to care for patients independently. Check out the nursing education requirements on their advertisement: No entrance exam required? No clinical experience? No thesis required? What has this world come to?
These are professionals who are going to be taking care of patients in less than two years. Some states allow NPs to manage patients independently with no physician oversight. That is just plain scary. This is an embarrassment to the foundation of anatomy, physiology, pathophysiology, neuroanatomy, microbiology, pharmacology, genetics — and on and on — required to care for patients independently. Read more »
*This blog post was originally published at The Happy Hospitalist*
July 21st, 2010 by Toni Brayer, M.D. in Better Health Network, Health Policy, Opinion, True Stories
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Most doctors have a love/hate (and mainly hate) relationship with health insurance companies. We struggle with their confusing and complex coding rules in an effort to be reimbursed for our care of patients. When patients leave the office, they may think that a bill is sent to their insurance company and payment follows. More often than not it rarely happens that way.
I am staring at an explanation of benefits (EOB) from Blue Shield of California for a patient I saw for a physical exam and Pap test. This patient had recently been hospitalized with a life threatening throat infection and abscess and saw me for needed follow up. I spent about 45 minutes with the patient, reviewing the events leading to hospitalization, coordinating the medications, as well as addressing the routine screening and examination of a middle aged woman with some chronic health problems. Read more »
*This blog post was originally published at ACP Internist*
June 29th, 2010 by JessicaBerthold in Better Health Network, Humor, Opinion, True Stories
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A version of the following post by Kimberly Manning appeared on the blog Reflections of a Grady Doctor:
May and June mark the end of our academic year in medical education. The medical students either advance to the next level or become sho’ nuff and bonified doctors — albeit uncertified and untrained — but doctors nonetheless. The interns exit the novice stage and become residents — one week asking someone senior what to do, the next telling someone junior what to do. And of course, the senior residents and fellows finally get the stamp of approval that officially releases them from the nest. It’s kind of bittersweet for folks like me — the surrogate mommies and daddies that helped guide them along this path to becoming full-fledged physicians. Read more »
*This blog post was originally published at ACP Hospitalist*
