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A Doctor’s Guilt About Healthcare Costs

Times are tight and we’re all looking to save money, be it our own or someone else’s. Many will say that when it comes to the skyrocketing costs of healthcare, doctors are responsible for part of the problem.

Doctors order too many tests, either to cover ourselves in the event of a malpractice suit, or because patients pressure us, or because we genuinely believe that the tests are necessary for patient care, but in many circumstances, a cheaper option is available. We order medications that are expensive when cheaper medications are available. And psychiatrists offer care — like psychotherapy — that could be done by clinicians who are cheaper to educate and willing to work for less money. Read more »

*This blog post was originally published at Shrink Rap*

Pre-Med Vs. Liberal Arts: “Don’t Know Much Biology”

Study painting, drama or the “soft” social sciences and you’ll probably be a pretty good doctor anyway. Mt. Sinai School of Medicine has been doing it for years and compared students in a special liberal arts admissions program to its traditional pre-med students.

For years, Mt. Sinai has admitted students from Amherst, Brandeis, Princeton, Wesleyan, and Williams colleges based on a written application with personal essays, verbal and math SAT scores, high school and college transcripts, letters of recommendation, and personal interviews. No MCAT is required.

Students need to take one year of biology and one year of chemistry and maintain (swallow hard) a “B” average. They later get an abbreviated course in organic chemistry and medical physics. Read more »

*This blog post was originally published at ACP Internist*

Twitter Used To Gauge The Nation’s Mood

A team from Northeastern University and Harvard Medical School has been analyzing words used in tweets by American users in an attempt to gauge the public mood around the country.

What they discovered was that users on the West Coast seem to be quite a bit jollier than those on the East Coast. It’s not clear whether the data was collected during the summer or winter months and accordingly adjusted, for that surely would affect the readings.

Researchers were able to infer the mood of each tweet using a psychological word-rating system developed by the National Institute of Mental Health’s Center for the Study of Emotion and Attention. The system ranks words based on how they make people feel. Read more »

*This blog post was originally published at Medgadget*

Life Without A Mental Disorder: Is It Possible?

There’s a noteworthy column in Psychiatric Times, “Normality Is an Endangered Species: Psychiatric Fads and Overdiagnosis,” by Allen Frances, M.D. He was chair of the task force that worked on the Diagnostic & Statistical Manual — DSM-IV — one edition of the “bible of psychiatry.” He is professor emeritus of psychiatry at Duke University School of Medicine. There’s a lot of common ground between what Dr. Frances writes and what Dr. Daniel Carlat (the subject of an earlier blog posting) writes about. Dr. Frances is concerned about the directions that might be taken in the authoring of DSM-V, now underway.

Excerpts:

“Fads in psychiatric diagnosis come and go and have been with us as long as there has been psychiatry. The fads meet a deeply felt need to explain, or at least to label, what would otherwise be unexplainable human suffering and deviance. In recent years the pace has picked up and false “epidemics” have come in bunches involving an ever-increasing proportion of the population. We are now in the midst of at least 3 such epidemics–of autism, attention deficit, and childhood bipolar disorder. And unless it comes to its senses, DSM5 threatens to provoke several more (hypersexuality, binge eating, mixed anxiety depression, minor neurocognitive, and others). Read more »

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

Single-Session Psychotherapy: The Cab Driver Story

Here’s a story that came out of the American Psychological Association (APA) conference:

I was in a cab going to dinner. The cab driver found out I was a psychiatrist so he told me about his life-changing experience with therapy.

At one time he was having an incredible problem with his life. He was using cocaine, couldn’t keep a job, and his relationships were going down the tubes. Therapy helped him quit cocaine and change all that. (Which was good, since he was the driver of my cab. I really wanted him not to be high or in distress.) This kind of turn-around story isn’t unusual for me — parolees will often come back and tell me about things they’ve done in free society that they’re proud of. The unusual part of this story is the fact that he made all of these changes after a single one-hour session. Read more »

*This blog post was originally published at Shrink Rap*

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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