Some interesting medical-ish links
A couple of blog entries in the last few weeks caught my attention. Both are well worth reading…
- Panda Bear, MD with his usual charm makes some good points on health care sustainability:
Now consider that most of my chronically sick patients are in no way making even the slightest effort to take care of their health and, where my otherwise healthy patient had an isolated cardiac event which should be relatively easy to manage, these patients each have several to a dozen deadly medical problems which are only prevented from killing them by the expenditure of vast sums of health care dollars. Fifty years ago they would not have survived the intial heart attack or the the failure of their kidneys. Their kindly country doctor would have arrived at the house with his well-worn doctor’s bag, examined the patient, looked appropriately grave and directed the family to call their priest and the funeral home. The total cost to the health care system would have been whatever the doctor charged for his visit and the patient’s family themselves would have paid the bill.
It is therefore senseless to complain about the cost of health care and long for the fairly recent days when providing medical care did not suck up a fifth of our gross domestic product. Times have changed. Medical care today is expensive because it is a sophisticated enterprise employing some of the highest-skilled and most intelligent people in our society. Fifty years ago, while doctors were equally intelligent and trained to be superlative diagnosticians, the treatment options for serious medical conditions were severely limited and the deteriorating course of a cancer patient, for example, was followed more for the intellectual exercise than for the ability to intervene. There was no Golden Age of medicine when doctors were more caring and provided effective and economical treatments. Doctors may have been more caring fifty years ago but thats’ all they had to offer. It was just play-acting which is not very expensive.
- Shadowfax opines on malpractice reform:
What I want, both as a practicing physician and as the manager of a large medical group, is for a system that accurately relates “bad care” and financial liability. It’s not personal, to me. Our group takes care of over 150,000 patients annually, and in a high-acuity environment like ours, staffed by fallible human beings, mistakes are going to happen. So compensating injured patients is and ought to be just a cost of doing business.
But the problem is that it’s not predictable, or rather that it is predictable for the wrong reasons. A sympathetic plaintiff is a potent threat, and I can recall several cases which we settled despite excellent care, because the risk of a huge judgment was too high. On the other hand, I have seen a number of cases where the care was, let’s say “debatable,” but our attorneys play the game well and the lawsuit went away. Certainly we win more than we lose, so if some contend the system is rigged in our favor I wouldn’t necessarily disagree, and we can tell a case that is a potential loser, so there is some predictability.
- The BMJ debunks some common medical myths (via BoingBoing):
hysicians understand that practicing good medicine requires the constant acquisition of new knowledge, though they often assume their existing medical beliefs do not need re-examination. These medical myths are a light hearted reminder that we can be wrong and need to question what other falsehoods we unwittingly propagate as we practice medicine. We generated a list of common medical or medicine related beliefs espoused by physicians and the general public, based on statements we had heard endorsed on multiple occasions and thought were true or might be true. We selected seven for critical review:
• People should drink at least eight glasses of water a day
• We use only 10% of our brains
• Hair and fingernails continue to grow after death
• Shaving hair causes it to grow back faster, darker, or coarser
• Reading in dim light ruins your eyesight
• Eating turkey makes people especially drowsy
• Mobile phones create considerable electromagnetic interference in hospitals.
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