Reading About Thinking (on D. Kahneman’s Ideas on Perceptions of Knowledge)

An article appeared in yesterday’s NYT Magazine on the hazards of over-confidence. The Israeli-born psychologist (and epistemologist, I’d dare say), Nobel laureate and author Daniel Kahneman considers how people make decisions based on bits of information that don’t provide an adequate representation of the subject at hand. He recounts how poorly, and firmly, army officers evaluate […]

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In Defense of Primary Care, and of Sub-Sub-Sub-Specialists

An article in the March 24 NEJM called Specialization, Subspecialization, and Subsubspecialization in Internal Medicine might have some heads shaking: Isn’t there a shortage of primary care physicians? The sounding-board piece considers the recent decision of the American Board of Internal Medicine to issue certificates in two new fields: (1) hospice and palliative care and (2) advanced heart failure and plans in-the-works for official credentialing in other, relatively narrow fields like addiction and obesity.

The essay caught my attention because I do think it’s true that we need more well-trained specialists

Posted in Essential Lessons, Future of Medicine, health care costs, health care delivery, Medical Education, PolicyTagged , , , , , , , Leave a Comment on In Defense of Primary Care, and of Sub-Sub-Sub-Specialists

Thoughts on Geraldine Ferraro, and Myeloma

Like many New Yorkers, feminists?, hematologists and other people, I was saddened to learn yesterday of Geraldine Ferraro‘s death. The Depression-era born mother, attorney, criminal prosecutor, Congresswoman, 1984 Democratic VP-candidate and part-time neighbor to yours truly, succumbed to complications of multiple myeloma at the age of 75. Myeloma is a cancer of plasma cells – […]

Posted in cancer survival, cancer treatment, Hematology (blood), Oncology (cancer), Public IllnessTagged , , , , , , , , 5 Comments on Thoughts on Geraldine Ferraro, and Myeloma

Why It’s a Good Idea to Get a Second Opinion, and Maybe a Third, But Rarely a Fourth

A few years ago I started writing a book on what it was like to be a cancer patient and an oncologist. This morning I came upon this section on second opinions: Is it OK to get a second opinion? Definitely. And there’s no need to be secretive about it, or to worry about hurting […]

Posted in cancer treatment, Communication, Empowered Patient, Life as a Doctor, Life as a Patient, Oncology (cancer), Patient-Doctor RelationshipTagged , , , , , , 1 Comment on Why It’s a Good Idea to Get a Second Opinion, and Maybe a Third, But Rarely a Fourth

Uncertainty Rules (on Eyjafjallajokull, volatility and a patient’s prognosis)

As pretty much anyone traveling in Europe this week can tell you, it’s sometimes hard to know what will happen next. Volcanologists – the people most expert in this sort of matter – simply can’t predict what the spitfire at Eyjafjallajokull will do next.

It comes down to this: the volcano’s eruption could get better or it could get worse…

Posted in Communication, Diagnosis, Life, Life as a Patient, Oncology (cancer), ScienceTagged , , , , , , , , Leave a Comment on Uncertainty Rules (on Eyjafjallajokull, volatility and a patient’s prognosis)

Are Doctors Necessary?

Ten years ago, my colleagues and I squirmed in our swivel chairs when a few tech-savvy patients filed in bearing reams of articles they’d discovered, downloaded and printed for our perusal.

Some of us accepted these informational “gifts” warily, half-curious about what was out there and half-loathing the prospect of more reading. Quite a few complained about the changing informational dynamic between patients and their physicians, threatened by a perceived and perhaps real loss of control.

How a decade can make a difference. In 2008 over 140 million Americans…

Posted in Communication, Empowered Patient, Essential Lessons, Health IT, Life as a Doctor, Patient-Doctor Relationship, Public Health, Social MediaTagged , , , , , , , , , , , , , Leave a Comment on Are Doctors Necessary?

Information Overload

Last week I received an email from a former patient. He has hemochromatosis, an inherited disposition to iron overload. His body is programmed to take in excessive amounts of iron, which then might deposit in the liver, glands, heart and skin. He mentioned “some amazing videos on hematology and hemochromatosis and genetics” he’d discovered on YouTube.

This is the future of medicine, I realized. … Whether physicians want their patients to search the Internet for medical advice is beside the point. We’re there already, whether or not it’s good for us and whether what we find there is true.

Posted in Communication, Empowered Patient, Future of Medicine, Health IT, Hematology (blood), Social MediaTagged , , , , , , , , , , , Leave a Comment on Information Overload
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