I am appreciative for all the doctors, nurses and others who are working today at the hospital.
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Yesterday the AMA news informed me that cyberchondria is on the rise. So it’s a good moment to consider the term’s meaning and history. Cyberchondria is an unfounded health concern that develops upon searching the Internet for information about symptoms or a disease. A cyberchondriac is someone who surfs the Web about a medical problem and worries about it unduly. Through Wikipedia, I located what might be the first reference to cyberchondria in a medical journal: a 2003 article in the Journal of Neurology, Neurosurgery, and Psychiatry. A section on the new diagnosis starts like this: “Although not yet in the Oxford English Dictionary, the word ‘cyberchondria’ has been coined to describe the excessive use of internet health sites to fuel health anxiety.” That academic report links back to a 2001 story in the Independent, “Are you a Cyberchondriac?” Two Microsoft researchers, Ryen White and Eric Horvitz, authored a “classic” See more Cyberchondria Rising — What is the Term’s Meaning and History? 
Yesterday some 3900 people swam, biked and ran in New York City’s 11th annual triathlon in what might be a celebratory event of human strength and perseverance. According to this morning’s paper, a 40-year-old woman suffered a heart attack during the 1500 meter swim in the Hudson. She was hospitalized and said to be in stable condition. A man, aged 64, became unconscious mid-way through the swim and was pronounced dead. The man’s death was the second in the history of NYC’s triathlon; three years ago someone else didn’t make it through the water segment. In March, 2009, the LA Times ran a piece on Death by Triathlon. Most who died in triathlons were men between the ages of 35 and 55 years. Most of the deaths occurred during the swimming portion of the race. Triathlon (Wikimedia Commons image) At the pool where I swim, I see people training See more On Deaths in the New York City Triathlon, and Pushing Ourselves to Limits 
The other day I came upon MyFoodAPedia.gov, sponsored by the U.S. Department of Agriculture. I love the site’s name and logo. The site allows you to look up a food and see how cooking it in different ways, or adding sauce or a condiment, affects the calories and nutritional components. Try looking up what’s in a half cup of broccoli florets, raw, cooked, or cooked with some butter. Or an English muffin… See more MyFoodAPedia, A Government-Sponsored Resource For Nutritional Facts I’ll be staying near my home in Manhattan this week. But if I did have plans to travel by airplane for the holiday, I think I’d be apprehensive about the new screening procedures implemented by the Transportation Safety Authority (TSA). My concern is not so much with the scanners…Rather, I’m worried about screening errors — false positive and false negative results, and about harms – physical and/or emotional, that patients and people with disability may experience during the screening process. See more The Transportation Safety Authority Screens Travelers Inside and Out A question central to today’s discussion – which does at least acknowledge the decline in breast cancer mortality – is the extent to which mammography is responsible for this trend, as opposed to other factors such as increased awareness about cancer, better cancer treatments and other variables. So while this little debate might seem minor and technical, reflecting some pettiness and distinct personalities among the various physician-bloggers, it bears on a serious issue for medicine, which is not so easily resolved: what are the tasks that we really want doctors to do, and not to delegate. This discussion relates to a recent editorial in the New York Times on whether we really need physicians to administer anesthesia…It bears also on simpler matters — whether doctors should spend time calling patients themselves about routine test results, adjust coumadin and other drug doses … See more Big Implications of Blog-Bickering About What Doctors Should Be Doing 
In some ways this seems like a pro-active, well-intentioned policy that could save lives. On the other hand, as discussed in the NEJM piece, the new screening policy raises a host of challenging issues: * how will colleges inform minor players’ parents about results? * how will the schools handle players’ privacy?… See more Perspective on Screening for Sickle Cell Trait in Student Athletes 
… this egg story reminds me of a gradual change in how we practiced medicine in the years after the start of the AIDS epidemic. In 1983, when I entered medical school, few doctors wore gloves except when they were performing surgery…A few years later, when I was a resident physician and pregnant fellow, the concept of universal precautions came into widespread practice. Doctors and nurses learned – had to be instructed — to don gloves whenever they drew blood or potentially came into contact with any patient’s body fluids because, the idea emerged, anyone might have … See more Cooking With Universal Precautions …Live Each Day Like There’s a Lot of Them Left.…What she articulated is the idea that maybe the best thing to do after cancer is to live, essentially, as you would do otherwise, except with a bit of added balance: See more Another Take On An Ordinary Day 
…the office has expanded and become so systematized that when I go there I don’t feel like I’m visiting a doctor, the kind of professional who sincerely cares about my health. Instead I feel like a commodity, which I suppose I am. See more Eye Care 
The Big C’s plot includes at least two “atypical” and potentially complex features. First, Cathy chooses not to take chemotherapy or other treatment. This intrigues me, and may be the show’s most essential component – that she doesn’t just follow her doctor’s advice. Second, she doesn’t go ahead and inform her husband, brother or son about the condition, at least not so far… See more First Take On the Big C But what’s also true, in a practical and bottom-line sort of way, is that a good physical exam can help doctors figure out what’s wrong with patients. If physicians were more confident – better trained, and practiced — in their capacity to make diagnoses by physical exam, we could skip the costs and toxicity of countless x-rays, CT scans and other tests. …like many people, I’ve been carrying around a mental stack of offices I’ve been meaning to call. So instead of taking care of some serious work that I really need to do, I ran the list: See more Today’s Calls Jackie is supposed to be a crackerjack nurse who has some serious problems including drug addiction. That premise might be fair enough, in a House-like way, if her life-saving skills had unique value. But they don’t: the underlying problem with this show is that Jackie has no exceptional or redeeming qualities as a nurse. Sure, she cares about some of her patients, but that’s nothing extraordinary… See more Shutting Off Nurse Jackie There’s been a recent barrage of med-blog posts on the unhappy relationship between doctors and electronic communications. The first, a mainly reasonable rant by Dr. Wes* dated August 7, When The Doctor’s Always In, considers email in the context of unbounded pressure on physicians to avail themselves to their patients 24⁄7. That piece triggered at least two prompt reactions: Distractible Dr. Rob’s** essay on Why I Don’t Accept eMail From Patients and 33 Charts’ Dr. V on The Boundaries of Physicians Availability. Perhaps the most astonishing aspect of these three guys’ essays is that, in 2010, there’s still a question about whether doctors should use email to communicate with patients. It’s hard for me to imagine physicians – including bloggers — so disconnected. But many are. Last year, I had the opportunity to speak with Professor Nathan Ensmenger, a historian of technology at the University of Pennsylvania who’s studied physicians’ A front-page story on the Humanities and Medicine Program at the Mount Sinai School of Medicine, here in Manhattan, recently added to the discussion on what it takes to become a doctor in 2010. The school runs a special track for non-science majors who apply relatively early in their undergraduate years. Mount Sinai doesn’t require that they take MCATs or the usual set of premedical science courses – some college math, physics, biology, chemistry and organic chemistry — before admission. The idea of the program is two-fold: first, that the traditional med school requirements are a turn-off, or barrier, to some young people who might, otherwise, go on to become fine doctors; second, that a liberal arts education makes for better, communicative physicians and, based on the numbers published in a new article, a greater proportion who choose primary care. Today Orac, a popular but anonymous physician-scientist blogger, considers the See more Back to Basics – But Which Ones? |
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connections…