What Does it Mean if Primary Care Doctors Get the Answers Wrong About Screening Stats?

The new findings have no bearing on whether or not cancer screening is cost-effective or life-saving. What the study does suggest is that med school math requirements should be upped and rigorous, counter to the trend

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On Admitting Nice, Ethically-Minded People to Med School

This week the Times ran a leading story on a new med school admission process, with multiple, mini-interviews, like speed dating. The idea is to assess applicants’ social, communication and ethical thinking (?) skills: …It is called the multiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United […]

Posted in Future of Medicine, Medical Education, Medical Ethics, Premedical, ScienceTagged , , , , , , , , 3 Comments on On Admitting Nice, Ethically-Minded People to Med School

TV Meets Real Life Oncology, and Anticipating the MCATs

Yesterday I wrote on some tough decisions facing a TV show‘s protagonist. She’s got metastatic melanoma and might participate in a clinical trial when the show resumes. Now imagine you’re an oncologist, or a real patient with this killing disease – you really need to be on top of new developments, to understand the pros […]

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New Findings on Leprosy and Armadillos

A surprise lesson arrived in my snail mailbox today: the April 28 issue of NEJM includes a fascinating research paper on a probable cause of leprosy in the southern U.S. New, detailed genetic studies show that armadillos, long-known to harbor the disease, carry the same strain as occurs in some patients; they’re a likely culprit […]

Posted in Dermatology, Diagnosis, Genetics, Infectious Disease, Medical Education, Medical NewsTagged , , , , , , , 4 Comments on New Findings on Leprosy and Armadillos

Sad Stats for Science Knowledge in U.S. Schools

Today’s Times reports on our nation’s students’ poor science test results. The results are bleak: only 34% of fourth graders scored at a “proficient” level or higher; just 30% of eight graders scored at a proficient level or higher; 21% of twelfth graders scored at a proficient or higher level in science. The mega-analysis, prepared […]

Posted in Empowered Patient, Future of Medicine, Informed Consent, Medical Education, Patient Autonomy, Public Health, ScienceTagged , , , , , , Leave a Comment on Sad Stats for Science Knowledge in U.S. Schools

First Inspection of Google’s Anatomy

This morning I toured Google’s new Body Browser. The trip wasn’t as easy as I’d envisioned; I got sidetracked on my way, having to update my Web browser before entering. The site requires an advanced Web browser, like Chrome beta or Firefox 4.0, to accommodate 3-D graphics.

Update accomplished, I forged into Google-woman’s frame. (There is no man available, as yet.)

Posted in Anatomy, Communication, Empowered Patient, Future of Medicine, Health IT, Medical Education, Wednesday Web SightingTagged , , , , , Leave a Comment on First Inspection of Google’s Anatomy

The Physical Exam’s Value is Not Just Emotional

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.

Posted in Diagnosis, Essential Lessons, Medical Education, Patient-Doctor Relationship, Physical ExaminationTagged , , , , , 4 Comments on The Physical Exam’s Value is Not Just Emotional

Back to Basics – But Which Ones?

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 […]

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When ‘No’ Turns Positive in Medical Care and Education

The medical word of the month is a most definite “no.”

The word is featured, explicitly and/or conceptually, in recent opinions published in two of the world’s most established media platforms – the New York Times and the New England Journal of Medicine. Their combined message relates to a point I’ve made here and elsewhere, that if doctors would or could take the time to provide full and unbiased information to their patients, people might choose less care of their own good sense and free will.

Let’s start with David Leonhardt’s April 7 column, “In Medicine, The Power of No.” In this excellent essay…

Posted in Communication, health care costs, Medical Education, Patient Autonomy, PolicyTagged , , , , , 2 Comments on When ‘No’ Turns Positive in Medical Care and Education

9 + 1 Ways to Reduce Health Care Costs

Recently in the Times’ “Patient Money” column, Lesley Alderman shared nine physicians’ views on how we might reduce our country’s health care mega-bill.

Here, I’ll review those comments, add my two cents to each, and then offer my suggestion (#10, last but not least!) regarding how I think we might reduce health medical costs in North America without compromising the quality of care doctors might provide.

The “answers” from…

Posted in Communication, Future of Medicine, health care costs, health care delivery, Ideas, Medical Education, Patient-Doctor Relationship, Policy, Public HealthTagged , , , , , , Leave a Comment on 9 + 1 Ways to Reduce Health Care Costs

Henrietta’s Cells Speak

“One of the ways that I gained the trust of the family is that I gave them information.” (R. Skloot, a journalist, speaking about her interactions with Henrietta Lacks’ family, Columbia University, 2/2/10)

Posted in Books, Communication, Essential Lessons, Ideas, Informed Consent, Life as a Patient, Medical Education, Medical Ethics, Oncology (cancer), Patient Autonomy, Patient-Doctor Relationship, Privacy, Reviews, Science, Women's HealthTagged , , , , , , , , , , , , 1 Comment on Henrietta’s Cells Speak

Why Medical Lessons?

One of the things I liked best about practicing medicine is that I was constantly learning.

Making rounds at seven in the morning on an oncology floor would be a chore if you didn’t get to examine and think and figure out what’s happening to a man with leukemia whose platelets are dangerously low, or whose lymphoma is responding to treatment but can’t take anymore medicine because of an intense, burn-like rash. You’d have to look stuff up, sort among clues

Posted in Communication, from the author, Ideas, Life, Life as a Doctor, Life as a Patient, Medical Education, Medical Ethics, Patient-Doctor RelationshipTagged , , , , , , , , 1 Comment on Why Medical Lessons?

How Well Do You Really Want to Know the “Red Devil?”

I know what it’s like to get the “red devil” in the veins.

You can learn about Adriamycin, a name brand chemotherapy, on WebMD. Or, if you prefer, you can check on doxorubicin, the generic term, using MedlinePlus, a comprehensive and relatively reliable public venture put forth by the National Library of Medicine and National Institutes of Health. If you’re into organic chemistry, you might want to review the structure of 14-hydroxydaunomycin, an antibiotic and cancer therapy first described 40 years ago…

Posted in Breast Cancer, cancer treatment, Essential Lessons, Life as a Doctor, Life as a Patient, Medical Education, Oncology (cancer), Women's HealthTagged , , , , , , , , , 2 Comments on How Well Do You Really Want to Know the “Red Devil?”

On Juno and Screening Test Stats

“Well, well” says the convenience store clerk. “Back for another test?”

“I think the first one was defective. The plus sign looks more like a division symbol, so I remain unconvinced,” states Juno the pregnant teenager.

“Third test today, mama-bear,” notes the clerk.

…”There it is. The little pink plus sign is so unholy,” Juno responds.

She’s pregnant, clearly, and she knows she is.

(see clip from Juno the movie*)

Think of how a statistician might consider Juno’s predicament…

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Dinner with my Family

Family gatherings centered on two things – food, and talk about medicine. We spoke of interesting cases (always nameless), challenging conditions and, even back then, the constraints of health care costs. My fiancé, now husband of over 20 years, couldn’t get over how debate over health care dominated our Rosh Hashanah and Thanksgiving feasts…

…when I learned I had breast cancer, I knew exactly what to do. The decisions, though difficult, were almost straightforward, buttressed by my knowledge and familiarity with the language of medicine…

Posted in Communication, Empowered Patient, Life as a Doctor, Life as a Patient, Medical Education, Patient-Doctor RelationshipTagged , , , , , 5 Comments on Dinner with my Family
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