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Latest Posts

Physician Learns A Lot Doing AFib Research With No Funding

I learned a lot from putting together an abstract for a national heart meeting.

  • More than just learning how to e-submit, e-upload and e-print a large poster;
  • More than what t-tests and chi-squares measure;
  • More than learning that females respond differently to AF ablation;
  • And surely more than which coffee shop offers the best work place.

Putting this thing together showed me stuff: the process of discovery, it’s role in helping us be better doctors and the difficulties inherent in doing this kind of valuable research in our current system.

So of course…bloggers blog.

First: Many have asked why we bothered doing research? What’s the motivation? Money? Fame? A greater purpose?

It was none of these. Read more »

*This blog post was originally published at Dr John M*

Keeping Up With New Things: Nurse Decides To Go Back To School

Nursing instructors grading Exams in the 1950s. Courtesy of Johns Hopkins Medical Archives on Flickr.


I remember it well. Cramming all night for a nursing exam, taking the test, and hoping for the best. It was a nerve racking experience for the students, but I’ve always wondered what it was like for the instructors. Check out these old gals. Grading papers was time consuming before computerized tests, but I bet they got some pretty entertaining answers.

Miss Jones, Medical Surgical Instructor: “Oh my God, I can’t believe this answer. It’s right up there with the excuse, “my dog ate my care plan.”

Mrs. Smith, OB/GYN Instructor: “I know what you mean. These young people are the future of our profession. Read more »

*This blog post was originally published at Nurse Ratched's Place*

Are MDs More Effective At Running Hospitals Than MBAs?

It’s been more than five years since Henry Mintzberg released the enlightening book ‘Managers, not MBAs’, a well-reasoned criticism of prevailing management education that basically revolves around Master in Business Administration (MBA) programs. Financial crisis was not even in sight but Mintzberg, a professor at McGill University in Montreal and one of the most important guiding lights in the questionable field of management, already pointed out that it was a serious danger for modern organizations to rely on professionals that had just finished their MBAs as the prime source for senior managerial positions.

Mintzberg focused his criticism on two essential aspects. First, most programs are aimed at people with no previous experience or knowledge about organizations and how they look like from the inside… and these same people then storm into companies believing that the real world works exactly as business school taught them it does. The second point is that many of these business schools spread a perverted set of values, such as the hunt for short-term profit, the belief that a good aim justifies any means and the urge to translate all human behaviors into accountable figures (the ‘countophrenia’ depicted by Vincent de Gaulejac in his must-read ‘La Société Malade de la Gestion’).

Then the crisis rose, and many CEOs of the biggest organizations had their share of responsibility for it, as they were enjoying multi-million dollar bonuses while taking their companies to the edge of bankrupcy. Most of them came from the most famous business schools in the world. I have outlined in the past the outrageous conflict of interests of many of these institutions, starting with Harvard, as Charles Ferguson perfectly displayed in his brilliant documentary ‘Inside Job’.

‘Social Science and Medicine’ published in its August issue a very interesting work by Amanda Godall, professor at the IZA Institute for the Study of Labor in Bonn, Germany. Godall’s is the first empirical research on the correlation between hospital results and having MDs in their top managerial positions. Read more »

*This blog post was originally published at Diario Medico*

The Best Doctors Are Constantly Learning

Monday’s New Yorker has a story, Personal Best, by Atul Gawande. It’s about coaching, and the seemingly novel idea that doctors might engage coaches – individuals with relevant expertise and experience — to help them improve their usual work, i.e. how they practice medicine.

Dr. Gawande is a surgeon, now of eight years according to his article. His specialty is endocrine surgery – when he operates it’s most often on problematic glands like the thyroid, parathyroid or appendix. Results, and complications, are tracked. For a while after he completed his training he got better and better, in comparison to nation stats, by his accounting. And then things leveled off.

The surgeon-writer considered how coaches can help individuals get better at whatever they do, like playing a sport or singing. He writes:

The coaching model is different from the traditional conception of pedagogy, where there’s a presumption that, after a certain point, the student no longer needs instruction. You graduate. You’re done. You can go the rest of the way yourself…

He wonders about how this might apply in medicine: Read more »

*This blog post was originally published at Medical Lessons*

The Natural Evolution Of Science: As Knowledge Grows, Treatments Change

I read with interest a blog post by Robert Krulwich of NPR fame on why there is so much public resistance to accept changes in truth with new scientific discoveries (some of which was new to even me)…

1) Triceratops with their beautifully placed 3 horns is actually the teenage dinosaur version of the adult Torosaurus (who had ugly asymmetric horns). Now… a decision had to be made regarding which name to stick with. Ultimately, “Triceratops” won out, perhaps because of the “Save the Triceratops” Facebook page???

2) The same unfortunately is not true for the Brontosaurus. It was clear that Apatosaurus is the same dinosaur and as such, the “Brontosaurus” name is no more much to the dismay of many lay public… Read more »

*This blog post was originally published at Fauquier ENT Blog*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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