December 5th, 2011 by ChristopherChangMD in Opinion
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Would YOU as the patient see a doctor who is a well-known jerk, abuses drugs, gives the wrong diagnosis more often than not, and is known to like ordering very invasive tests??? Be honest…
The other week, a patient with a chronic cough exclaimed to me that she wished the fictional character Dr. House of TV fame actually existed in real life, because he was somebody who can diagnose anything.
I looked her straight in the eye and told her that somebody like Dr. House in the real world would be a physician nobody would want to see for many reasons:
- In the real world, patients expect doctors to have the correct diagnosis from the beginning (might forgive one wrong diagnosis). Dr. House seems to always get things wrong multiple times before he gets it right. I seriously doubt most patients would have stuck around as long as they do on the TV shows before going elsewhere. Read more »
*This blog post was originally published at Fauquier ENT Blog*
October 7th, 2011 by Sergio Minué, M.D. in Opinion, Research
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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*
September 13th, 2011 by RamonaBatesMD in Opinion, Research
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Many women with large breast and weight issues seek breast reduction. I was taught to encourage them to lose weight first. Now there is a very small study that backs this up (full reference below).
The American Society of Plastic Surgeons issued a press release entitled “Breast Reduction and Bariatric Surgery—Which Should Be Done First?” and provided the answer “Final Results May Be Better When Weight Loss Comes First.” I agree, but find it odd that such a small study was published. There should have been more patients included.
Jeffrey A. Gusenoff, MD, and colleagues reviewed two groups of patients who sought consultation for body contouring surgery August of 2008 and February of 2010 after massive weight loss (defined as a weight loss of greater than 50 pounds).
Group I (n=15) included Read more »
*This blog post was originally published at Suture for a Living*
August 15th, 2011 by Sergio Minué, M.D. in Health Tips, Opinion
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“Bueno es saber que los vasos
nos sirven para beber;
lo malo es que no sabemos
para qué sirve la sed”.
Proverbios y cantares.XLI. Antonio Machado
(‘It’s good to know that glasses
are what can help us drink;
The trouble is, we don’t know
What is the purpose of thirst’)
The one thing you can’t afford to have missing when you start a scientific congress or any other professional meeting is not a notepad, a pencil or even an iPad – nowadays, it’s a bottle of water. Offices, airports, handbags and lecture halls, all of them are bursting with all kinds of bottles. It seems they are essential to work and even to stay alive.
Bordering nonsense, some people desperately search for a bottled water vending machine as soon as they arrive at the airport, even if that means gobbling it down in a minute before walking through the security checkpoints.
It is now a common belief that continously drinking water (6 to 8 glasses a day according to NHS, at least two litres -half a gallon- according to other sources) is the healthy thing to do. Read more »
*This blog post was originally published at Diario Medico*
July 2nd, 2011 by Happy Hospitalist in Health Policy, Opinion
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Over the last few years, you may have heard a lot about the value of checklists in ICU medicine and their ability to reduce mortality, reduce cost and reduce length of stay. But a recent study took the concept one step further and suggested that checklists by themselves may not be effective unless physicians are prompted to act on the checklist.
As reported in the American Journal of Respiratory and Critical Care Journal, a single site cohort study performed at Northwestern University Feinberg School of Medicine’s medical intensive care unit compared two rounding groups of physicians. One group was prompted to use the checklist. The other group of physicians had access to the checklist but were not prompted to use it.
What they found was shocking. Both groups had access to the checklist. However, patients followed by physicians who were prompted to use the checklist had Read more »
*This blog post was originally published at The Happy Hospitalist*
