Patient safety: “What You Don’t Know Can Kill You”

patient safetyEven doctors are afraid of hospitals

One of my best friends is a physician, and we have an agreement: if either of us needs to go into the hospital for surgery, the other will be there to make sure everything is done right.

Hospitals are scary places, even for–especially for–health care professionals.

Dr. Laura Nathanson’s husband died as a result of incorrect diagnosis and delayed treatment due to poor communication between his doctors. To help inform and guide other families, she wrote a book, What You Don’t Know Can Kill You: A Physician’s Radical Guide to Conquering the Obstacles to Continue reading

Medical ethics: “The Immortal Life of Henrietta Lacks”

medical ethics henrietta lacksOne woman’s unwitting contribution to medicine

I’m always interested in medical ethics news, and a few days ago I saw Henrietta Lacks’s name mentioned.

Who is Henrietta Lacks?

She was a poor, African-American woman who, in 1951, died at the very young age of 31 from an aggressive form of cervical cancer. Sadly, she left behind five young children.

A research team at Johns Hopkins, where she was treated, collected some of her cervical cells. Mrs. Lacks was never informed or asked for consent; it was 1951, after all, and the concepts of patient rights and privacy were basically non-existent.… Continue reading

Pushing back against too much medicine

As someone who advocates for less medical care, I’m always thrilled to see physicians and others in the health care industry step forward to protest over-testing, over-screening, over-diagnosing, over-treating and over-charging.

Here are some of my favorite health care blog posts and news articles from the last week.

“Testing Wisely” by Dr. Rob Lamberts 

Dr. Lamberts is embracing the newest trend in primary care: the direct-pay model. He does not accept health insurance, but rather charges a modest (age-based) monthly fee per patient. Booting the insurance companies not only lowers his overhead costs considerably, but frees him from so many … Continue reading

“The Happiness Project”

twelve patientsThe unloved woman

I recently read two books that provoked my thoughts. The first was Twelve Patients: Life and Death at Bellevue Hospital by Dr. Eric Manheimer, the medical director of what is probably the largest public hospital in America.

Located in New York City, Bellevue sees patients from all demographics—incarcerated, homeless, undocumented, uninsured, mentally ill, addicted—and treats the worst trauma cases in the city.

Dr. Manheimer sees it all, and he writes compelling stories about the patients and their situations. He also comments on America’s health and health care in general.

His chapter entitled “The Unloved Woman” struck me … Continue reading

Weekly rounds July 19, 2013

Flight delayed? Learn CPR!

For the next six months, Dallas-Fort Worth airport is hosting a trial program to teach “hands-only” CPR to travelers. An automated kiosk, developed by the American Heart Association in partnership with American Airlines, guides passengers through a simplified CPR technique using video instructions and a manikin torso. If the program is successful, it will be expanded to other airports.

Hands-only CPR does not require rescue breaths and is as effective as regular CPR. It sounds like a useful way to pass some time, and I’d love to try it if I’m ever in one … Continue reading

“Until I Say Good-bye”

until i say good-byeLiving with joy

I am not obsessed with my death, but I am always aware that one day I will surely die. As a physician once said, “Life is 100% fatal.”

In the normal course of events, we don’t choose either the manner or time of our death, but I like to think that I might have some control over the final months, weeks, days of my life. (Unless I’m hit by a bus or something equally sudden.)

Perhaps my wish for control is in response to all the horrible, mercilessly-prolonged (and outrageously expensive) deaths I’ve witnessed in intensive Continue reading

Perverse incentives: Where’s the outrage?

perverse incentives in health careThat’s a good question!

H. Gilbert Welch, MD, the author of Overdiagnosed: Making People Sick in the Pursuit of Health, wrote a recent op-ed in the New York Times in which he wonders at what point will the high costs—and profits—of medical care in America be considered “a crime”?

Medical care is intended to help people, not enrich providers. But the way prices are rising, it’s beginning to look less like help than like highway robbery. And the providers — hospitals, doctors, universities, pharmaceutical companies and device manufacturers — are the ones benefiting.

The crime of perverse incentives

Although … Continue reading

“The House of God”

house of godThe classic black comedy of medical training

The emotional and physical traumas of interns are well documented (if hilariously exaggerated) in The House of God by Samuel Shem. The “best medical students” become “terns,” the lowest of the low in the hospital hierarchy, and yet are expected to save lives on a daily basis, usually with little sleep and little or no supervision.

Shem, the pen name of a Harvard-trained physician, published “The House of God” in 1978 to provoke the medical education establishment and speak out against “the brutality of medical training.”

 July 1, the hospital New Year

This … Continue reading

Apps for the cyberchondriac

webmd appThe cyber-what?

The cyberchondriac. Cyberchondia is a term that’s been coined to describe a person who self-diagnoses using the internet, and then experiences acute anxiety when confronted with the grim details of possible afflictions.

Rash? Probably lupus. Upset stomach? Stomach cancer, of course.

I’ve done it. Admit it, you’ve done it, too.

WebMD’s Symptom Checker feature is so inconclusive in its results that it’s basically useless. For example, submit “headache” and after a few more refining questions you still get a list of over 50 possible conditions that have headache as a symptom. Migraine and tension headache are at the Continue reading

“Farmacology”

farmacologyHow are farming and medicine alike?

I just finished reading a thoughtful and informative book by Harvard-educated physician, Daphne Miller, MD. In Farmacology: What Innovative Family Farming Can Teach Us About Health and Healing, she makes an analogy between the “complex and dynamic” systems of soil and modern farming practices, and the human body and modern medicine.

After reading a book about soil ecosystems, Dr. Miller was struck by the similarities of the chemical processes that occurred in soil and those that happened in our own intestines.

Like our own biosystems, it [soil] too depends on bacteria and fungi

Continue reading

First aid for avulsions

avulsionsWhat are avulsions?

Avulsions are wounds where a chunk of tissue (all layers of the skin) has been partially or completely torn away. An amputation is a form of an avulsion.

Avulsions can be minor, such as slamming a finger in a door and crushing the tip, or life-threatening, such as the amputation of an arm or leg in an industrial or motor vehicle accident.

As you can tell from the picture, even a minor avulsion can be pretty ghastly to look at. But if you act quickly, you might be able to save the victim’s finger, toe or … Continue reading

Weekly rounds May 31, 2013

Ready, Set, . . .

With the implementation of the Affordable Care Act (ACA) fast approaching, and summer deadlines for insurance companies that want to offer plans on the new insurance exchanges, this week has seen a lot of news stories related to Obamacare.

California revealed its new exchange plans and the first look seems to indicate that premiums will be much lower than anticipated, even though several of the largest insurance companies opted out of participating in the exchanges.

But a closer look at the plans reveals two important considerations:

  1. The plans are “narrow-network” plans. To keep costs
Continue reading

Weekly rounds May 17, 2013

Stock up on DEET?

Any report that contains the word “deadly” gets the attention of the media, and this report by the Centers for Disease Control (CDC) was no exception. Last year 5,674 cases of the mosquito-borne virus were reported, and 286 people died. In comparison, only 43 deaths were recorded in 2011.

Weather conditions that favored the mosquito – warm and humid – were probably factors in last year’s increase in cases.

This news reminds me that I want to spend some time researching insect repellents and then write a post about them. Does anything work as well as … Continue reading

Weekly rounds May 10, 2013

I’ve finally realized there are just too many health-related news stories every week for me to comment on in a timely manner. And some news tidbits are interesting or funny, but really not worth a whole post.

But I would still like to share with you the stories that caught my eye over the week, so on Fridays I will start posting a weekly summing up, or “rounds” to use health care lingo, of what I have found of interest.

Don’t grocery shop when you’re hungry. Really?

In the did-we-really-need-a-study-to-tell-us-this? file, a research letter published in Journal of the American Continue reading

“Fat, Sick and Nearly Dead”

dvd fat sick nearly deadSometimes drastic change is required

Last night I watched a truly inspiring documentary, a testament to the power of a healthy diet.

Fat Sick & Nearly Dead chronicles Australian filmmaker Joe Cross’s journey to health. Fat, fortyish, and suffering from an autoimmune disease, Joe spends 60 days traversing America. But no fast food stops for Joe—his mission is to drink only fresh fruit and vegetable juice (he travels with his own juicer) for the entire 60 days. Joe believes fasting on juice will allow his body to heal from the inside out.

We all know the typical American diet (and … Continue reading