The Christmas holidays annually are a time for jolliness, cheer, and fun—from “Ugly Sweater” events to “White Elephant” gifts, and even The BMJ Christmas issue. It’s all in good fun, it can be especially helpful at this (often grey and gloomy) time of year, and it all seems to somehow make sense when one thinks of […]
Category: William Cayley
William Cayley: Is the Good Samaritan the wrong metaphor to use for doctors?
A story from the Christian New Testament has provided the literary namesake for countless medical facilities, as well as legal and ethical principles guiding care for those in need, but it may be the wrong illustration—or at least, not an adequate one. The “Good Samaritan” story is told in the book of Luke to answer […]
William Cayley: To doctor is to diagnose—part two
Having recently posted some thoughts on the continuing centrality of diagnosis in doctoring, I was happy to see the recent Institute of Medicine (IOM) report “Improving Diagnosis in Healthcare.” I especially appreciated the IOM’s clear statement that “Improving the diagnostic process . . . represents a moral, professional, and public health imperative.” The IOM describes […]
William Cayley: The value of the tweet
I’ve only recently begun tweeting, but have already been struck by the challenge of sometimes trying to convey complex ideas in 144 characters or less. The combinations of abbreviations, “hashtags,” and “@’s” can add complexity, but also confusion—the challenge is how to get the right balance of complexity, yet clarity. Writing the “perfect tweet” is […]
William Cayley: Neither complementary nor conventional
I appreciate Timothy Caulfield’s exploration of the “straw men” set up in many a discussion over integrative, complementary, or alternative medicines (CAM for short). However, I think we need to take the argument one step further. As he makes clear, many of the arguments proposed by “CAM-ers” against “conventional” medicine also apply to and undercut […]
William Cayley: Continuity over efficiency
It has become fairly clearly established that a strong primary care system is associated with better overall health for a society and a more equitable distribution of health in the population. A recent modeling study in the Annals of Family Medicine, which evaluated the “primary care paradox” (lower levels of evidence based care for individual diseases, […]
William Cayley: Life saving science?
This past week saw the interestingly coincident publication of a reanalysis of “Study 329” in The BMJ and an opinion piece in the New York Times, calling for more rapid dissemination of news about “medical breakthroughs.” “Restoring Study 329” reanalyzed data from the (controversial) 2001 study and demonstrated that, lo and behold, paroxetine and imipramine may not […]
William Cayley: Comfort always and advocacy for the vulnerable
Reading the Monday morning paper, I was greeted by stories about ongoing fights over whether or how to undo the Affordable Care Act (“Obamacare”) and controversies over solitary confinement. Later, while driving to work, I heard more news on the challenges facing those in eastern Europe who are confronted by a rising influx of immigrants. One final check […]
William Cayley: Ethics and professional wisdom
The recently publicized news that the American Psychological Association (APA) “colluded” with US governmental agencies to create ethical guidelines permitting psychologists to participate in “harsh interrogations” of military detainees is appalling. According to the APA’s own press release, the guidelines were “based at least as much on the desires of the US Department of Defense as […]
William Cayley: Diagnosis—what it’s not . . .
“Phew! At least you don’t have something bad.” “I know doc, but what is it?” I’m afraid that in medicine, we too often focus on the former, and not enough on the latter. How often do we see patients admitted to hospital to “rule out” an acute coronary syndrome? How often do we do a […]