My chief complaint . . . is with the chief complaint. One of the hallowed concepts in medical history taking and documentation is the “chief complaint.” Supposedly a way to set the agenda for a medical visit, in current practice it often gets both distorted and treated as a boundary setter. Ideally, in medicine, we […]
Category: US healthcare
Stuart Buck: Are scholars or journalists more to blame when correlation and causation are confused?
News stories about everything from nutrition to epidemiology to family behavior often confuse correlation with causation. Drink coffee, we are told, and you will lower your risk of dying (or perhaps raise it, depending on the week). Get married, and you will have stronger bones. Sophisticated news consumers in the know understand that it’s best […]
David Kerr: Self obsessing health technology
Has the health tech industry and those who fund it lost the plot? Apparently, the next must have technology is the connected toothbrush. A “data driven oral health startup” company in the United States has just received a multi-million dollar investment to further develop a smartphone connected toothbrush. With this toothbrush, an accelerometer measures how […]
William Cayley: Resilience, obstreperousness, and grit
Some people keep going, and going, and going . . . and some don’t. What makes the difference? I’m not sure we know, but I think it has something to do with resilience, obstreperousness, and grit. This week there has been a bit of a debate going on in our department over appropriate blood pressure […]
Saurabh Jha: How a fine-tooth comb is entangling Obamacare
The Affordable Care Act (ACA), which recently survived a major scare in the Supreme Court over the constitutionality of the individual mandate, has just met another potential nemesis. Halbig vs. Burwell is the latest lawsuit afflicting the ACA. The suit has been filed by Jacqueline Halbig, former health policy advisor to the Department of Health and […]
The BMJ Today: Improving vaccination rates
In the United States, the Centers for Disease Control and Prevention (CDC) held a press conference to discuss a recent survey, which found that rates of HPV vaccine coverage did not reach the 80% target. This in itself is not a surprise given the vaccination levels of previous years. But at the press conference, The […]
The BMJ Today: Dabigatran—the impact of The BMJ’s investigation
“The results of this investigation are somewhat shocking to me, but, reviewing the information, not entirely surprising.” That was the verdict of David Haines, section head of the Heart Rhythm Center at Beaumont Health System in the United States, on The BMJ’s investigation into dabigatran, the first of the new oral anticoagulants licensed to prevent […]
Tracey Koehlmoos: Regenerative medicine—where miracles and science overlap
Regenerative medicine. I did not know it existed until I began working with the Marine Corps. Even writing “regenerative medicine” reminds me that I am not in Bangladesh anymore, trying to produce miracles by scaling up a 20 cent zinc intervention aimed at every child under the age of 5 with diarrhea, or figuring out […]
The BMJ Today: Monday’s reflections on alcohol
Nothing seems more appropriate on a Monday than to think about the after effects of alcohol. We know that drinking too much is bad for health, but many have always taken comfort in the “fact” that moderate daily intake is associated with a lower cardiovascular risk. The question remains whether light to moderate drinking will […]
William Cayley: Awkward is when they need us
“I just hate this sort of thing.” When I overheard that at a recent funeral, as we waited in line to greet the bereaved family, I thought to myself, “How sad . . . and how true.” Sad, because times of grief are when others need us most, but also true, because most of us find […]