“Can’t I just fake it? Can’t I pretend to care, even if I don’t.” So an anonymous physician is reported to have responded during a workshop on caring communication with patients. My colleagues and I all scoffed with appropriate indignation when this story was told, as the same training was presented to us—but I’ve started […]
Category: US healthcare
William Cayley: The patient’s story comes first
Once upon a time, there was a pain, a positive test, and “a possibly abnormal x-ray requiring clinical correlation.” As they travelled the world, no one could figure out where they came from. Many physicians racked their brains, but they remained a mystery, until one wise person said, “tell me your story.” Our three travelers […]
Trish Groves: Postpublication review—what role should journals play?
The National Center for Biotechnology Information of the US National Library of Medicine has emerged from the US shutdown with a new service: PubMed Commons. It’s a system for commenting on published articles, though at this stage it’s running as a closed pilot. Hilda Bastian of PubMed Health reckons it could become “one of the […]
Edward Davies: Obamacare—it’s time to stop rooting for failure
“Obamacare” is much in the headlines right now and not for the right reasons. Having been the bargaining chip of choice for Republicans during this month’s shutdown, the “health exchanges,” through which patients can purchase insurance, are suffering some fairly major glitches. The consequence is that it is now open season on the Affordable Care […]
Leana Wen: Announcing the total transparency manifesto
Our healthcare system is broken and in dire need of reform. We all know the statistics: the US spends $2.7 trillion on healthcare, 30% of which is waste in the form of unnecessary tests and unnecessary treatments. Conflicts of interest are rampant, with 94% of doctors reporting an affiliation with a pharmaceutical or device manufacturing […]
Jett Aislabie: Airport noise and cardiovascular disease
Last week we published a cluster of papers on airport noise and cardiovascular disease. One US based study found a statistically significant association between exposure to aircraft noise and risk of hospitalisation for cardiovascular diseases among older people living near airports, and another found that high levels of aircraft noise were associated with increased risks […]
Edward Davies: How health is being hit by the US shutdown
The closure of Panda Cam at the Smithsonian National Zoo may be the highest profile casualty of the government shutdown in the US, but with a third week edging ever closer, some of the emerging consequences are a cause for considerably more concern. The nature of a shutdown means a comprehensive national picture is difficult […]
William Cayley: Caring about the patient’s story
Who do you care about? The authors of guidelines? The producers of evidence? Those who audit your practice? Or perhaps your patients? Sophie Cook’s recent post on consultation skills finally provided the impetus for me to put pen to paper (or rather, fingers to keyboard) regarding my own recent ponderings on these issues. I trained […]
Richard Smith: Doctors should think less about drugs and more about food
Doctors, who prescribe drugs, are at the top of the health hierarchy, whereas nutritionists are near the bottom. At medical school students learn a huge amount about drugs, but little or nothing about food. When managing patients doctors think drugs first and any other response a long way second. We’ve had pharmacopeias for over a […]
Georgios Lyratzopoulos reports from the diagnostic error in medicine conference
Amidst justified concerns about the potential for overdiagnosis it is easy to forget the great challenges associated with establishing a timely and accurate diagnosis in the first place. Many thousands of patients each year are believed to die or suffer serious harm because of missed diagnoses. In the US, in the last 25 years diagnostic […]