Interruptions to communication

The New York Times Cases section had an interesting discussion about interruptions during a clinical visit, both by the physician and the patient, and the chilling effect on communication and clinical care. The author outlines his typical response to disruptions. How do you think patients and physicians should handle disruptions? How can the interruptions be handled in a way that minimizes the potential harm they may cause?

Medical students behaving poorly

Several media outlets reported on a report this week from the Journal of the American Medical Association about medical students behaving poorly online. With the increased use of social media web sites, more schools are reporting incidents of poor behavior, including profane language, drunken behaviors, and sexually suggestive material. But few medical schools have policies of professionalism that extend to students' presence online. The report shows that medical schools have much work to do to address emerging technologies and work on ways to teach future doctors how to navigate the online social media world in a professional and appropriate manner.

A firsthand account of H1N1

Well if he was looking for an angle to tell the story, he now has it. CNN's well known medical correspondent Dr. Sanjay Gupta is now able to report on the H1N1 flu from the perspective of a patient. Dr. Gupta contracted the virus in Afghanistan and wrote about his experience as a physician/patient in his blog. Personal experiences color our communication with others. It will be interesting to see how the experiences of high-profile patients like Dr. Gupta will influence communication about H1n1.

Doctors working with spiritual healers

The New York Times had an article last weekend about a new program in a California hospital where Hmong Shaman are encouraged to visit patients and perform healing ceremonies in the hospital. The program is an example of how effective communication can foster understanding between patient and physicians, and also between cultures. Both the spiritual healers and the physicians have learned from about what the other does and why. Welcoming the Shamans has also helped to build a more trusting relationship between the Hmong community and Western medical practitioners. The Hmong patients, and the communities they come from, may be better able to trust and communicate with their physicians when their religious beliefs are upheld in the process.

10 countries, 10 approaches to an injury

The New York Times reviewed a book today "One Injury, 10 Countries: A Journey in Health Care" by Washington Post journalist T.R. Reid. The book reveals the different approaches and costs associated with the same frozen shoulder. I am intrigued by the premise. What do you think? What do these anecdotes add to our current health care policy debate?

Gauging public reaction to extreme caution

The New York Times City Critic conducted an amusing social experiment of sorts. Ariel Kaminer donned gloves, mask, goggles and a paper suit in a simulated effort to protect herself from the H1N1 flu and also gauge reactions to her protective measures. The result was an opportunity to examine the fine line between caution and excess. Interacting with others in society carries certain risks, including swine flu, but the potential rewards are worth the risk.

More on ghostwriting in medical journals

A study that was reported this week at a conference of journal editors sheds some new light on the use of ghostwriters in medical journal articles. Ghostwriters are paid writers who do not appear on the list of academic authors, who may be paid by pharmaceutical or medical device companies. The concern is that the unattributed authors introduce bias into a source where physicians turn for the latest in scientific developments.

It appears that some of the discrepancies in the study may be due to different journal policies having different authorship disclosure requirements. But this remains an important issue. Transparency in medical research and reporting is absolutely necessary in order to evaluate the evidence and make the best treatment decisions for the patients. Failing to disclose all the authors and their affiliations withholds an important key to sound medical-decision making. I hope that this study will encourage more journals to evaluate their current policies and work to make their author reporting requirements more transparent, so we can all learn from and evaluate the latest in medical research.

Medical students experience the ills of the health system firsthand

The New York Times had an article today about how medical students at the University of Washington spent their summer in underserved rural areas and clinics, where they learned firsthand about the ills of the American health care system. The students not only learned about how busy these clinics are, but also about the realities of reimbursements, matching prescriptions to Wal-Mart's $4 generic list, and ordering extra tests as protection against lawsuits.

The education the University of Washington medical students received working in those clinics cannot be found in any textbook or lecture. Seeing how the problems in the health care system affect real patients has the potential to open eyes and spur these young soon-to-be doctors to action, whether that action be advocacy for their individuals or advocacy on a policy level. And seeing how the health system affects patients will help prepare physicians to communicate and empathize with their patients as they navigate their way through the system and to good health.

Health care crisis close to home

The New York Times had an article featuring a clinic in my hometown of Milwaukee, Wisconsin. The clinic is the only urgent care facility in the northern part of the city, and while it serves a great need in a part of the city with few primary care doctors, it still faces financial collapse and it may not even be helped by provisions in both the Federal stimulus package and the proposed health care reform legislation. The eye-opening feature discusses the real problems patients in lower incomes neighborhoods have accessing care, even when they qualify for state-subsidized insurance. The case of Milwaukee Immediate Care shows that improving access to health insurance is only part of what is needed for real health care reform.