Just some stuff

Interesting stuff. Some depressing stuff. What is to become of us stuff.

More healthcare problems no one talks about, via White Coat Underground

Dirty little secret about patients as partners in health care via Musings of a Dinosaur. When you read this, don't think that #1 is advocating paternalistic medicine. No physician, no good one, anyway, makes a decision in a vacuum. The patient's thoughts, presentation, values, expectations, etc. are all a part of the equation. Unless the patient wants to sue themselves for a bad decision, though, the buck stops with me. I won't order something just because the patient wants it. I will push on something I really feel like the patient needs, but obviously, I'm not hog-tying too many patients and forcing them to get a colonoscopy. SOME OF THEM (and you know who you are) I will brow-beat. But a dirty little secret is that even though you know your body, your doctor knows more than you do about sick. (I'm excluding, by the way, all of you with real, live chronic diseases who can run rings around me about your particular disease and its treatment). Go ahead and hate me. I'm gonna listen to you, I'm going to think, I'm going to take your preferences and what you tell me to heart, I'm going to educated by you, but until you go to medical school and residency, and have spent thousands and thousands and thousands of hours poking bellies, rashes, cheeks, throats, and butts, and until you have a license to practice medicine in your state, you need me.

Good Lord. I was all over the stupid map on that. Moving right along....

Zuska. Read her.

Long, but absolutely dead-on post from Dr. Gorski, about the second most dangerous phrase a physician can utter (first being "In my experience...." which should always be backed up with "and according to the literature"):

There must be a reason, or how we support our own false beliefs

Remember, we used to use leeches for pneumonia and all manner of other disorders.

Last, but not least, Doc Gurley who at last weighs in on the healthcare debate in her own inimitable, funny, sympathetic, sarcastic, smart way. It makes me laugh, but it makes me sad, and it makes me miss my old practice (which is not to say that I don't love my new one). It is magic, patient care. Really. I've often been heard expounding that I could see patients in a parking lot or a garage, and I could, and I'd love it, as long as I had coffee.

Obama's Speech. What's an Internist to do?

What are patients to do?