Sunday, August 23, 2015

Is Overdiagnosis Harming Patients?

The article below mainly focuses on the detection of miniscule cancers by advanced technology.  Though there's no doubt that this may prevent many deaths, some cancers might not evolve into dangerous ones.  The patient would then need treatment for this cancer, and as many people are well aware, cancer treatments are no fun.  Patients and doctors need to be aware that not all health issues, like some cancers, are particularly problematic.  This would prevent the patient from becoming too anxious when there really is little need to be afraid.  Also, I think overdiagnosis remains an issue when trying to identify a mysterious disease.  Sometimes, I've heard, imagery reveals problems that have nothing to do with the patient's actual disease, therefore misleading doctors from arriving at the correct diagnosis.  In these cases, I think it's important to listen to the patient's symptoms and his or her story about how the illness progressed. This, in combination with certain tests, might better help physicians to pinpoint the exact cause, without having to do every test in the world to figure it out.  Perhaps physicians have discovered how to make diagnoses.  For the future, however, they need to know how to interpret these results, leading to the best treatment options for patients.  Any thoughts?  Feel free to comment.

From: http://health.usnews.com/health-news/patient-advice/articles/2015/08/20/tmi-in-medicine-the-problem-of-overdiagnosis

Monday, August 10, 2015

The Rise of Retail Medical Clinics

My opinion:  I think it's great that clinics are becoming more convenient for patients.  Retail clinics usually appear in busy places, like shopping areas.  The article focuses on CVS adding these clinics to their stores.  These are useful for patients who have urgent issues that are not emergencies, for example, sore throats and cuts.  Now, regular doctors are trying to compete, expanding their hours and creating apps that help patients set appointments.  But retail clinics, according to the article, seem to have mid-level healthcare providers like nurse practitioners instead of doctors.  I think that another kind of retail clinic with physicians would attract a different crowd of people, ones who are more willing to trust doctors rather than nurses or PAs.  But would doctors even want to work in such a setting?  I think that is unlikely, although some primary care doctors might be fine with it.  Ultimately, I can see hospitals and regular outpatient clinics dealing with harder or emergency cases, with more specialists on board, whereas retail clinics will treat less severe issues with mid-level providers.  Could this be the beginning of a separation between primary care and specialties?  And are there any other implications of this?  Feel free to comment. 

From: https://www.bostonglobe.com/business/2015/08/07/walk-clinics-are-forcing-big-medicine-rethink-retail-health-care/DUdP4usrTuVA2AIiJJfUHJ/story.html

Tuesday, July 14, 2015

Will Needles Disappear from Medicine?

My opinion:  The article in the link below discusses many potential advancements that can replace needles.  For example, pills may one day have tiny needles that inject the medication into the intestine so it can reach the bloodstream.  Another involves a pill that will dissolve in the tongue, diffusing through the membrane to the bloodstream.  There may even be microscopic patches full of needles that can be pressed into the skin.  All of these methods are remarkable, but, the article reminds us that only 10% of inventions make it to market.  I can see the needle patches being a reality, but I'm not sure about the edible pill.  What if the needles don't inject in the right place, like in the small intestine?  Also, I'm wondering what the patches will do to the skin over time, as they inject over such a wide area.  Regardless, I'm glad that alternatives are being researched.  Though it may be of minor concern to scientists, I'm sure many patients are tired of sticking themselves with needles.  Any thoughts?  Feel free to comment.

From: http://blogs.discovermagazine.com/crux/2015/07/13/needle-free-medicine/#.VaVeSIXEklI

Wednesday, June 24, 2015

Anesthesiologist Bad-Mouths Patient - Does This Occur Often?

I'm not surprised that there are some doctors who do this.  I've heard other stories where anesthesiologists demean their patients.  In my own personal experience, the operating room personnel sometimes swear at each other or make casual jokes, but these are never directed at the patient.  I just wonder how much of this is unaccounted for, since most patients don't have the opportunity to record their doctors.  Should all operating rooms be monitored after this incident? Does the patient even have the right to secretly record the operation?  Feel free to comment. 

From:  http://www.washingtonpost.com/local/anesthesiologist-trashes-sedated-patient-jury-orders-her-to-pay-500000/2015/06/23/cae05c00-18f3-11e5-ab92-c75ae6ab94b5_story.html

Monday, June 8, 2015

A Personal Analysis of Depression and Suicide in the Elderly

I write this after the recent passing of an elderly family friend due to suicide.  This event has taken quite a toll on us and our community, and I can't help but wonder how it could have been prevented.  Previously, I didn't think that seniors were very likely to commit suicide.  However, the following article insists that their depression is different.  Major life changes occur, for example, the death of a spouse or retirement.  Some believe that loneliness after these experiences may contribute to depression.  Contracting many illnesses could be another factor.  What's most interesting to me, though, is that it is not easily detected.  The article suggests that their symptoms may overlap with those of their other illnesses, ultimately hiding the depression.  In the case I described above, it also appeared that the onset of depression was very quick.  I don't know the answers to a lot of these questions, but like many others, I do not think that we value mental health in this country enough.  Looking back, I wish there was something I could have done, but there's no way I could have known.  Any personal stories or advice?  Feel free to share.


From: http://www.komonews.com/news/consumer/Senior-depression-is-different-and-often-undiagnosed-305790371.html

Friday, May 22, 2015

Will Anesthesiologists be Replaced by Robots, Nurses?

My opinion:  Considering that anesthesiologists are some of the highest paid professionals in medicine, many people believe that they should be replaced by assistants, such as certified registered nurses anesthetists (CRNAs), or even by robots.  The issue is, their replacements may not always provide adequate care, especially with complex surgical procedures.  Many states have already allowed for CRNAs to practice independently of anesthesiologists.  I believe that CRNAs and robots may be used in certain scenarios instead of anesthesiologists.  These doctors may not be eliminated, but will be used to a lesser extent to save money.  Do you think this will occur?  Feel free to comment. 

http://www.wsj.com/articles/SB10001424052702303983904579093252573814132

Wednesday, May 13, 2015

Millions of Births, Deaths Unrecorded

My opinion:  I am not surprised that so many people are not tracked, as poorer countries may not have the resources to keep records.  I agree with the article that the civil registration and vital statistics (CRVS) may make for better records.  When a family member dies, relatives may are asked questions that point to the most likely cause of death.  This is probably the best alternative to physician diagnosis, since many places lack doctors required for an examination.  I do wonder, though, if the family will have any motivation to complete the documents.  Furthermore, what if they are illiterate?  In those cases, someone else would have to do CRVS for them.  Finally, this may not capture the number of children who are stillborn, since it is easy to keep the child's birth a secret from the community.  I believe that a medical worker may have to be responsible for the collection of this data, although he or she does not necessarily have to be a doctor.  Any opinions of your own?  Feel free to comment.

Link:
http://www.medicalnewstoday.com/releases/293782.php