Did the NEJM publish a bad study about checklists?

Education
March 30, 2014

Recently, a study in the New England Journal of Medicine called into question the effectiveness of surgical checklists for preventing harm. Atul Gawande, one of the original researchers demonstrating the effectiveness of such checklists and author of a book on the subject, quickly wrote a rebuttal on the Incidental Economist. He writes, “I wish the Ontario study were better,” and I join him in that assessment, but want to take it a step further.

Gawande first criticizes …

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Did the NEJM publish a bad study about checklists?

The threat of technology to proper patient care

Tech
September 9, 2011

Dr. Abraham Verghese wrote in the New York Times recently about the threat of technology to proper patient care. This is an excellent piece and although I do not disagree with the overall message, I think Dr. Verghese conflates different issues currently plaguing our health care system.

Below, I provide some comments on a few of the major points Dr. Verghese writes about: “This computer record creates what I call an “iPatient” …

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The threat of technology to proper patient care

How social media will merge with electronic medical records

Social media
June 17, 2011

Bryan Vartabedian, MD blogs at 33 Charts about the convergence of medicine and social media.  A post last year gives a vision of how current social media concepts will merge with existing electronic medical record (EMR) technologies to produce a fully integrated communications system for health professionals.

The picture Dr. Vartabedian paints is a dream for those of us who extensively use technology in other parts …

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How social media will merge with electronic medical records

Why medical education needs to evolve away from memorization

Education
April 1, 2011

Skeptical Scalpel writing at KevinMD.com in a post giving some advice to second year medical students nails the problem with medical education on the head:

Rather than forcing [medical students] to memorize information, we should be teaching you how analyze and synthesize it as it relates to your patient.

Our increasingly sophisticated and robust understanding of the pathophysiology of human disease processes coupled with the growth in diagnostic testing power …

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Why medical education needs to evolve away from memorization

Useful things to buy during medical school

Education
January 26, 2011

The following is a brief list of some of the things I think have been useful and worth their money in my first two years of med school:

1. Large, widescreen computer monitor. The volume of information required to internalize during the preclinical years of medical school can’t be compiled and organized on paper. You would end up with bookshelves filled with those gigantic 4″ binders. Therefore, almost everything happens on …

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Useful things to buy during medical school

Paying for access to medical journals

Physician
November 28, 2010

I’m not sure about the validity of this study: Free Access to U.S. Research Papers Could Yield $1 Billion in Benefits.

Quantifying how much money will be saved by increased efficiency due to open access seems like fuzzy math at best.  However, we do need better access to medical journal articles.  As a researcher, I’ve constantly fought the battle against firewalled journals.  I am fortunate to be part of a university …

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Paying for access to medical journals

Should the public participate in preparing cadavers for students?

Education
October 9, 2010

The Wall Street Journal’s Health Blog carries an interesting piece about a program at Indiana University–Northwest that allows volunteers from the general public to participate in preparing cadavers for first year medical students.

This is a brilliant idea for several reasons:

  1. One persistent problem facing physicians is the extremely low health literacy of most patients.  Simply put, “health literacy” refers to how well patients can comprehend what their …

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Should the public participate in preparing cadavers for students?

Medical school is hard, and other medical student thoughts

Education
September 2, 2010

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Some reflections on my first semester of medical school.

1.  Medical school is hard. Yes, it’s true — medical school is as hard as people who have been through it make it out to be.

I was skeptical when I started mostly because I felt I had challenged myself while doing my undergrad degree and in graduate school.  I had taken heavy loads …

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Medical school is hard, and other medical student thoughts

Medical students should be paid for summer research work

Education
August 1, 2010

It’s summertime once again, which for many medical students means helping out with a research project over the next 8 weeks.

Participating in the design, execution and presentation of medical research is an invaluable learning experience for medical students. The growth of evidence based medicine means current and future physicians need to know how evidence is generated in order to effectively evaluate it and judiciously apply it to their practice.

Participating in …

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Medical students should be paid for summer research work

Chemicals that cause cancer can’t be accurately studied

Conditions
July 1, 2010

Nicholas Kristof in the New York Times writes about a new report from the President’s Cancer Panel calling attention to the role common chemicals may play in the development of cancer.

The overarching message is that we should be exercising much more caution in our trust of chemicals.

I am not familiar with the nuances of regulatory policies for chemicals, but (as Kristof points out) the “existing regulatory presumption [is] that …

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Chemicals that cause cancer can’t be accurately studied

EMRs are ugly, and what the next generation of doctors can do

Tech
June 8, 2010

I was in our family practice clinic today and couldn’t help but noticing once again that the electronic medical record (EMR) system they use looks like it was designed in the 1980s.

Gray boxes with tiny free text fields and little check boxes. Unfortunately, the aesthetics are the least infuriating design element.

Why is nothing connected in current EMRs? The single most important thing that has led to the proliferation and usability …

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EMRs are ugly, and what the next generation of doctors can do

Why primary care doesn’t appeal to this medical student

Education
May 18, 2010

I try to read as much as I can of everything floating around the medical blogosphere. I think the most recurrent topic I come across is why current medical students aren’t choosing to go into primary care.

It’s a great topic that relates to health care reform, making it ripe for medical bloggers to comment on relentlessly. Probably the most often cited reason is low reimbursement for primary care (read: primary …

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Why primary care doesn’t appeal to this medical student