Maggie Mahar has some great history on the origins of the “good cholesterol” vs “bad cholesterol” stuff
, and how we got to our thinking about cholesterol to begin with. I don’t know how the woman has time to write and research all this for her blog, but
she’s absolutely amazing. When residency starts, I’m going to seriously be cutting back on my blog reading, but Maggie’s won’t be leaving my
Feed Reader anytime soon. If you’re not reading it, I’ll say it again: you’re missing out on some of the best of the web.
As I’ve said before,
patients should not control their own medical records
. If this Google Health product is an addition to the medical record for patients to use, fine. But if you think a physician is going to trust a patient’s
listing of his or her weight over the scale in his or her office, you’ve got another thing coming, Google. (I’m also looking forward to a three page
Google Health printout of a patient’s “allergies.”) It would, however, be nice to be able to get results of colonoscopies and stress tests, which it
looks like Google may be able to do.
If you want an honest review of Google Health, feel free to contact me, Google. (I’m a trusted tester!) Until then, color me skeptical. (And Patient Sam
Sample–watch your kidney function. Lisinopril plus ibuprofen is just asking to shut down your kidneys.)
Okay so my idea for a daily randomness of linkage didn’t really pan out. But some random health care and non-health care goodies:
Mythbusting Canadian Health Care, Parts
One
and
Two
. Brings up a number of good points I hadn’t considered before–doctors that spend less time with billing and financial headaches have more time to read
and keep up with their specialty.
My Favorite Liar
: Blogger recounts a trick an Econ professor would use to keep his students’ attention during lecture. Brilliant. One of my best lecturers I’ve ever had
was
Dr. Gil Chu
, who taught our Molecular Bio course. His trick was incredibly effective: 10 questions had to be asked during class before we were allowed to leave, and he kept a
tally on the board. It fostered a classroom where the
assumption
was that the material was hard, that we were moving fast, and that he probably wouldn’t explain everything perfectly the first time. And because students felt
comfortable asking questions–you were contributing to the class being able to leave on time–people also asked things they were curious about. We were
thinking!
Why Meth Is A Horrible, Horrible Drug.
(Probably not safe for work.) A terribly sad video of a young woman, turned psychotic by the drug, from the A&E show “Intervention.” If you ever
hear of a person running naked through the streets… they’re probably on meth.
Hey Jon Marshall, DO, thanks for
recommending Hydroxycut
! I know you’re just a “Resident Physician” as the commercial says (funny, it didn’t mention
you’re a radiologist in training
) but you radiologists interact with patients and advise them on weight loss pretty consistently, right? Look, you’re pretty hot and all, and I’m sure
that helps sell the pills, but seriously, dude. You chose medicine for “the science behind it. I also like dealing with people and helping them,” and
you’re hawking a product with
pretty iffy science behind it
(Hydroxycut
was sued
for making false statements about it being “clinically proven” and paid to settle). And you have to admit, it’s kind of funny that you “like
dealing with people,” so you went into radiology.
(Side note: what’s with
Midwestern University DO School
? They seem to be churning out the resident DO physician product marketers–it’s where both Dr. Marshall and
Dr. Swanson
went.)
To be fair, at least the Hydroxycut site
gives references
for their scientific research (in one study of 30 whole patients, another with 60) plus two studies that seem to be about caffeine and green tea.
Hydroxycut isn’t limited to DOs, however. They’ve got
Nick Evans
, a MD and attending orthopedist/sports medicine man hawking the product, too. (At least his specialty is related to exercise and weight loss.) Dr. Evans,
dude, you look huge!
(My favorite is the
Bodybuilding Anatomy book with his head photoshopped on a drawing of a bodybuilder torso.)
The old adage is “trust no one” in medicine, but sometimes, I think, maybe we should apply that to medicine itself. It’s certainly humbling to
realize that what we hypothesize to be true and what seems to make sense to us, even from a physiologic theory, and even with supporting data, might not necessarily
be
true. It’s an important reminder–to both physicians and patients–that we’re all unfortunately human. That we don’t have all the answers,
that even with the best of intentions–and best of knowledge–we can be wrong. After all, what is medicine but humans trying to understand, grasp, and alter
insanely complex biological systems that have been under development for hundreds of millions of years? We set limits, values, and numbers to help us decide
“what’s normal” and “what’s disease,” but in reality, they’re gross, gross simplifications we accept so that we can triage,
differentiate, and make sense of what’s going on inside that black box that is the patient’s body.
It doesn’t mean that there are no absolutes, or that medicine or science is flawed more than anything else is flawed, or that there are not facts. Just that the
physician who thinks he is always correct and is master of the human body is doomed to fail and do harm. I tie it back to
this great quote from MedRants
about unintended consequences:
The law of unintended consequences is what happens when a simple system tries to regulate a complex system. The political system is simple, it operates with limited
information (rational ignorance), short time horizons, low feedback, and poor and misaligned incentives. Society in contrast is a complex, evolving, high-feedback,
incentive-driven system. When a simple system tries to regulate a complex system you often get unintended consequences.
What was it? What was the lie and when did doctors learn it? The lie was this: ‘if you become a doctor, your profession of medicine will be all you need for
happiness and fulfillment.’ In short, physicians learned to validate themselves by way of a profession.
I believe my generation of physicians never grew up with a great lie. We knew we wouldn’t make the most money (or at least, we should have known this); we knew
that medicine was time-consuming, but we chose it anyway. And the medical schools chose us for our diversity, life-experiences, and well-roundedness. They’ve
selected out for people who have taken time off before school (almost half of my graduating class), who have had other careers, who have explored other interests.
Found other things besides medicine that make them happy.
Look at the fields that are incredibly popular today: they either make a lot of money, offer a good lifestyle, or both (I’m looking right at you, ophtho). We
want
to have free time outside of our careers. We
want
to have families and relationships. Sure, we’re ready to make sacrifices, but we weren’t told a lie–or maybe we just never believed it. We’ve
had the opportunity to study abroad; we’ve been exposed to foreign countries and cultures; we have taken courses in religion, anthropology, linguistics,
sociology–and we know there are more things to life (exciting, interesting, thrilling ones at that)–besides a job. (For Dr. Leap, that appears to be his
faith.)
Now, perhaps this is to the detriment of our future patients–that their future doctors want more out of life than just being great doctors for them. Perhaps it
is for the benefit of them. I guess only time will tell.
Hey Jon Marshall, DO, thanks for
Bodybuilding Anatomy book with his head photoshopped on a drawing of a bodybuilder torso.)
