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Showing posts with the label business and medicine

Republican and authoritarianism

Let's follow the news for signs the Republican party is abandoning democracy and the rule of law for authoritarian rule. Scott Walker, always against the best interests of the people of Wisconsin, just signed a bill stripping the incoming Democratic Governor of most of his power. The people of Wisconsin just elected the new governor to govern their state, as Walker had before him. They elected him to change the policies of the past governor. So, against the wishes of the people of the state, the outgoing Governor and the Republican legislature changed the rules of what a governor can and can't do. The Republican are losing so they are changing the rules in their favor. When you can't give a rational, convincing argument to support your position you can either resort to cheating or be a good loser and try to defend you opinion in the next round of elections. Because the Republicans have chosen to cheat means they are have to arguments to support their position and therefo...

The Electronic Medical Record and a little note about illness as memory

First, a couple months ago I wrote an essay titled "Illness as Memory". Originally, I thought the idea was so compelling that it should be a book, but the energy to do the research for a project that big has not welled up in me, yet. But the idea is alive. Today, on the website QuantaMagazine this article appeared: https://www.quantamagazine.org/stem-cells-remember-tissues-past-injuries-20181112/. Stem cells may have memories of previous injuries and how to fix them. These memories may give rise to a variety of autoimmune diseases.  If my essay interested you, I suggest you take a look at this link. Another theme in several of my posts has been the harm done to the profession of medicine by business people. In a recent New Yorker article, Atul Gawande, writes about the electronic medical record program EPIC. Here is the link: https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers. And here is my take on this issue. But first I want to back up a...

Healthcare 2 - The Patient-Doctor Relationship

If experience qualifies as expertise, then, on the subject of the physician-patient relationship, I am an expert. During my career as an emergency physician, I saw well over 100,000 new patients. As a patient I survived two cancers, multiple blood clots in my lungs, and a bunch of other non-lethal problems. In addition, I have read a number of books about the physician patient relationship. So, now that you know my credentials, here is what I have learned... All patients want to be treated with respect. They want the doctor to listen carefully, ask questions and respond in a non-demeaning manner. This needs to be done in person, with eye to eye contact. The information acquired needs to be in the doctor's head and not just in his computer. Information in the computer is for billing, to refer back to, or to send to another physician. A good doctor builds a model of the patient in his head consisting of age, sex, prior medical history, family history, psychosocial status, current s...