Image of stamp reading 'You are sick' resulting from a diagnostic test

Diagnostic Test Ordering: 4 Questions to Ask

Giving a blood sample, sliding into a scanner, even lying on the stainless steel bed of an x-ray machine — A diagnostic test, while not anyone’s idea of fun, is not that big a deal, right? Those of us in the medical biz are well aware of the risk of harm associated with surgery or other procedures and the expected and unexpected adverse effects of medicines. We tend to forget, though, that diagnostic tests can also cause harm. It’s not the test itself, that is risky, it’s the results — and what we do with them — that can do… Read more »

Medical Research Papers: Translation Needed

Medical Research Papers: Translation Needed

I used to have the “bedside stack.” This pile of journals that I planned to read was always topped by. . . the latest Stephen King novel.

Now my e-mail in-box is filled with “online first” and “table of contents” announcements from numerous journals.

The problem with reading journal articles is obvious: they are hard to read. They seem to be written in English, but not in a language I use day to day.…Read More »

Photo of person injecting EpiPen into thigh

Outrage about Outrageous drug prices – and what to do about it

The outrage is building. Drug prices are nothing less than astounding. The American Academy of Family Physicians is just the latest group to join The Campaign for Sustainable Rx Pricing, a non-partisan coalition aiming lower drug prices in the U.S. From AARP to professional societies to insurance companies to Wal-Mart, the coalition is attempting, through legislative support, to slow the rapid growth of drug costs.…Read More »

Red button with word's "don't panic"

Genetic Screening: Another Way to Worry Healthy People?

Last week the Food and Drug Administration approved the marketing of a 23-and-me, a test previously marketed as a way to trace ancestry, for screening individual’s genetic predisposition to certain medical diseases or conditions.

At first glance it might make sense. Screening to know one’s genetic profile for a disease should be helpful, right?

Not so.…Read More »

Photo Ephesus Celsus Library Facade

Medical Research Journals-The Rise and Fall(?) Part 1

The Bill & Melinda Gates Foundation spends $4billion a year supporting scientific endeavors, much of it on medical research. But you won’t be reading about any of their breakthroughs in JAMA, New England Journal of Medicine, or The Lancet. No, as of last week the Foundation is doing an end-run around medical journals, requiring that all research findings be freely available in an online repository.

This move reflects the Foundation’s – and many others’ – frustration with medical research journal publishers’ controlling of access to studies and the resulting slow dissemination of research findings.…Read More »

Medical Research Journals-The Rise and Fall(?) Part 2

In part 1 of this post, I talked about how medical research journals rose to become the standard-bearers for disseminating new research findings. In this post I will focus on how medical research journals slow down – way down – the spread of research, and speculate on the growing role of social media.

“I’ll do a Medline search.”
“I found an article.”
“My research was published in [insert medical research journal].”
“According to the [insert medical research journal]. . .”

…Read More »

Image of woman taking notes

It’s Time to Change the MOC Process

Everyone knows the problems with the maintenance of certification testing. The tests, no matter what specialty, ask arcane details of obscure issues in medicine, information that easily could be – and is — looked up. It doesn’t test most physicians’ stock-in-trade: decision-making. The score has little to do with performance in practice.

However, to totally forgo ongoing assessment and certification turns the quality control of medical practice over to payers, including the government. In addition to it affecting our income, do we really want our abilities to be represented by how well we check off boxes in the electronic health record?…Read More »