Saturday, February 7, 2009

Testing Treatments for Better Healthcare

Testing Treatments for Better Healthcare, 2006

Authors: Imogen Evans, Hazel Thornton, and Iain Chalmers
131 pdf pages

The foreward sells it:

"This book is good for our health. It shines light on the mysteries of how life and death decisions are made. It shows how those judgements are often badly flawed and it sets a challenge for doctors across the globe to mend their ways.
Yet it accomplishes this without unnecessary scares; and it warmly admires much of what modern medicine has achieved. Its ambitions are
always to improve medical practice, not disparage it.
My own first insight into entrenched sloppiness in medicine came in the 1980s when I was invited to be a lay member of a consensus panel set up to judge best practice in the treatment of breast cancer. I was shocked (and you may be too when you read more about this issue in Chapter 2).
We took evidence from leading researchers and clinicians and discovered
that some of the most eminent consultants worked on hunch or downright
prejudice and that a woman’s chance of survival, and of being surgically
disfigured, greatly depended on who treated her and what those prejudices
were. One surgeon favoured heroic mutilation, another preferred simple
lump removal, a third opted for aggressive radiotherapy, and so on. It was
as though the age of scientific appraisal had passed them by."

A good read...


Monday, February 2, 2009

The See-Through Doctor: Sitting Naked in the Exam Room

The See-Through Doctor: Sitting Naked in the Exam Room Medscape Journal of Medicine, 2008; 10(8): 186
"There once was a time, only dimly remembered today, when doctors still hesitated to ask a patient to disrobe, struggling instead to drop the mouth of a stethoscope down a slightly unbuttoned shirtfront.
While this may sound like history from the horse-and-buggy era, it was commonplace in this country just 50 years ago.[1] Yet in that relatively short time, patient and physician roles have metaphorically begun to reverse. Today, it is the patients who are demanding that reluctant doctors stand naked in the exam room. “Your test results have just come back from Dr. Google,” they begin accusingly, “and I think we should discuss those patient satisfaction scores.”

Includes video.

Interesting changes in the Doctor-Patient Relationship...

Books on Doctors as Patients and a few on the Doctor-Patient Relationship