Thursday, October 24, 2013

Annoying things about medical reporting

1. An article in Time magazine is headlined "It's Not You, Doctors Are Just Rude."

The first sentence of the article is " Doctors-in-training are in need of a dose of compassion."

It describes a paper from Johns Hopkins and the University of Maryland about intern communication behaviors. Interns were watched by trained observers.

Although interns were pretty good about touching patients and asking open-ended questions, they only introduce themselves 40% of the time and explained their roles only 37% of the time. They also sat down with patients just 9% the time.

Observations were made on 732 patient encounters, but only 29 first-year internal medicine trainees were involved.

The abstract did not explain whether these first-year interns had received any training in communication ("interpersonal skills and communication" is one of the 6 ACGMA core competencies), nor did it state at what point in their first year the study was done.

The headline of the piece in Time is a bit misleading since it suggests that all doctors are rude. Similarly, the first sentence of the article somehow brings in compassion.

The study was not about rudeness or compassion; rather it was about communication.

Maybe Johns Hopkins and the University of Maryland need to do a better job of teaching its interns, and maybe Time magazine needs to do a better job of reporting.

2. An article from a website called iMedicalApps gushes with excitement about the fact that Google Glass can be used by a surgeon to view continuous vital signs while operating.

It could be that Google Glass is going to revolutionize medical care, but I don't think it's going to be useful in the context of a surgeon looking at vital signs while she is operating.

You cannot concentrate on the operation and look at a Google Glass display of vital signs.

When I was operating, I was fully focused on the procedure. I depended on the anesthesiologist to alert me to any significant changes in the patient's vital signs.

If I wanted to know what the vital signs were, I simply asked the anesthesiologist. For me, that low-tech action was adequate.

3. Here's a headline from the Los Angeles Times. "Walk this way: Men slow down when sex is at stake."

This one is about a study from PLOS One that looked at 11 male and 11 female college students who walked around a track alone, with a significant other or with friends of the same or opposite sex. The study found that men walked significantly more slowly when they were paired with a female romantic partner compared to walking with another man or a woman who was simply a friend.

The authors concluded following: "Because the male carries the energetic burden by adjusting his pace (slowing down 7%), the female is spared the potentially increased caloric cost required to walk together."

This finding supports the idea that men are helping their romantic partners conserve energy and thus promote reproductive success. This is apparently a big issue in hunter-gatherer societies who walk long distances. It's not quite so clear why college students walking 400 meters would do the same thing. The authors speculated that it might be an evolutionary issue.

Regarding the article, a woman who follows me on Twitter said, "Not my hubby, tho we do have 2 kids."

Sorry LA Times, this one's not about sex, but I guess it makes for a better headline.

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