tag:blogger.com,1999:blog-4968787219619380438.post5341966050388588461..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Is do-it-yourself surgery the future of medicine? Skeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger48125tag:blogger.com,1999:blog-4968787219619380438.post-84579139173885465662015-08-10T20:04:07.189-04:002015-08-10T20:04:07.189-04:00Comments on this post are now closed.Comments on this post are now closed.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-73371966948636638612015-08-10T19:34:27.282-04:002015-08-10T19:34:27.282-04:00frankbill,
You have to read between the lines. AC...frankbill,<br /><br />You have to read between the lines. ACA requires measurement of effective outcomes. AHRQ integrates evidence based decision making assistance with EHR systems. Part of measurement of effective outcomes involves if evidence based treatments (of the AHRQ) are followed or not. <br /><br />NIH: <br /><br />Electronic health record: integrating evidence-based information at the point of clinical decision making (Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878937/)<br /><br />Measure Once, Cut Twice – Adding Patient-Reported Outcome Measures to the Electronic Health Record for Comparative Effectiveness Research<br />(Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3779680/)<br /><br />U.S. Agency for Healthcare Research & Quality (AHRQ):<br /><br />ePSS Electronic Preventive Services Selector<br />(Link: http://epss.ahrq.gov/PDA/index.jsp )<br /><br />The ePSS is an application designed to help primary care clinicians identify clinical preventive services that are appropriate for their patients. Use the tool to search and browse U.S. Preventive Services Task Force (USPSTF) recommendations on the web or on your PDA or mobile device. <br /><br />Module 17. Electronic Health Records and Meaningful Use <br />(Link: http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod17.html)<br /><br />The American Chiropractic Association (ACA):<br /><br />Medicare: Quality <br />(Link: http://www.acatoday.org/content_css.cfm?CID=2296) <br /><br />The ultimate goal of all parties is to have effective outcomes measures.<br /><br />University San Francisco:<br /><br />Evidence-based Change in Practice: Development and Implementation of Type II Diabetic Flow Sheet <br />(Link: http://repository.usfca.edu/cgi/viewcontent.cgi?article=1048&context=dnp)<br /><br />AMA:<br /><br />2015 Physician Quality Reporting System <br />(Link: https://www.ama-assn.org/ama/pub/physician-resources/clinical-practice-improvement/clinical-quality/physician-quality-reporting-system.page)<br /><br />Policy Options to Encourage Patient-Physician Shared Decision Making <br />(Link: http://www.nihcr.org/Shared-Decision-Making)<br /><br />Improving Health Care Outcomes through Personalized Comparisons of Treatment Effectiveness Based on Electronic Health Records <br />(Link: http://onlinelibrary.wiley.com/doi/10.1111/j.1748-720X.2011.00612.x/abstract)<br />A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-71712039992049279682015-08-10T13:24:30.646-04:002015-08-10T13:24:30.646-04:00A. Banterings Can you provide the place you got yo...A. Banterings Can you provide the place you got your information about your quote.<br /><br /> One of the goals of EHR is to create a library of evidence based guidelines. Physicians will be forced to follow these new guidelines and essentially become slaves to the machines.... frankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-51014309910036706942015-08-09T17:16:11.663-04:002015-08-09T17:16:11.663-04:00artiger,
That also gives me a segue to my next th...artiger,<br /><br />That also gives me a segue to my next thought, let's see if you agree with this:<br /><br />One of the goals of EHR is to create a library of evidence based guidelines. Physicians will be forced to follow these new guidelines and essentially become slaves to the machines....A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-81833605134657327692015-08-07T14:36:11.356-04:002015-08-07T14:36:11.356-04:00Banterings, obviously we see things very different...Banterings, obviously we see things very differently. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-26977851597182311142015-08-07T13:08:35.100-04:002015-08-07T13:08:35.100-04:00Skep,
Your statement "As I said in my post, ...Skep,<br /><br />Your statement "As I said in my post, Malcolm Gladwell thinks any college graduate could be a cardiac surgeon" is very telling. Theoretically Gladwell is correct that any could be a cardiac surgeon, although not necessarily a GOOD surgeon. <br /><br />I am sure that you heard the joke, "What do you call the person who graduates last in their class from med school?"<br /><br />"Doctor..."<br /><br />Your umbrage is with your job being replaced by a robot. The feeling is that due to the sacrifice, skill, education, etc. your job should can not be replaced by robots. That was once thought of people who built cars. <br /><br />There is a big difference between a hand-assembled Bentley coupe and a mass-produced Toyota, but both get you from point A to point B.<br /><br />If you think about it logically, humans are just organic robots/computers. Neurons are just organic microchips. Granted that human learning is more efficient and intuitive, but eventually we will have programmed in every possibility or what to do if the unknown arises.<br /><br />Just like with the human surgeon, there will be a fail safe if the unknown/unforeseen occurs. The body is basically a map with each having variations, again easily programmed. <br /><br />As for the "human touch," we may not have that until robots/computers become self aware. We, as a race are not ready to be creators of a new life form. We will be like the 16 yr old mother with our self aware children. <br /><br />The biggest problem will be us seeing them as possessions and not as sentient beings. Some of the best books/films that tackle this issue are:<br /><br />- The Alien movies<br />- I, Robot (Isaac Asimov)<br />- A.I. Artificial Intelligence (Steven Spielberg)<br />- Bicentennial Man (Robin Williams)<br /><br />Here is an good MIT article: The SElf-awarE Computing (SEEC) Model (Link: http://groups.csail.mit.edu/carbon/?page_id=475)<br /><br />At the point that they become self aware, then they will be able to show compassion and have the "touch." The rate technology is progressing, I believe that I will see it my lifetime.<br /><br />Of course, shortly after that it will be "Merry Christmas from Chiron Beta Prime." <br /><br />Link: https://www.youtube.com/watch?v=B3DyxaCYlfg A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-21146174300870600562015-08-07T09:31:14.210-04:002015-08-07T09:31:14.210-04:00As I said in my post, Malcolm Gladwell thinks any ...As I said in my post, Malcolm Gladwell thinks any college graduate could be a cardiac surgeon. The omnipotent robot should be able to put the patient on bypass and perform the surgery with ease. If blood is needed to prime the heart-lung machine, the robot could make some in the patient's kitchen.<br /><br />The medical pod would be sufficient for recovery even if the patient required intensive care and mechanical ventilation for a few days. If a robot can do all of that, surely it could wipe the patient's butt too.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-24644491555440378132015-08-07T08:56:50.972-04:002015-08-07T08:56:50.972-04:00How would one DYI open heart surgery? How would one DYI open heart surgery? frankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-70001705702819897082015-08-06T22:42:28.302-04:002015-08-06T22:42:28.302-04:00artiger,
"Wow, must be nice to not only be a...artiger,<br /><br />"Wow, must be nice to not only be a player in the game, but also to be a referee. "<br /><br />That is what you did with the "hydrocodone" argument. How could I argue against regulating hydrocodone, so hence my "nanny government" was discredited. <br /><br />I took your argument and did the same thing that you did, so either you support this disastrous implementation of EHR or admit you were wrong. <br /><br />For appendicitis, I merely pointed out that there were less invasive options. <br /><br />"I agree, our mortality rate overall is 100%. So, are we to abandon health care?"<br /><br />But quality of life is not only for end of life.<br /><br />Watson is the extreme representation of the science of medicine, I realize the human side. Watson is already working as part of a healthcare team treating patients.<br /><br />Compare Watson to the fictional physician House M.D. He may be human, but is more like Watson than Rex Morgan. Human touch is the art. Believe me, I know about the power of the compassionate human touch. <br /><br />One of the best examples was told by a doctor that treats HIV positive patients. One patient commented that he appreciates her examining him without gloves [where fluids are not involved] because that is one of the few times that he gets to experience the touch of another human being. <br /><br />"I agree, our mortality rate overall is 100%. So, are we to abandon health care? "<br /><br />No, but this takes away that power that many assume healthcare has over patients; their lives. Beauchamp and Childress incorrectly refer to this as "choosing health." This has led to the over-medicalization of life. <br /><br />The above statement puts quality of life on par (if not above) length of (extending) life. <br /><br />I realize and accept all those things that you mention. I also do NOT reject the feasibility of med pods or DYI surgery. <br /><br />"I wonder if cold metal would be better than human epidermis."<br /><br />I prefer the human touch over both cold metal and the human epidermis. A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-67789924545842945782015-08-06T21:39:52.840-04:002015-08-06T21:39:52.840-04:00Banterings,
"i created a situation where my ...Banterings,<br /><br />"i created a situation where my argument wins either way..."<br /><br />Wow, must be nice to not only be a player in the game, but also to be a referee. <br /><br />I do support EHR, at least the concept of having a record that is legible and accessible. I do not support the implementation of it such as it has occurred. <br /><br />For appendicitis, you can treat it with antibiotics and be successful...about two thirds of the time. You can treat it surgically and be successful...about all of the time. You think there aren't complications with treating with antibiotics? Besides that, waiting with something like that can lead to a more difficult operation. Scalpel has blogged about the studies on this area several times, correctly pointing out that the studies are flawed. Still, if it makes you feel better, I do mention this option with all the relevant information to every patient with appendicitis that I see, prior to operating. So far, everyone has chosen surgery. <br /><br />I agree, our mortality rate overall is 100%. So, are we to abandon health care? <br /><br />This one, though, really piqued my interest..."right now watson plays the same role as any other physician, he is a member of a team."<br /><br />Watson might be able to suture the cheek of the 8 year old who got hit with a golf club, if not now, then someday...but can Watson make the child laugh while painful lidocaine is being injected into his wound, or put him at ease by relaying a story of his own episode of being sutured after being hit above the eye with a golf club at a similar age? Watson can explain the indications for a colonoscopy as well as the risks and the instructions for bowel preparation...but can Watson tell you what it's like to go through a bowel prep, or to actually have a colonoscopy? Watson can find a breast lump, maybe even biopsy it (now or someday)...but can Watson sit down and hold your hand as he tells you that you have breast cancer, bring you tissues as you sob, tell you that you are not alone and that you will be OK, and that we'll get through this together? Will Watson sit down and talk to your daughter in California for 30 minutes and explain everything you've already discussed in the office visit the previous day? <br /><br />A lot of what we do in health care goes beyond diagnosis and treatment. You're missing the human side of it. Sometimes, people come to us without actual discernible pathology...yet they are healed with a human ear, a human voice, or a human touch. I don't know how many times I've had a patient complain about seeing another doctor, saying "he never even touched me". I wonder if cold metal would be better than human epidermis. You tell me. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-50752413616274613492015-08-06T13:38:56.601-04:002015-08-06T13:38:56.601-04:00frankbill,
NOT ME! I have a portable generator; d...frankbill,<br /><br />NOT ME! I have a portable generator; do-it-yourself power generation if you will. Yes, I am no electrical engineer and power generation is state and federally regulated, but when storms came through a few years ago and my neighbors were without power for 2 days, life went on as normal.<br /><br />A bit of sarcasm, but just another illustration of how DYI technology gets in the hands of the common person. <br /><br />What you also pointed out is the whole basis of Malcolm Gladwell’s book; we have all these great technological advances that improve life, yet they are dependent on electricity. Take away the electricity and we might as well be living in the Bronze Age.<br /><br />The deeper issue here is the American sense of self-reliance has been undermined by the welfare state. Why do anything when government will provide someone to do it for you?<br /><br />I remember the cold war survivalist culture of the 1980s and many having machines that produced or a stock of "colloidal silver" (not to be confused with "silver salts"). Colloidal silver is (thought) to be just as good as (if not better than) antibiotics. (I do not want to have this debate either...)<br /><br />This same self reliance has historically been seen in farmers and in groups like the Amish. One of the last bastions of self reliance is in The Republic of Conch (A.K.A. Key West). See: http://www.conchrepublic.com/history.htm<br /><br />When we had the gulf oil spill and all the coastal states were crying for help from FEMA, citizens of The Republic of Conch took it upon themselves to be prepared if the oil washed up on their shores. Instead of waiting for FEMA, the municipal government along with private citizens prepared an emergency plan and trained for the event.<br /><br />All was funded by private and municipal funds. They even began to move coral gardens and had a plan to evacuate remaining coral gardens. See the Time Magazine article: http://content.time.com/time/nation/article/0,8599,1996441,00.html<br /><br />A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-77220971119752634162015-08-06T11:56:57.378-04:002015-08-06T11:56:57.378-04:00Technology can be a good thing as long as we keep ...Technology can be a good thing as long as we keep in mind in can become useless if we loose power. In the past few years storms have left thousands without power for two weeks or more. Many had no heat and no way to cook meals to say nothing about cell phone service. <br /><br /> frankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-57213884072659940742015-08-05T22:50:54.615-04:002015-08-05T22:50:54.615-04:00artiger,
my point to "you supporting ehr&qu...artiger, <br /><br />my point to "you supporting ehr" is that almost all physicians say that government should not dictate how they take notes, bill, run their practice, etc. i simply used what you thought to be a "slam dunk argument" to illustrate a "point of view," of government regulation in an example that you surely cannot support. <br /><br />i created a situation where my argument wins either way...<br /><br />appendicitis - antibiotics... then wait and see?<br /><br />"Unless you consider death or permanent disability to be positive outcomes."<br /><br />guess what? everyone of your patients will die at least once. it is just a matter of when and how we choose that makes the difference. when i go, i will do it on my terms, with dignity, and make it look good. <br /><br />"Evidence based medicine is not the same thing as wait and see in every disease state. "<br /><br />when we finally start practicing evidence-based medicine. much of what we have today is ritual. how many guidelines say:<br /><br />"...despite the lack of evidence, [insert name of organization here] recommends that patients receive [insert ritualistic medical procedure here]..."<br /><br />i call it voodoo medicine. before i get blasted for this, let me back it with a 2013 nejm reference: http://www.jwatch.org/na32275/2013/09/26/clinical-practice-guidelines-require-scrutiny-quality<br /><br />we may not be to the point that the salon down the street tanning bed are replaced with med pods, but we certainly have the technology to begin creating the first (rudimentary) med pods; the ones that do suturing. <br /><br />right now watson plays the same role as any other physician, he is a member of a team. http://www.kevinmd.com/blog/2013/03/ibms-watson-starts-medical-career.html<br /><br />"In Malcolm Gladwell’s newest work David and Goliath, he suggests that when we fail to recognize both the strengths and weaknesses of different alternatives, we risk not seeing the best solutions. Gladwell argues that we tend to overvalue one particular trait, such as Goliath’s size, while failing to recognize a seemingly less powerful skill, like David’s slingshot ability. The important thing is that each holds a tactical advantage, depending on the conditions of battle." <br /><br />source: http://www.kevinmd.com/blog/2013/11/watson-siri-david-goliath-health-care-delivery.html<br /><br />"...wear their own garments. It's really not that unusual these days."<br /><br />...thank you satisfaction surveys.A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-50453566225440112482015-08-05T18:53:43.292-04:002015-08-05T18:53:43.292-04:00Banterings, I don't recall saying anything abo...Banterings, I don't recall saying anything about supporting EHR. I certainly don't like the idea of using it as a billing tool (although I do like being able to access records from outside the hospital). <br /><br />"hydrocodone can be purchased online or (at least use to be) otc in mexico."...Not a good comparison. <br /><br />What I said was "NOT treating a lot of diseases also carries risks too." Your argument for something like prostate cancer certainly has merit. Appendicitis, a leaking aneurysm, a heart attack, I'm not so sure. The risks of iatrogenic injury are outweighed by the risks of do it yourself, or wait and see. Unless you consider death or permanent disability to be positive outcomes. Evidence based medicine is not the same thing as wait and see in every disease state. <br /><br />Someday, self treatment or medical robots or whatever will likely be possible, even the norm. We're not even close to that today, not from the technologic nor societal standpoints. <br /><br />My hospital is not the only one that lets people wear their own garments. It's really not that unusual these days. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-46079250083097168812015-08-05T16:09:41.096-04:002015-08-05T16:09:41.096-04:00skep,
no hostility, against my beliefs of serenit...skep,<br /><br />no hostility, against my beliefs of serenity...<br /><br />artiger,<br /><br />i guess you are right about the nanny government thing. especially when physicians can not properly keep records or accurately bill. i can see why then you support ehr....<br /><br />note: before anyone tries to crucify me for my sarcasm, i am just making a point with the example that i was given. i hope artiger sees how his view applies to him as well.<br /><br />i believe that we need some regulation, but as a society we have too much regulation. <br /><br />i never questioned artiger's (or anyone here) ability or compassion. i am sure that you have helped many. i agree with you about end of life choices as well. there was a very good article written in the wsj (i believe) about physicians' choices at end of life. <br /><br />hydrocodone can be purchased online or (at least use to be) otc in mexico.<br /><br />"treating a lot of diseases also carries risks too"<br /><br />is this not the (new) evidence based way of dealing with conditions that have been over-medicalized (wait-and-see)? the implication has been that do-it-yourself is somehow dangerous and the traditional medical response is not (i.e. iatrogenic injury ignored).<br /><br />i am simply taking in to account all potential risks and benefits.<br /><br />my whole point has been:<br /><br />1.) our technology is there, although in its early stages possibly not refined. <br />2.) technology will refine, become cheaper, safer, easier, and more commonplace. read the history of cell phones (https://en.wikipedia.org/wiki/History_of_mobile_phones)<br />3.) there are reasons that people would prefer to do things themselves; quality of work, poor treatment/customer service are the predominant reason, not saving money<br />4.) i explore that perhaps the resistance to the idea MAY be linked to #3. an overly simplified metaphor is teachers' unions opposing home schooling because parents are not capable of educating their children. <br /><br />as to the gown thing, that is a whole different issue that i am not going in to here... i congratulate your facility for coming out of the dark ages<br /><br />A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-30949917628133126412015-08-05T14:19:11.191-04:002015-08-05T14:19:11.191-04:00Banterings, you don't need a license for an ul...Banterings, you don't need a license for an ultralight, and you don't need a license or training to buy an aspirin. You do need it to prescribe hydrocodone. <br /><br />You can call it nanny government if you like, but that's hyperbole. Come down here and try to take care of people who can't even read the words we've typed here. I let them make all the decisions they like, but I'm not going to enable people to do harm to themselves (e.g., giving an antibiotic to someone who has a viral infection, even though they really think they should have it). You have no idea how many people I've talked out of having feeding tubes placed in their terminal loved ones ("We can't let Mama starve!" [even though she has metastatic cancer from head to toe]). And on and on. <br /><br />Certainly, just about any treatment carries a risk of iatrogenic injury. Not treating a lot of diseases also carries risks too. <br /><br />I'm not sure what your hang up is about hospital gowns. Our patients wear their own pj's or whatever. Unless they don't have any clothes of their own. Then we put a gown on them. <br /><br />I agree that hospitals are to be avoided unless you are truly ill. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-42857247418281016792015-08-05T14:18:30.439-04:002015-08-05T14:18:30.439-04:00A., I think Frankbill was simply telling me you al...A., I think Frankbill was simply telling me you already had a blog. Why the hostility?Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-2239870118922141982015-08-05T13:59:04.264-04:002015-08-05T13:59:04.264-04:00frankbill,
Exactly what is your point?frankbill,<br /><br />Exactly what is your point?A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-37052509281669535632015-08-05T13:27:01.628-04:002015-08-05T13:27:01.628-04:00He all ready has a blog.
If you click on A. Banter...He all ready has a blog.<br />If you click on A. Banterings name it will take you to his information and clicking on Banterings of a Mad Man brings you to his blogfrankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-83324795366574153742015-08-05T11:42:06.189-04:002015-08-05T11:42:06.189-04:00Dear A. Banterings,
My post was only 560 words. Y...Dear A. Banterings,<br /><br />My post was only 560 words. Your comments run to over 2000 words at this point. You have a lot to say, much of it thought-provoking. I think it's time you set up your own blog. <br /><br />My blog is hosted by Blogger, a branch of Google. It's free and very easy to use. There are other platforms such as Wordpress.<br /><br />Let me know when and if you do so.<br /><br />Regards, <br /><br />SSSkeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-16697161825387973062015-08-05T11:15:05.783-04:002015-08-05T11:15:05.783-04:00What about the patients that do know their meds? W...What about the patients that do know their meds? What about the patients who are comfortable doing that? I know how to replace the timing belt on my car (after years of SCCA & EMARA racing), but I choose to take it to a mechanic to have that work done. <br /><br />This is not a mandate, it WILL BE an option. Perhaps the bigger question here is (from your "Ultrasound Selfie" post) WHY one of the results from the Intel survey was "53% said they would trust a test they personally administered as much or more than if that same test was performed by a doctor?"<br /><br />Why is there such a resistance to some people taking control of their own health? <br /><br />Perhaps the answer has to do with how satisfied people are with how they are treated during their healthcare experience. Perhaps the attitude expressed here about patients is the same attitude causes harm and suffering:<br /><br />But now, reducing patient suffering — the kind caused not by disease but by medical care itself — has become a medical goal…<br /><br />Or loss of privacy...<br /><br />"These are harms," Dr. Sands said. "They elicit suffering. They can be long lasting, and they currently are largely unquantified, uncounted, unrecorded." (Source: NY Times, Doctors Strive to Do Less Harm by Inattentive Care <br /><br />Link: http://www.nytimes.com/2015/02/18/health/doctors-strive-to-do-less-harm-by-inattentive-care.html?hp&action=click&pgtype=Homepage&module=photo-spot-region&region=top-news&WT.nav=top-news )<br /><br />So the thought that the patient does more harm self-Dx and self-Tx may NOT be true although there is no study to compare the two. You can NOT say that Dx and Tx by a physician is without harm either. <br /><br />Here is a great article on ProPublica, "When Harm in the Hospital Follows You Home." (Link: http://www.propublica.org/article/when-harm-in-the-hospital-follows-you-home)<br /><br />Just search the NIH's PubMed for "iatrogenic trauma." Every system and every body part has the potential to sustain this trauma. The most common being infection, vascular, urinary, renal, and thorax. Here are just 2 excellent examples:<br /><br />Marshall JC. Critical illness is an iatrogenic disorder. Crit Care Med. 2010 Oct;38(10 Suppl):S582-9. PubMed PMID: <br />21164401. http://www.ncbi.nlm.nih.gov/pubmed/21164401<br /><br />Forgey M, Bursch B. Assessment and management of pediatric iatrogenic medical trauma. Curr Psychiatry Rep. 2013 Feb;15(2):340. PubMed PMID: 23307562. http://www.ncbi.nlm.nih.gov/pubmed/23307562<br /><br />Here is another way patients are treated: "The dreaded hospital gown, described as health care's prison jumpsuit, often imposed on patients needlessly: study" (Link: http://news.nationalpost.com/health/the-dreaded-hospital-gown-described-as-health-cares-prison-jumpsuit-often-imposed-on-patients-needlessly-study)<br /><br />Ask any nurse or healthcare professional: one of the most dangerous places for your health is the hospital. Read more at : http://www.beliefnet.com/Wellness/Health/galleries/Reasons-to-Stay-Out-of-the-Hospital.aspx<br /><br />I argue do-it-yourself surgery IS a way to stay out of the hospital and it is no surprise why patients would rather trust their care to themselves.<br /><br />Please note that I am NOT saying self care is better, but in lack of a study it MIGHT be. This also depends on the procedure, the technology, and the patient. There are obvious risks of iatrogenic trauma. <br /><br />A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-1036919471603215772015-08-05T07:10:03.995-04:002015-08-05T07:10:03.995-04:00Most of my patients didn't know their meds eit...Most of my patients didn't know their meds either. The Internet makes me laugh sometimes because everyone on it thinks it's the real world. It's not. This reminded me of a post I wrote last year on the topic, "Ultrasound selfies? How surveys can mislead." http://skepticalscalpel.blogspot.com/2014/07/ultrasound-selfies-how-surveys-can.html<br /><br />Les, thanks a lot. :-)Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-90115680886671631132015-08-05T00:33:03.248-04:002015-08-05T00:33:03.248-04:00But autonomy without understanding is dangerous.
...But autonomy without understanding is dangerous.<br /><br />Those are the arguments of Stalin, Lenin, Mao, etc. Nanny government. <br /><br />Your patients may not know their medications, but that does NOT take away their autonomy...<br /><br />You may need a license for a plane, but one is NOT needed for an ultralight. <br /><br /> --"The Federal Aviation Regulations (FAR) 14 CFR, Part 103A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-84810684496389055212015-08-04T20:53:28.935-04:002015-08-04T20:53:28.935-04:00I made ONE comment about cyborgs....I made ONE comment about cyborgs....Lesnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-28391026305533452552015-08-04T17:53:07.972-04:002015-08-04T17:53:07.972-04:00I could probably learn to fly a plane. Time, expe...I could probably learn to fly a plane. Time, expense, and credentials prevent me from doing so (legally). Treating patients comes with similar "barriers". <br /><br />I don't know what kind of patient population you are routinely exposed to, but it must be a lot different from mine. The majority of my patients cannot even name their medications, much less the indications for taking them. I'm not talking about a one-time antibiotic, I mean the medications that they take on a DAILY basis. <br /><br />Look, I'm a big proponent of autonomy, not just with end of life care but also with current day-to-day decisions. But autonomy without understanding is dangerous. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.com