REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.
TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com
IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice
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Cyberchondria: "Doc, I Know My Diagnosis, Tell Me if I am Right"
With the widespread access to the Internet and all the "medical information" sites throughout, it is not surprising that "cyberchondria" (patient worries about diagnoses that they obtained by researching the Internet) is becoming a common experience for physicians to encounter. Read the article in Amednews.com (American Medical Association News)
about cyberchondria and return and let's talk about it. What are the "goods" and what are the "bads" aspects of this Internet educational opportunity? ..Maurice.
A Doctor's Decision: Whether or Not to "Call the Cops"
A most interesting scenario was posted on Medpedia
by Scott M. Dyck which I am, in part, reproducing here but you might want to go there to review the responses there but also feel free to make your comments here. If you were the doctor in this case, what would you do? ..Maurice.
You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy's back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother.
Doctor vs Computer: Can a Computer Make a Better Diagnosis?
I found this visitor question on a discussion forum
:" i was debating this with some doctors who say that it would be impossible to program a computer to make diagnoses as well as they can. i find this pretty ridiculous. whatever thought process/string of questions they would use to analyze the situation are the same that the computer would be programmed to use. the compute:r would then analyze all available information, ask questions, analyze the answers and assign probabilities. in fact, it seems like this would be way simpler than some of the things computers have already been programmed for. what do u think?"
So what do I think?
My opinion, as a doctor, is that what is input into a computer for calculation is the most important part of the process of making a diagnosis and deciding on a treatment program to benefit the patient. No amount of computer power or access to data storage will substitute for the physician's input of the history and the physical findings of the patient. A computer posing questions to a patient and the patient responding will never substitute for a direct doctor-patient communication. There are many subtleties, nuances of a history which can never be accessed by a computer, such as body language and verbal expressions and there is no way for a computer to perform a complete and worthy physical examination. A robot used in surgery still requires a doctor behind it and no robot will attain the skills to inspect, auscultate, palpate and percuss and then interpret the findings. To me, how complete and understood is the input of data both from a patient telling a history and the doctor performing a physical is the basis for the diagnosis. Poor input will always lead to poor output. And, finally, it will always take a doctor to analyze the results of the computer to confirm its diagnosis. I would agree that the doctor with knowledge and with experience and then working together with the computer can be most productive of the correct diagnosis.
So.. what do you think?
Patient Modesty: Volume 47
We continue here the discussion regarding how the concerns about healthcare provider gender selection by patients and ways for the patient to be more comfortable with those who attend them can be brought to the attention of all those who provide service and maintain the status quo in the healthcare system. ..Maurice.
ADDENDUM (1-16-2012) On this date, PT, a long-time writer to this thread on Patient Modesty, wrote the following comment which includes a potentially valuable suggestion for a method for those who want to change the current medical system regarding patient modesty and caregiver gender selection. This is what he wrote:
" Rosa parks was a single woman who started
a movement with a single act of resistance,Malcolm X
took another path and my style is more like Rosa parks
My style is more like Genghis Khan until I
realized that the pen is mightier than the sword. My idea
to solve this issue is a 40 step process, meaning I have
put together 40 different avenues of approach over a
period of about 10 months.
Here is the first avenue, visit www.change.org
to start a petition. Now I suggest you start perhaps at a
hospital or clinic that you in the past had concerns with.
Others around the world will join the petition
and to be effective use multiple facilities in each city. Keep
in mind this is a medium to bring our concerns forward. The
first of many mediums we will use as I suggested in volume
46 of Dr. B's blog.
NOTICE: AS OF TODAY FEBRUARY 20, 2012 "PATIENT MODESTY: VOLUME 47" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 48
Graphic: From Google image resource modified by me with Picasa3.