tag:blogger.com,1999:blog-32053362.post5335194576066830274..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: The shamans knewPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-32053362.post-59821624151228765612012-01-24T10:31:25.902-05:002012-01-24T10:31:25.902-05:00I understand the comments as they relate to acute ...I understand the comments as they relate to acute complaints - and, in fact, this may reflect our backward approach to treating disease ratehr than maintaining health. But, in fact, our greatest opportunity for saving lives is likely in treating conditions for which acute complaints are infrequent - hypertension, diabetes, obesity, sedentary lifestyle, tobacco addiction, algochol abuse and dependence. I also think some of the comments by Dr Kosterich suggest a normal huam condition - we values losses more than gains. So, while better blood pressure control has been shown on average to reduce morbidity and mortality, "adding more tablets...can expose people to risks on the downside such as falling due to fainting." This is a classic omission bias.James M. O'Brien, Jr., M.D., M.S.https://www.blogger.com/profile/01257286674480575518noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-34076710663948690952012-01-24T07:26:38.101-05:002012-01-24T07:26:38.101-05:00Dr. Kosterich's essay is excellent. The other ...Dr. Kosterich's essay is excellent. The other fallacy that potential patients (as well as some doctors) fall into is that there is a thin bright line between health and disease. In my field of pathology, one can often trace a progression of more severe atypia over time which finally crosses an arbitrarily-defined line into what we call cancer. We quickly learned that if we used the term 'carcinoma in situ' for some tissue types, as opposed to 'severe atypia', the clinician would feel obligated to treat it. It was that word 'carcinoma', no matter the modifier.<br />As do many doctors, I think long and hard before I go to the doctor with symptoms and put myself on the medical treadmill.<br /><br />nonlocalAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-17900148363611353052012-01-24T03:54:27.984-05:002012-01-24T03:54:27.984-05:00Being an old school former surgeon I remember two ...Being an old school former surgeon I remember two sayings of my elder colleagues:<br />1. Courage is never needed for immediately operating a patient, it is needed for NOT immediately operating the patient.<br />2. Only snooty doctors say that they've ever cured even one of their patients, the maximum they were able to do was creating optimal circumstances for natural healing processes, or in a less favorable situation, didn't work against them.<br /><br />Experimental MouseAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-77696740068172634792012-01-23T22:18:51.868-05:002012-01-23T22:18:51.868-05:00From Facebook:
Marilyn Morrissey
I agree with thi...From Facebook:<br /><br />Marilyn Morrissey<br />I agree with this basic premise. However, being able to distinguish between mundane and worrisome symptoms is dependent upon exquisite clinical judgement, a sixth sense, if you will. That kind of judgement only comes with LOTS of clinical experience and plenty of supervision. Sadly, I've seen too many serious, even deadly, conditions missed due to inexperience, minimalization of symptoms or excessive concern for the bottom line.Marilynnoreply@blogger.com