Where to start? I missed some great medical posts while I was toiling away at the beach (hey, it's hard to track that bartender down sometimes!).
The ever interesting Orac got appropriately incensed by comments made in a post at Pharyngula:
Surgeons and other medical staff are the equivalent of technicians, engineers, plumbers or carpenters. They are not scientists. They are not studying the details of the relevant science. They don't have to understand it - just carry out procedures by rote. Though the ones who do have a clue will be a lot better at adapting to new circumstances because they'll make more correct guesses based on their understanding than the clueless ones will.Gee, all along I thought that college and medical school diplomas on my wall, and the six years of training that followed it, represented a little more than what one might expect to get from ITT Tech. Fortunately, we have comments like this that amply illustrate the need to improve our educational system -- starting with elementary school, which seems about as far as this commenter got. See Orac. Read his post, and you'll understand that evisceration is too nice a word to use to describe how he goes after this guy. Believe me, evisceration is best left to us technicians.
Bard Parker has two insightful posts that concern what I would term "trendy" medicine. The first analyzes an article in Annals of Surgery which is one of the few studies that critically evaluates whether the mandated 80 hour work restriction has actually produced its intended effects: are errors being reduced? The answer is, as I have long suspected, not really. In fact, as Dr. Parker shows, decreasing resident experience may be leading to more problems ..... and that will be magnified when these residents eventually make their way into private practice. Dr. Tony throws in his two cents here.
The other post I would point readers to is a good review of this WSJ editorial concerning the British Health Service. Kitty was kind enough to point me in this direction as well.... but I was too far away from a computer to get to it in time. Dr. Parker's post is worth reading, as is the original article. I don't think that anyone aside from a few on the far left really believes that the British system would be a good replacement for our own, but too many people in the US get sucked in by the "universal care" mantra without looking critically at what goes on in their hospitals (more problems exist in Canada).
Finally, Kevin had a great post today about practicing defensive medicine. Who does it? Virtually all of us. Why? I think the term "defensive" should be self-explanatory. He's asking for e-mails from those who have clear-cut cases where they have had to do more, rather than what is actually necessary, to provide "CYA Insurance." I'll be sending mine, and encourage others to do so as well.
That's it for now. It's 2 PM where I was a few days ago, 6 PM here, and my body feels like it's 3 AM.