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“A state of institutional denialism”

Over a quarter century ago, a young woman was admitted to a New York hospital with fever and agitation. She never walked out. Libby Zion died while under the care of he primary care doctor and two medical residents. The exact cause of death was never identified, but the case led to a forced examination…

Science journalism pet peeve

I frequently read about the latest medical and scientific “breakthroughs” in the mainstream media, and in modern media such as sciencedaily.com. One commonality is lack of citations. If I’m lucky, they may cite the source journal or meeting. If I’m really, really lucky, they may even give a general date (e.g., “JAMA in June”). But…

Author Chris Mooney has a provocative piece up at the Washington Post today. He argues that scientists are misunderstanding the dynamics of science-policy debates. Because, he argues, ideology often trumps scientific fact in the minds of the public, we (scientists) need to work harder to engage the public to win their hearts before we win…

I miss you!

When you walk into a good coffee shop, you can smell it. It’s a smell nothing like the smell of the old, sour coffee sitting in a carafe at the office. It’s the smell of dark, dark beans, cracked open, releasing complex odors of fruit and of heat. And as much as I enjoy sitting…

We need to fix Medicare NOW!

Medicare is the government health care program for the elderly. For internists such as me, Medicare patients make up around half our practice. Because of historical budget tools, every year Congress goes through the motion of watching our reimbursement cut, and quickly fixing it. It’s a terrible system. As a small business, my costs are…

ACGME moves to limit resident work hours

When it comes to medical blogging, no one has been as consistently good, fresh, and snarky as Orac. Respectful Insolence sets the standard for all other medical blogs, and though Orac may not be a media star like some other med bloggers, his writing has had a significant impact on some important medical issues such…

Summer reading list

I’m looking forward to having some time to read this summer. I’ve planned a total of two weeks away from work, and if all goes well, I’ll get some time to plow through a few good reads. My first trip away will be my usual gig as a camp doctor in Ontario. Last year I…

Another Fathers’ Day—so soon…

I visited a physician this week as a patient. The details of the meeting are in the TMI category, but the long a short of it was he gave me advice that the altmed folks wouldn’t believe. Surrounded by the most advanced diagnostic technology, armed with a nearly infinite pharmacopoeia, he made a single recommendation:…

Why are you wasting my time?

I’ve been teaching internal medicine for a number of years now. The practice of internal medicine falls into two broad categories; inpatient medicine, and outpatient medicine. Because of certain historical imperatives, internal medicine training is heavily biased toward inpatient education, and these days, inpatients are sick. To qualify for hospital care a patient must be…

How did we get here?

My wife is an accomplished professional. She loves her profession, and she’s damned good at it. But she is officially “unemployed”, and it kills her every time she has to put that down on a form. So how is it that she came to be unemployed? When we met, MrsPal and I were both working…