[Reblog] What happens to medicine when it has no heroes?

What happens to medicine when it has no heroes?.

From the 4th December 2013 KevinMD article  by A COUNTRY DOCTOR, MD |

A few years ago, a medical journal piece about electronic medical records with built-in decision support announced that the days of super-physicians and master diagnosticians were over.

Being a doctor isn’t very glamorous anymore, and being a good one seems rather obsolete with so many guidelines and protocols telling us what to do.

A hundred years ago, William Osler, a practicing physician, had single-handedly written the leading textbook of medicine, reformed medical education, helped create and chaired Johns Hopkins and become the chair of medicine at Oxford.

Today, it is virtually necessary to be a researcher to teach at a university, let alone chair a medical school. The only other way to advance in medicine is to go into administration. Leaders in medicine are not chosen for their mastery of clinical practice, but for their managerial or business acumen.

The culture of clinical excellence has few heroes in our time. Pharmaceutical companies sometimes speak of “thought leaders” on the local level, which is more often than not only their way of building momentum for their drug sales through promoting early adoption of new medicines. Doctors today practice on a level playing field, where we are considered interchangeable providers in large organizations and insurance networks. Media doctors don’t earn their position based on clinical mastery, but rather their communication and self promotion skills.

What happens to medicine when it has no heroes? Who defends the ideals of a profession that is becoming commoditized? What keeps new physicians striving for clinical excellence with only numerical quality metrics and policy adherence as yardsticks? How are the deeper qualities of doctoring preserved for new generations of doctors, and how are they kept in focus with all the distractions of today’s health care environment — because people still worry and suffer; they are more than bodies with diseases or abnormal test results.

Every day, doctors on the front lines treat two dozen fellow human beings with every imaginable condition. How do we carry on, with only our own ideals as beacons in the fog, if we are left to ourself to defend our higher purpose, without champions, mentors, or heroes?

“A Country Doctor” is a family physician who blogs at A Country Doctor Writes:.

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IBM Watson in a Clinical Setting: Replacing Physicians?

Wondering if a computer can ever intuit as a human, no matter how good the programming…

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ScienceRoll

I’m a geek and you know how much I support the inclusion of digital technologies in medicine, healthcare and medical education. At the same time, I always highlight the fact that doctors will be needed for practicing medicine, robots cannot do their job. I know Vinod Khosla thinks otherwise.

Now, after watching the video demonstration of how Watson could help a clinician, I have doubts about a future. We will see how it gets integrated in everyday medicine. I support the IBM Watson project very much, but I hope medical professionals, humans, will always play the major role in the practice of medicine.

See also the Medgadget report.

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Troubled Teens Could Benefit from Online Access to Health Records, Say Researchers

 

From the 22 October 2012 article at ScienceDaily

 

 Online health records could be surprisingly useful for at-risk teenagers who cycle through the juvenile justice system. A new study from the Stanford University School of Medicine and the Santa Clara Valley Medical Center found that these young people have high rates of Internet use and an unexpectedly favorable attitude toward accessing their health records online.

Teens who get in trouble with the law could particularly benefit from online health records because they generally have worse health than other adolescents — and no one keeping track of the health care they do receive. These teens’ health problems range from spotty immunization histories to chronic diseases such as asthma, sexually transmitted infections, mental illnesses and substance abuse. And not only do poverty, difficult relationships with their parents and frequent moves make it hard for them to get consistent health care, these problems also increase the chances that doctors who are treating them will not have access to their medical histories..

…

The teens were enthusiastic about the option, with 90 percent saying it would be useful to have their health information automatically put online so they could access it later.

“I didn’t expect this level of interest because they don’t typically think of health as something that’s part of their daily lives,” Anoshiravani said, adding that these teens engage in risky behaviors that make them seem cavalier about their health.

These teens’ need for reliable and accessible health records is made even more urgent because they often do not have family members overseeing health-related chores, such as tracking immunizations and medications, checking lab results or recording their medical history. The lack of records is a problem not just in the short term but also when these teens reach adulthood, especially for those who survived serious medical events in childhood. “They may turn 18 and not know they were born with a heart defect that was surgically repaired,” Anoshiravani said.

Contrast that situation to a typical teenager. “A parent or grandparent is going with them to the doctor and keeping their health records,” Anoshiravani said, noting that troubled teens don’t have that help. And it’s not realistic to expect these teens to keep a hard copy of their medical file. “Carrying around pieces of paper that they could lose did not make sense to them, but having a place to check this information online did make a lot of sense,” he added.

The researchers were surprised to find that the teenagers would also share online health records: The vast majority of the respondents were willing to share their records with doctors and half said they would want to share the information with their parents.

The next step, Anoshiravani said, is to implement and test online health records for at-risk teens. The biggest challenge will revolve around the issue of information-sharing, since minors’ parents are entitled to see some parts of their health records, while other types of records cannot be shared with parents without the patients’ consent….

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