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Showing posts from January, 2013

Serenity Prayer Can Ease Chronic Pain

One of the toughest parts of treating patients is managing their expectations.  We wish that everyone could enjoy a perfect recovery with complete healing, but the medical profession is imperfect and life is unfair.  Some folks cruise by decade after decade without a scratch, while others sag under the weight of chronic illnesses.   Accepting reasonable expectations can change the game for patients and their families.  If the patient’s expectations exceed what is possible, then the patient will never be satisfied and the dissatisfaction may assume a life of its own, which can torment with virulence equal to the disease.   Second and third opinions may be sought, which usually lead to more testing and frustration.  Learning to accept what is possible – though enormously challenging – creates a path toward leading a fuller and more satisfying life.   While I haven’t been burdened with a chronic disease, I do personally understand that acceptance of a situation opens a path toward hea

Medical Malpractice, Tort Reform and James Bond? Let Me Explain.

Sometimes, I feel like I belong in law enforcement.   There was a time in my life that I seriously considered a career where I would haul in the bad guys and make society a better place.   Of course, every American male youngster fantasized that he would one day drive the Aston Martin, get the girl, defuse the bomb, and sip on a martini that was shaken, not stirred.  I was no different.  I was 10 years old then when my pal Lewis and I were secret agents with the requisite weapons, invisible ink and secret codes.   At the risk of disclosing that I have a tincture of obsessive compulsiveness, I still retain the files of our secret organization.  While Lewis has expressed concern that these files in the wrong hands could threaten international order, I have reassured him that the enemies of mankind will be unable conquer our layers of sophisticated encryption.  At risk of being accused of hyperbole, Israeli and American intelligence agencies studied our secret files as a template for th

Is Colonoscopy the Best Colon Cancer Screening Test?

The medical arena, like society at large, is permeated with self-interest. This reality makes me very skeptical that comparative effectiveness research, which I support, will get airborne. In medicine, every heath care reform, new medicine, new medical device or revised medical guideline is at some constituency’s expense.  Recognizing and dismantling conflicts of interests is one of our greatest challenges and threats.  When I was a gastroenterology fellow over 20 years, our department was active in new technologies to crush and dissolve gallstones and stones that had wandered from the gallbladder into the liver pipes. Millions of dollars of R & D were spent and the procedures were done in specialized centers in the U.S and abroad. The treatments were cumbersome and only modestly effective, but the treatments continued year after year. Then, laparoscopic cholecystectomy arrived, a new operation that could remove gallbladders with much less pain and recovery time. At that momen

Medical Quality: Myth or Science?

On the morning that I began this post, I read in our local newspaper that Tennessee is soon expected to have a law that would permit public school teachers to offer views on climate change and evolution that are counter to orthodox doctrine on these subjects. No, I don’t think that creationism is science and it should not be disguised as such. Global warming, or climate change, however, is more nuanced. While it is inarguable that temperatures have been rising, it is not certain and to what extent human activities are responsible for this. Clearly, this issue has been contaminated by politically correct warriors and those who have an agenda against fossil fuel use. Science, like all scholarship, should be a pursuit of the truth, without a destination in sight. Believing or wanting to believe that man is turning the world’s heat up may sound plausible, but it may not be true. Just because something sounds true and logical, doesn’t make it so. In addition, repeating an opinion