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Showing posts from January, 2020

Personalized Medicine - The Future of Medicine

Future doctors will celebrate that they no longer prescribe the same drug at the same dosage for hypertension or pneumonia or arthritis or cancer or many other conditions.   Who knows even if drugs will be the mainstay of medical treatment.   Tomorrow’s treatments will be tailored to one’s age, gender, weight, race, overall medical condition, severity of the medical threat and genetic profile, among other variables.   We don't all wear the same sizes of socks and shoes, but yet medicine today has a one-size-fits-all treatment utility.  A new era, however, is upon us. What will be the fate of my beloved colonoscopies or heart catheterizations or blood draws or biopsies of tissues?    Fear not.   They will all be available to you, just as Van Gogh paintings or fossils of T-Rex are -  in museums.   The first exhibit will be a diorama of the physician’s office from yesteryear, adorned with some antique artifacts such as a stethoscope, an EKG machine and a reflex hammer.  

Electronic Medical Records - Broken Promises

I have written, or more accurately ranted, about electronic medical records (EMR) systems throughout this blog.   While the systems have clearly improved since their mandatory introduction into the medical universe, they have still not delivered on many of their promises. Of course, EMR has brought tremendous advantages to the medical profession and we are all grateful for the technology.   But this progress has exacted a cost.   Many of them are clumsy to utilize.   When the technology breaks down or freezes, the office become paralyzed.   The systems are vulnerable to hackers who can exploit personal medical data or demand ransomware.   Many of the computerized notes   are so filled with pre-populated fluff carried over from prior visits, that it can be challenging to identify new medical information.   I often scroll through several pages in search of the physician’s thoughts and plans.   And a physician who is staring at a computer screen during an office visit will create a

There is Too Much Technology in Medicine

As promised, here is the continuation of last week's post where I discussed the loss of physicians' diagnostic skills which have been largely replaced by technology. Of course, the medical community celebrates the miracles that technology has brought us.  Innovation has improved our lives and will continue to do.  On this issue, there is no debate. But, as with many advances, there is a cost.  Here's my take on the downsides of the technologization of the practice of medicine.   Could a CAT Scan Do Damage? Readers, Scan Below! Overreliance on technology has cost zillions of dollars. Much of the overdiagnosis and overtreatment in our health care system – which I have decried on this blog – is caused by medical technology. Technology has strained the doctor-patient relationship.  It is often easier to order a scan than to have a deeper conversation with patient who needs advice and counsel, particularly when physicians’ schedules are jammed. CAT scan

Can Doctors Still Examine Patients?

Does your doctor really know how to use a stethoscope or palpate your abdomen? Today’s physicians do not have the physical exam skills that our predecessors did.   We can argue if this truth has diminished medical quality – I’m not sure that it has.   But it has completely changed how medicine today is practiced.   The reason for declining physician exam skills is that technology has largely supplanted physicians’ hands, eyes and ears.   In the olden days, the stethoscope was the diagnostic tool for examining hearts.   I spent a month as a medical student with a legendary cardiologist who could make all kinds of cardiac diagnoses right at the bedside using 2 advanced medical instruments known as ears.   Surgeons and gastroenterologists in years past had to make   diagnoses of acute appendicitis and other abdominal emergencies based on feel and their ‘gut’.   Neurologists made accurate diagnoses of stroke just using their clinical skills. An Advanced Medical Instrument