Not long ago the internet was captivated by the video clip of a physician using a wine glass to teach percussion. The display elicited a sense of nostalgia and long-lost wisdom. The clip put 20th and 21st century medicine into stark contrast. But when was the last time you used percussion to make a diagnosis? Predictably, every smartypants in the audience has ... Continue Reading about Percussion – An Obsolete Physician Skill?
I’ve heard it a thousand times. 'The patient wanted testing done.' So the doctor ran a blood test. But few people really want a blood test. What they want is to know that they don’t have something horrible. I’ve seen it a thousand times with young parents. Anxiety competes with their trust in me as we discuss what could be going on with their child. I never ... Continue Reading about The Request for a Blood Test – Why More Testing May Not be Better
I spoke with a young pediatrician recently who complained about her late hours in the office. A lot of calling patients with questions about labs. On cursory review, she seems to do a lot of medical tests. It makes sense. Here’s the math: Two sessions per day of 10-12 children per session and everyone gets a comprehensive metabolic panel (as an example). 48 hours ... Continue Reading about Medical Tests – The More You Order, the More You Explain
This is the opening of a Quartz article reporting on the FDA’s recent 23andMe approval to sell analysis for 10 genetically linked diseases: Doctors are losing their role as the gatekeeper of our health information, for better or worse. The article concludes with this question: As patients get more information, the important question to ask is: Will they know what ... Continue Reading about 23andMe and a Doctor’s Control
A young colleague approached me about how to conduct an infrequently ordered and challenging diagnostic test for pancreatic insufficiency. When I asked about the indication, I learned that mom was a worried. The drive to test was really about reassurance. Not an uncommon scenario. I'm shaping some ideas on tests. A few thoughts: Testing is a small part of ... Continue Reading about A Few Ideas on Diagnostic Testing
Health care’s race to the consumer was met with some chatter last week with the announcement that LabCorp will allow patients to order their own diagnostic testing through their consumer lab. This is good, but consumer lab testing can be a tricky proposition. Numbers and results devoid of context are only numbers. Outside of the body from which the number comes ... Continue Reading about Consumer Lab Testing: Will the Doctor be Out?