Wednesday, July 26, 2017

The LA Times's crucifixion of Dr. Puliafito is not appropriate, and has left the most important question unanswered

Two weeks ago the LA Times broke a story that Dr. Carmen Puliafito, former Dean of the Keck School of Medicine of USC, had been abusing drugs and keeping company with a group of younger individuals who engaged in drug use and illicit activity.  Much of this activity occurred while he was Dean, and it is a shocking story- a 66 year-old titan of the field of ophthalmology, renowned for inventing a device that revolutionized the field and forging both the 1st and 2nd ranked programs in the country (University of Miami's Bascom-Palmer and previously USC's Doheny before its split)- found partying with a prostitute and her friends while taking methamphetamine and other drugs.

Sunday, April 9, 2017

As an Intern, I Support the ACGME's Increased Duty Hour Limits

Last month, the ACGME formally increased its work-hour limits for resident physicians, a change that was widely covered in the press.

This decision has also been significantly mis-reported.  While it may seem like all residents will now work for longer hours, in reality, only first year interns will be allowed to work longer 24 hour shifts, where the previous maximum was 16- a limit adopted in 2011.  2nd year and up, the restrictions will not change: 24 hour shifts, no more often than every 3rd day, with an 80 hour per week average which were the restrictions adopted in 2003.

Friday, December 16, 2016

A Response to the Volume Pledge

Dr. Pronovost is a leading figure in the patient safety movement, and is someone I greatly admire.  His work with surgical checklists is touted by Dr. Atul Gawande as having saved more lives than any researcher in the past decade.  However, I disagree with his latest initiative- to get hospitals who perform certain procedures at very low rates to stop performing them altogether.

On the surface, it seems like a perfect idea- hospitals that perform few surgeries of a certain type usually have worse outcomes and higher patient mortality than hospitals that perform many of them, a fact that has been known for decades.  However, the issue is more complex than it first appears.

Friday, December 2, 2016

How Much is a Human Life Worth: A Question we Need to Answer

With the election of Donald Trump, there has been much speculation about his plans for the ACA- speculation that rose again after the announcement that Dr. Tom Price, MD, is to be appointed as his Secretary of Health and Human Services.  But the reality is that any health plan in the United States- Trumpcare, Pricecare, Obamacare, Hillarycare, and someday perhaps Warrencare or Bidencare will not work because of our collective failure as a society to answer a question that every foreign health system has answered in some way:

Saturday, August 13, 2016

When will the Medical Bureaucracy learn that Performance Metrics in Healthcare can be Lethal?

Yet another scandal regarding performance incentives in healthcare has surfaced.  This time, the area is transplant medicine.  It was reported that the demands by the Center for Medicare and Medicaid (CMS) for extremely low complication and death rates (with the threat of loss of accreditation and shutting down of the program) has led to thousands of kidneys and livers being discarded while tens of thousands languish in waiting lists, desperate to escape the living hell that is dialysis.

Sunday, June 19, 2016

Questions to ask When Picking a Medical School if You Want to be a Good Doctor

I graduated medical school this May from the Keck School of Medicine of USC.  And only now can I speak about what I should have cared about when picking a medical school in the first place.  Originally, I had picked USC for a unique medical engineering program called Health, Technology, and Engineering, and because I heard colloquially that it had good clinical training since it had a major county hospital.  I was extremely fortunate that I did so.

Is the FDA's "Ban" on Gay Men Donating their Blood Discriminatory?

In the wake of the horrific Orlando shootings, there has been renewed attention given to the US Food and Drug Administration's (FDA) so-called ban on blood donations from Gay men.  A congressman called the ban discriminatory, and demanded it's repeal- a call joined by the American Medical Student Association and many others.