Thursday, September 17, 2015

Eko the Electronic Stethoscope: A Failure to Comprehend the Rituals of Medicine

A glowing article on electronic stethoscopes recently appeared in the Chicago Tribune.  The Eko Core is a device which, "brings the power of modern technology to an already essential device. The implications could be huge for patient care."

I am no Luddite- I chose to attend USC for medical school because of it's Health, Technology and Engineering Program- to further my interests in engineering and building new devices while going through a full, rigorous medical education.  But it pains me to say that I suspect this is yet another overhyped device that does not fulfill a true healthcare need.  It has fallen prey to a common problem- a lack of deep understanding of medical science and practice by an engineering team seeking to provide an elegant solution to a perceived technical problem.

Sunday, September 6, 2015

Marijuana, Neurosurgery, and Physician Impairment

A brief article several days ago posted the name and picture of a neurosurgery resident accused of smoking marijuana on the job.  Dr. Gunjan Goel, MD is a neurosurgery resident at UC San Diego, and the list of her awards and publications alone is almost as long as my entire residency application.  The article is brief, and rather uninformative.  The only facts that are known are this: the Medical Board of California investigator demanded a hair sample, and in response Dr. Goel acknowledged smoking 3-4 occasions over a 6 month period, on her days off.  This incident touches on a lot of complicated issues- intoxication on the job, surgeon quality and competence, and not least of all anti-drug enforcement efforts.

This piece was picked up by KevinMD, and one of the commentators posted this link to the full court complaint.  The highlights are that no action was taken by the medical board for 8 months after the complaint was received, and that Dr. Goel had a negative urine test and positive hair test- a result consistent with occasional, recreational usage rather than heavy, daily use.

I will not comment further, as this piece is not so much about this individual case, but rather about the more general problem of what regulations and rules should guide the medical profession with regards to marijuana as this country increasingly moves towards legalization.