As their roles change, Pharmacists need new Regulations, Norms, and Freedom from Corporate Interests

Pharmacists play an essential role in the healthcare system today, one that is ever-expanding.  They check for drug interactions, watch for signs of opioid over-prescribing, and try to determine whether a drug for one condition prescribed by one doctor will negatively impact the patient because of another diagnosis the patient has.  In hospital units, their roles have become yet more complex- often serving on various quality committees, managing daily dosages of medications like warfarin and vancomycin, and more.  I rely upon them in the hospital daily- to catch mistakes, and to advise on drug dosages and choices.  Many in the community give flu vaccinations, and some are even trying to gain "provider" status under Medicare, allowing them bill directly for treating patients.  This has been accompanied by a drastic change in the preparation of the average pharmacist- where once it was a 5 year bachelor's degree, now it is a graduate degree- a change recent enough that as of 2014, over 60% of pharmacists practicing had trained under the old system.

CNN vs. the Mayo Clinic: Did an American Hospital Imprison a Patient?

In an astonishing story, CNN claims that the famed Mayo clinic imprisoned an adult patient there against her will.  In an unusual move, the patient's family signed a consent form for the hospital to respond without concern for HIPAA privacy protections, and even more unusually Mayo released a statement so scorching that it all but accused CNN of committing blood libel.  CNN stood by it's story and claimed multiple Mayo spokespeople were shown to have no grasp on the details of the case, and spent an inordinate amount of time accusing Mayo of significant shadiness with whether a meeting was "on-the-record".  But, as with so many problems in medicine, this situation too boils down to a failure to communicate on Mayo's part, and a failure to understand medicine on the part of CNN.

The strange saga of Dr. Eugene Gu- #Resistance hero to accused Rapist

To many active on social media the saga of Dr. Eugene Gu, from #Resistance figure to accused rapist, is a long and strange one that holds some lessons for many physicians in the social media age.

Alfie Evans: A Reasonable Economic Decision Disguised as a Horrific Moral Determination

The tragic case of Alfie Evans has roiled Great Britain and the world. Alfie was a 2 year old child in the United Kingdom with an unknown degenerative brain disease who eventually deteriorated to the point that he required life support- his brain had become mostly liquid, and he could not see, speak, or hear. Alder Hey hospital decided his condition was terminal and irreversible, and wanted to stop further treatment. His parents disagreed, and wanted to transfer care to another hospital in Italy which was willing to accept him. Alder Hey went to court, arguing that it was better that the child be allowed to die because keeping him alive was cruel and harmful. They ultimately won, and Alfie Evans passed away. This has sparked a great outcry, particularly among the pro-life movement in the US. And indeed, the idea that the state can literally declare that death is better than life for anyone should be horrifying to everyone.

But the decision to take Alfie off life support was a reasonable and ethical one- if it was justified as being fair to all patients. It is even a reasonable one for individual doctors to conclude that further treating a patient in front of them is harmful and not ethical. But when court decided it had the right to decide that the child should die rather than live, it became an abomination.

"Gun Control" Ideas that Might Actually Pass and Reduce Mass Shootings, From a Doctor and a Gun Owner

I am a resident physician in General Surgery at the Baylor College of Medicine, and I work and train a great deal at Ben Taub- one of only two Level I trauma centers in Houston, and thus one that sees an extraordinary number of Houston's victims of gun violence. But I am also a gun-owner, who took up shooting in the Boy Scouts. And, I am the son of immigrants who refuse to touch firearms, but yet who were free to immigrate to America because of their invention. Like most of Houston, I am thus a study of contradictions, and this gives rise to some unique ideas and perspectives on how to prevent mass shootings and gun violence that may actually find support from both sides in this divided time.

The Resident: Learn the Lessons, Laugh at Everything Else

A new medical TV show, The Resident, made a big splash in the social media- largely for a perceived negative portrayal of physicians.  One EM physician even published a long editorial on NBC news condemning it as reducing trust in the entire medical profession.  The creator of the show, Amy Holden Jones, has been viciously attacked on twitter for the show, and even accused of causing patient deaths by decreasing trust in the medical establishment.