Ebola, Texas Health Presbyterian Hospital, and Medical Errors

Ebola is in the United States!  Everybody (please don't...) panic!  Quarantine all Texans!  Though that might be a good idea anyway (just kidding).  More on Ebola in general in another post if I have time.

First off though, we've found out more information about the sequence of events leading to the hospitalization of the patient, Thomas Duncan.  Apparently, he came to the hospital, told people he'd come back from Liberia, and was still discharged home.  He was only admitted 2 days later when his nephew called the CDC.  The tale reveals a fascinating story of medical quality and system error.

Informed Consent is a Chimera

This post by Paul Levy got me thinking about informed consent, and a case I saw recently got me to take a little time and write about an issue frequently ignored in medical school.

A bit of background for non-medical readers: Informed Consent is a term in medicine for when doctors get the agreement of the patient to do something to said patient.  For example, before a patient is cut open for surgery, the patient has to say "yes I want to be cut open and have _____ happen".  Less extreme examples abound- the patient has to consent to anything from a blood draw for a lab test to a CT scan.  Part of informed consent is that the patient has to be "informed".  It is acceptable for a patient to say "tell me nothing, just do it", but the patient has to be offered information regarding their disease as well as the risks and benefits of the procedure they are consenting to.  For example, "This x-ray will tell us whether or not you have pneumonia or something else, but may slightly increase your risk of cancer in the long run.  I recommend you get it.  Do you agree?"

The Coming Downfall of Medicine: Scientific Corruption

Some recent news about a(nother) scandal in the pharmaceutical industry has led me to post on something that is critical to the future of medicine and science.

Let me start off by saying that I believe strongly in most medicines. I think the data behind their safety is incontrovertible. But for medicines that were invented recently, that same data would still leave me quite suspicious.

Here's why.

America Doesn't Have a Gun Violence Epidemic- We Have a Poverty Epidemic and an Outbreak of School Shootings

Many people are talking about a gun violence epidemic.  This is understandable, in light of what seems like a never-ending stream of horrific school shootings.  Sandy Hook Elementary School, Santa Monica Community College, Arapahoe High School, UC Santa Barbara- the list goes on and on.

Those with more liberal views are responding to all this chaos and violence by going so far as to call for a repeal of the 2nd Amendment.  As you can imagine, this has predictably gone over quite well with the NRA and it's allies.  These are the folks who, in the immortal and inconceivably badly phrased words of President Obama, "cling to their guns and religion."  Matching the President's lack of tact with an insensitivity that borders on psychopathy, Joe the Plumber addressed the parents of the kids killed at UCSB by declaring, "your dead kids don't trump my constitutional rights."

Amidst all this back and forth between right and left is a shared delusion:  There IS NO gun violence epidemic.  There IS a school shooting epidemic.  These two problems are not the same.  And the solutions that can actually save hundreds if not thousands of lives become clear once the problems have been elicited and defined

Why Colleges Fail at Punishing Rapists, and a Radical Idea for Justice

Sexual Assault on campus is problem that has been receiving unprecedented amounts of attention lately.  Just a few days ago, it was announced that 55 colleges are under investigation for failing to adequately handle sexual assault and create a non-discriminatory environment under Title IX, a federal law that prohibits discrimination based on sex in all institutions that receive federal funding.  It is commonly held that 1 in 4 female students will be assaulted during their time in college, though it must be acknowledged that all such statistics are disputed.  Nevertheless, it is increasingly clear that no American college does anything approaching a decent job of punishing rapists and doing justice to survivors.

Why Your Doctor Doesn’t Work For You

Many doctors are ambivalent about the Affordable Care Act. This is not due to the primary aims of the bill- after all, more people with health insurance means more paying patients, so what’s not to like? Rather, doctors are worried about the other, less publicized pieces of the bill, and related changes to Medicare and Medicaid that have quietly reshaped medicine- and often not for the better.

The Political Picking of a Surgeon General

There's a bit of buzz in the news recently over President Obama's nominee for Surgeon General, Dr. Vivek Murthy.