by Chris Nickson, MB ChB

Treat the patient, not the disease.

Care more particularly for the individual patient than for the especial features of the disease.
— William Osler

We enter medical school eager to help the sick and the dying. Over the years this golden objective is transmuted into the base lead of disease-specific diagnostics and therapeutics. Our absorption in the strangeness of the manifestations of a remarkable pathophysiological process may distract us from its impact on the person.

Olser warned us of this danger:

There is a tendency among young men about hospitals to study the cases, not the patients, and in the interest they take in the disease lose sight of the individual. Strive against this.
— William Osler

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Read the rest of Empathy is still at the heart of medicine

2 comments | Tags: Patient | Category: Physician practice

by Randall S. Bock, MD

I am currently 53 years old, but I recently found an imperfection in my near-vision.  I was probably laboring for a year or so before caving in: purchasing reading glasses. I am using them right now and they have made all the difference.

In the space of a few months, I went from no reading glasses to seven pairs. I bought all seven online together as a package recently, for the grand sum of $10.00. That comes out to less than $1.50 per pair. I keep one set by my bedside, one in the kitchen, one at my office, one in the car — they’re always at hand.

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Read the rest of Why are hearing aids so expensive, and reading glasses so cheap?

7 comments | Tags: Specialist | Category: Diagnosis and treatment

by Doctor Grumpy

“Dave” showed up at my office last week with neck pain, worsening weakness in his arms and legs, and changes in his bladder control. All signs pointed to something gone bad in his neck.

His internist had already thought of this, because he’d ordered the appropriate MRIs. And they’d all been read as normal, leaving me without a cause.

Here is where the problem began. Everything about Dave’s exam and story pointed to something serious in his neck. But the tests were normal.

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Read the rest of Some MRI places have good quality machines, others are obsolete

No comment | Tags: Radiology, Specialist | Category: Diagnosis and treatment

by George Lundberg, MD

We all know that obesity is a huge and growing (no puns intended) problem in the U.S. and most other developed countries.

The proven harmful consequences of obesity to the individual and the public health, as well as to the national treasuries, are devastating. The solutions are both simple and complex.

For most adults who are of normal weight (BMI under 25), simply maintain your normal weight. If you are overweight (BMI 25 to 30), consider this a wake-up call and act now, before you become obese. Stop eating.

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Read the rest of Stop eating before you become obese

9 comments | Tags: Patient | Category: Diagnosis and treatment

by Howard Luks, MD

How far will some women go to fit into high heels? The menu of services at Beverly Hills Aesthetic Foot Surgery in Studio City, Calif., provides a clue.

There’s the trademarked “Cinderella Procedure”—a preventive bunion correction that makes feet narrower. The clinic also offers the “Perfect 10! Aesthetic Toe Shortening” that invisibly trims toes that hang over the end of sandals or have to be crushed into tight shoes. There’s also “Foot-Tuck Fat Pad Augmentation,” in which fat from the patient’s abdomen is injected into the balls of her feet to provide extra cushioning for long days on high heels.

“It’s unrealistic to tell women not to wear high heels,” says the clinic’s founder, podiatrist Ali Sadrieh. “I came up with procedures that allow the women to function, pain-free, in the real world.”

The quote, from the Wall Street Journal, outlines a very troubling trend.

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Read the rest of Cosmetic foot surgery can have serious downsides

1 comment | Tags: Specialist, Surgery | Category: Specialist

by Kevin Pho, MD

Nothing polarizes the heath care debate more than defensive medicine. A recent study from Health Affairs will only add more fuel to the fire.

Here’s what I wrote a couple of years ago in USA Today: “When you consider that rampant testing is a major driver of escalating health care dollars, addressing defensive medicine should be a primary goal of cost containment.”

Is that still true?

Well, yes and no.

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Read the rest of Defensive medicine costs less money than physicians think

10 comments | Tags: Malpractice | Category: Malpractice

Do we really need to focus on 150,000 miles of roads? They must be popping champagne bottles in the corner offices of the oil industry and at OPEC headquarters. Focusing on getting off the gasoline habit would have been a far wiser commitment.

More landing strips, encouraging us to fly, fly, fly, gulping ever greater quantities of fossil fuels? Maybe that’s not such a good idea.

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