Cell 2 Soul: The Humane Health Care Blog

Doctors Tell All – And It’s Not Good

by Meghan O’Rourke, The Atlantic, November 2014

Meghan. O’Rourke is a writer and poet who has suffered with an obscure autoimmune disorder for over a decade.  Her reflections on American medicine are important and iinstructive.  This article is available as full free text. 

O'Rourke writes:
This essay is about why it has become so difficult for so many doctors and patients to communicate with each other. Ours is a technologically proficient but emotionally deficient and inconsistent medical system that is best at treating acute, not chronic, problems: for every instance of expert treatment, skilled surgery, or innovative problem-solving, there are countless cases of substandard care, overlooked diagnoses, bureaucratic bungling, and even outright antagonism between doctor and patient. For a system that invokes "patient–centered care" as a mantra, modern medicine is startlingly inattentive   –  at times actively indifferent – to patients needs. To my surprise, I have now learned that patients aren't alone in feeling that doctors are failing them. Behind the scenes, many doctors feel the same way. A crop of recent books was a fascinating and disturbing ethnographic of the opaque land of medicine, told by participant-observers wearing white coats.

Here are our expanded notes from "Doctors Tell All. Download Doctors Tell All – And It’s Not Good

A Lion in the Berkshires

Professor Burns in his barn library circa 2012

Jim Burns was my neighbor in Williamstown, Massachusetts.  During the last two yeas of his life, I spent many hours chatting with him about matters great and small.  As a phyciaian, I was witness to his slowing down, to his becoming a lion in winter.  Jim died this past July.  His partner, Susan Dunn, sent some pense (thoughts). 

"In 1973 or 1974, at one of the first Williams College faculty meetings I attended as a young assistant professor, the discussion was about whether the college should sell the lovely Mount Hope estate. I remember that a tall, well-spoken professor stood up and said that he hoped that the college would not sell this extraordinarily beautiful property --  and that in fact,  he had recently escorted Lady Bird Johnson up  there; and he mentioned how impressed she had been. I was sitting next to my friend Jay Pasachoff and I asked Jay, “Who is that?” And he said, “That’s James MacGregor Burns.”  For the full text of Susan's remarks: Download ABOUT JM Burns

Paper Teachers

I was asked to write an essay for the International Journal of User-Driven Healthcare on postgraduate learning.  Since the article is not available free open access, I have attached it here.

Abstract: Physicians spend many years immersed (drowning?) in their professional literature. There is no way anyone can keep up with it and most of it is, after all, forgettable, boring and sadly inaccurate. The attached essay’s  thesis is that the arts (literature, music, fine art, film) are vitally important to one’s personal and professional development. They provide the Continuous Medical Inspiration that trumps the mandated Continuing Medical Education. Although the professional may not realize it, each of us has a personal canon comprised of those works of art that guide us in our daily lives. “Paper Teachers” covers, among other topics,  thoughts on documenting one’s Personal Canon.

Download “Paper-Teachers_”_-Towards-a-True-Postgraduate-Education

 

“To sit alone in the lamplight with a book spread out before you and hold intimate converse with men of unseen generations - such is pleasure beyond compare.” Kenko, Essays in Idleness

 

40 Years on This Huge Stage

this huge stage presenteth nought but shows
Sonnet # 15

First, there was “Boyhood,” filmed over 12 years with the same cast, a groundbreaking story of growing up as seen through the eyes of a child.

Now, there is “Forty Portraits in Forty Years, photographs by Nicholas Nixon, who chronicles the four Brown sisters annually every year since 1975.

This is an amazing collection.  While “Boyhood” is fiction, “Forty Photographs” is snapshots of reality.  If a picture is worth 1000 words, what volumes are contained in these two score images!

But at my back I always hear
Time's winged chariot hurrying near;
And yonder all before us lie
Deserts of vast eternity. 
                         Andrew Marvell:  To His Coy Mistress.

 

Physicians on the Take

Recently, payments to your physicians by PHRMA and device makers have been made public. That's good news. The bad news is that it is damnably difficult to access this information. There appear to be many firewalls. Suffice it to say, many physicians in the US are on the take. It may even be worse in Canada. It must be the same everywhere expensive drugs and treatments are utilized.

Here are links to the recent New York Times articles about this new database.
1.  What We’re Learning About Drug Company Payments to Doctors, September 30, 2014
2. Detailing financial links of doctors and drugmakers, October 1, 2014

I found the government site difficult to navigate.
However, the Dollars for Docs web site was much simpler and gives similar information.

These sites probably underreport payments, but they still have meaningful information.